Whitlow in Africans: Prevention and Treatment

How can herpetic whitlow be prevented?

Prevention is less expensive than cure, according to a well-known saying. This is true when one considers the pain and expense that will be incurred if one contracts herpetic whitlow.

You can take the following measures to reduce your risk of contracting herpetic whitlow:

• Limit or avoid contact with those infected with the virus.

• Wash your hands often to maintain general hygiene.

• If you are a healthcare worker, use PPE (personal protection equipment) and supplies such as face masks, hand gloves, and disinfectants regularly.

• Use condoms and other safe sex practices.

• Monitor and discourage hand suckling, biting, and licking by children.

• Have one sexual partner.

How is herpetic whitlow treated?

Herpetic whitlow can resolve on its own within two to three weeks of infection [9], but keep in mind that you will have to endure severe pain during this time. However, if you can't wait for your immune system to kick in, you might want to hasten things up by using antiviral medications, such as acyclovir [10].

Acyclovir is available in tablet form in doses of 200, 400, and 800mg. It is also available in cream and ointment form. Other antiviral agents in the same family as acyclovir include famciclovir, valacyclovir, and ganciclovir; however, acyclovir is the most widely available in Africa. 

Painkillers  such as Ibuprofen or diclofenac can be used to relieve the pain and inflammation. The lesions should not be cut or drained because this can worsen the scars or spread the virus. 

Herbal treatment of whitlow 

Despite advances in orthodox medical practice, traditional modes of treatment are still widely used on the African continent. Whitlow, like many diseases, has a collection of herbs used in its treatment. Tea tree oil, eucalyptus oil, lemon balm, aloe vera, and peppermint oil are some of the herbal remedies popular for their antiviral properties against whitlow.

• Tea tree oil: It is native to Australia but grows in many parts of Africa. A 2001 study conducted by Schnitzler and others confirmed that tea tree oil has antiviral properties that kill both HSV-1 and 2. [11]

• Eucalyptus oil: The same scientists (Schnitzler and others) who investigated the antiviral properties of tea tree oil also studied eucalyptus oil and found the same results.

• Lemon balm oil and peppermint oil: A 2011 study discovered that lemon balm and peppermint oil are not only effective against herpes, but also against acyclovir-resistant strains of the organisms. [12]

• Aloe vera: According to this study, aloe vera gel had a significant antiherpetic effect at concentrations ranging from 0.2 to 5%. [13] 

As a result of these studies, we now have potential alternatives to the standard acyclovir treatment for herpes simplex, particularly given the drug's growing resistance. 

Conclusion

Herpetic whitlow, a viral nail infection caused by herpes simplex, affects both adults and children, with increased prevalence in Africa due to various risk factors. Although it can resolve without medical intervention, antiviral medications like acyclovir can expedite recovery. Preventive measures include maintaining hygiene, practicing safe sex, and avoiding direct contact with infected individuals. Additionally, traditional herbal remedies such as tea tree oil, eucalyptus oil, and aloe vera have shown promising antiviral properties against the condition.

References

1. Al-Qattan MM, AlQadri NG, AlHayaza G. Herpetic Whitlow of the Hand in Infants. J Hand Microsurg. 2020 Apr 28;14(3):197-199. doi: 10.1055/s-0040-1710199. PMID: 36016636; PMCID: PMC9398566. Available from here

2. Reward EE, Muo SO, Orabueze INA, Ike AC. Seroprevalence of herpes simplex virus types 1 and 2 in Nigeria: a systematic review and meta-analyses. Pathog Glob Health. 2019 Jul;113(5):229-237. doi: 10.1080/20477724.2019.1678938. Epub 2019 Oct 24. PMID: 31645218; PMCID: PMC6882437. Available from here.

3. Gill MJ, Arlette J, Buchan K. Herpes simplex virus infection of the hand. A profile of 79 cases. Am J Med. 1988 Jan;84(1):89-93. doi: 10.1016/0002-9343(88)90013-7. Available from here. 

4. Betz D, Fane K. Herpetic Whitlow. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from here. : https://www.ncbi.nlm.nih.gov/books/NBK482379/

5. Nasrallah GK, Dargham SR, Mohammed LI, Abu-Raddad LJ. Estimating seroprevalence of herpes simplex virus type 1 among different Middle East and North African male populations residing in Qatar. J Med Virol. 2018 Jan;90(1):184-190. doi: 10.1002/jmv.24916. Epub 2017 Sep 12. PMID: 28817197; PMCID: PMC5724503. Available from here

6. CDC. Your Immune System and Diabetes. [internet, n.d]. Cited July 14. Available from here

7. World Health Organization. Herpes simplex virus. [internet, n.d] cited July 14. Available from here.

8. Smith JS, Robinson NJ. Age-specific prevalence of infection with herpes simplex virus types 2 and 1: a global review. J Infect Dis. 2002 Oct 15;186 Suppl 1:S3-28. doi: 10.1086/343739. PMID: 12353183. Available from here.

9. Polayes IM, Arons MS. The treatment of herpetic whitlow--a new surgical concept. Plast Reconstr Surg. 1980 Jun;65(6):811-7. doi: 10.1097/00006534-198006000-00014. PMID: 6247731. Available from here.

10. Cheong WK, Thirumoorthy T. Acyclovir in the treatment of herpes simplex virus infection. Ann Acad Med Singap. 1987 Oct;16(4):631-5. PMID: 3446004. Available from here.

11. Schnitzler P, Schön K, Reichling J. Antiviral activity of Australian tea tree oil and eucalyptus oil against herpes simplex virus in cell culture. Pharmazie. 2001 Apr;56(4):343-7. PMID: 11338678. Available from here..

12. Schnitzler P, Reichling J. Wirksamkeit von Pflanzenprodukten gegen Herpesinfektionen [Efficacy of plant products against herpetic infections]. HNO. 2011 Dec;59(12):1176-84. German. doi: 10.1007/s00106-010-2253-0. PMID: 21607799; PMCID: PMC7080060. Available from here.

13. Rezazadeh F, Moshaverinia M, Motamedifar M, Alyaseri M. Assessment of Anti HSV-1 Activity of Aloe Vera Gel Extract: an In Vitro Study. J Dent (Shiraz). 2016 Mar;17(1):49-54. PMID: 26966709; PMCID: PMC4771053. Available from here.

Related:

What you nails say about your health (Slideshow)

Published: July 17, 2024

© 2024. Datelinehealth Africa Inc. All rights reserved.

Permission is given to copy, use and share content freely for non-commercial purposes without alteration or modification and subject to source attribution