Whitlow is the infection with swelling around finger nails. It is the condition where both or any one edge of the finger is inflamed followed with small corny appearance. These small corns may burst open leading to bleeding and pus formation (abscess). Such a corny mass may protrude from the nails or skin surface. They are also known as felon.
Usually, the term whitlow is used when there is herpes infection leading to finger tip infection.
The term is Felon is used when there is palmar aspect (in the palm side of finger tip).
• Herpetic whitlow and
• Melanotic Whitlow
Signs and Symptoms
Due to small protrusion
• Burning sensation,
• swelling and
• Severe pain, itching etc. is observed in the localised lesion.
• Often fever and fatigue are also associated.
It is common in the individuals who have poor hygiene.
Due to improper cleaning, the union space of the nail and the skin, mild infection may be caused and hence the condition is resulted.
People working in water for longer duration of time are more prone to this disease. Excess water weakens the skin seal and soaps or detergents will remove the protective skin oils, leaving the skin dry and more liable to split.
In children the infection is commonly caused by the chewing or sucking of fingers or thumbs.
Whitlow can happen due to herpes simplex virus (HSV).
Skin to skin contact with another person infected with active symptoms of the herpes virus
Contact with another part of one’s own body that has active symptoms of whitlow
Biting or picking at the cuticle, damage through work and overenthusiastic manicuring
Whitlow Symptoms and features:
Initially, redness and pain appear superficially.
Gradually it enters into deeper tissues and pus is formed.
Due to pus and infection, severe pain and swelling of the whole finger is observed in a few.
Generally only the tip and edges of the finger are affected.
But in rare cases, the abscess reaches bones.
Base of the nail is usually not affected. The pain is relieved by pressing the nail bud, for a little while.
Whitlow can be caused due to herpes infection – HSV1 and HSV2. It is commonly found in thumb sucking children with HSV1 infection.. They contract infection from oral mucosa.
In some cases, the infection spreads from genital herpes.
Herpes whitlow may be associated with swelling, pain, redness and often with fever.
In Ayurveda, the condition is known as Chippa. Some consider it as Upanakha or Nakhapaka also.
Line of treatment
Line of treatment for Whitlow (Chippa):
Keeping the hand in little elevated position reduces the pain easily.
Proper cleaning and bandage are essential in case of pus collection
Dipping the finger in salt water gives mild relief and aching pain is subsided soon.
Local application of medicated powders and pastes for a period of 5-7 days gives good relief (see below for remedies).
Internal medications so as to purify the blood (Rakta shodhana) reduce the pain (Vedana shamaka) and decline the swelling (Shothahara-anti-inflammatory) contribute good benefits.
Incision and drainage may be essential if the abscess is deep with pus collection. In case of herpes whitlow, incision or surgical procedure is not recommended.
Practice safe sex.
Reduce stress, sleep good. Stress leads to depleted immunity, giving virus an opportunity to exhibit disease.
Improve immunity with regular usage of black pepper, Tulsi leaves, neem oil, Chyawanprash, Brahma rasayan etc.
Tips External remedies for Whitlow:
Do not burst open the vesicles. Popping of vesicles leads to worsening of pain and burning sensation.
Neem paste with linseed: Fine paste of Neem leaves and Atasi (linseed) is prepared and warmed. It is applied over the lesion and bandaged. It disinfects the abscess and initiates healing process. It also relieves pain instantly.
Drum stick leaves with Nirgundi (Vitex negundo) The leaves of Shigru (drumstick) and Nirgundi are taken in equal quantities and fine paste is made. To this, rock salt (Saindhava lavana) is added and tied around the affected finger. Gradually the swelling is decreased and pain is relieved.
Dusting of Tankana bhasma (Borax calx) is beneficial.
Tankana bhasma is mixed with lemon juice and a paste is made. This paste can be applied around the nails. This reduces the swelling and burning sensation.
Take Triphala churna. Make Triphala Kashaya and use this Kashaya to wash the affected fingers. Wipe out the moisture. Learn how to make Triphala Kashaya
Make a mixture of neem powder and turmeric powder. Apply it regularly over the affected area, at least twice a day.
Make a paste of neem oil with turmeric powder. Apply it regularly.
Triphala guggulu -Acts as anti-inflammatory and provides analgesic effect too
Kaishora guggulu– Purifies the lesion due to its potent blood purificatory nature.
Gandhaka rasayana – Acts as antibiotic pacifies the pain and swelling.
Pancha tiktaka guggulu- Helps to over the infection if any due its bitter principles.
Amritadi guggulu – A rejuvenator prevents from recurrent incidences.
Mahanimbadi kashaya– Anti bacterial and anti-inflammatory too
Guggulu tiktaka kashaya– Reduces the chances of super infections.
Care and caution prevents the chances of finger bed infections and corny growth in the edges of the nails. Even though mechanism of Whitlow is simple if worsens painful condition may prolong and in few cases minor surgical intervention may be also essential.
Article by Dr MS Krishnamurthy and Dr Hebbar.