Definition and Overview

Warts are skin growths that appear when the topmost layer of the skin is infected by the human papillomavirus, more commonly known as HPV. This virus can enter the body through broken skin such as cuts, wounds, or scrapes. It spreads through skin contact and sharing personal belongings such as towels, handkerchiefs, and razors, among others with individuals who have warts.

There are many different types of warts and these include the following:

  • Common warts – This is the most common type that usually grows on the hands
  • Filiform warts – This grows around the mouth, nose, and beard area
  • Plantar warts – grows on the soles of the feet
  • Genital warts – a more serious type of wart that affects the sensitive parts of the body
  • Periungual warts – warts that grow under or on the surrounding area of the fingernails
  • Flat warts – these are smaller and flatter warts that grow on the face, legs, and arms

Causes

The human papillomavirus that causes warts thrives in warm and moist environments. Many people get infected with wart-causing HPV in swimming pool areas, public showers, and locker rooms. However, once infected with the human papillomavirus, you will not immediately grow a wart. There are also cases where warts do not develop at all, mainly because people are not equally susceptible to warts. Warts are most common among:

  • People with immune system disorders
  • Young adults
  • People who spend a lot of time in public showers and locker rooms
  • People who share personal items with others
  • Those who wear tight-fitting shoes that can cause the feet to get sweaty

There are also many different types of HPV. The virus that causes common warts is different from the one that causes plantar warts. However, there are HPV types that can cause two or more types of warts, so if your common wart is caused by an HPV that can also cause genital warts, then you will have a higher chance of getting genital warts. Note, however, that common warts do not cause cancer-causing genital warts.

How to Identify A Wart

Warts do not form on the outer part of the skin immediately after an HPV infection. Most warts grow silently beneath the skin for several years before becoming visible on the outside. They also come in different shapes and sizes, with some appearing like big bumps and some flatter and less noticeable. Here are some signs that a bump or skin growth is a wart:

  • Warts are part of the blood supply so tiny blood vessels usually grow in their cores. In bigger warts, these may be slightly noticeable and may appear like dark dots in the center.

  • Warts grow on top of the lines and creases of the skin unlike skin tags and moles.

Although warts are not painful, when they grow in body parts that usually receive pressure, such as the soles of the feet, they can cause some pain.

Who to See and Types of Treatments Available

If you notice an abnormal skin growth, you can have it checked by:

  • Nurse practitioners
  • Your family doctor
  • Internists
  • Pediatricians (for young kids)
  • Dermatologists

Warts don’t normally require treatment. However, if you want to get rid of them for any reason, you have several options including the following:

  • Salicylic acid – A common topical medication used to treat warts is salicylic acid. This is widely available over-the-counter and is often used to treat other skin problems such as pimples or acne.

  • Cryotherapy – This is a procedure where the wart is frozen before it is removed.

  • Chemical peels

  • Electrosurgery – This is the process of burning the warts using electrical current.

  • Curettage – This is often used together with electrosurgery or cryotherapy, as the warts often need to be cut off after they are frozen or burned. This procedure should only be performed by a medical professional.

  • Laser surgery. This is a minor surgery that uses a laser beam to remove the wart.

There is no guarantee, however, that these treatments will produce permanent results. In many cases, warts only reduce in size or go away temporarily but come back or grow in another part of the body. This is because the treatments only remove the wart but not the virus inside the body.

Some doctors recommend watchful waiting before prescribing any treatment. Watchful waiting refers to a period of observing the wart before using any treatment. In many cases, warts go away on their own after some months or years.

Not all warts require treatment, but there are instances when medical attention is necessary. See a doctor or dermatologist immediately if your wart is:

  • Abnormally dark in color
  • Abnormally large
  • Growing fast
  • Bleeding
  • Causing pain that disables you in some way, i.e. when plantar warts make it painful to walk
  • Spreading
  • Swollen
  • Appears red or has red streaks extending from it
  • Feeling tender
  • Filled with pus
  • Causes a fever along with any of the above symptoms
    References:

  • Lacey C. (2005). “Genital warts and genital papillomavirus disease.” The Medicine Journal. http://www.medicinejournal.co.uk/article/S1357-3039(06)00252-0/abstract

  • Ahmed I. (2010). “Viral warts.” Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed. pp 770-775. Edinburgh: Saunders Elsevier.
  • Wolff K., Johnson RA. (2009). “Human papillomavirus infections.” Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 6th ed. pp 787-794. New York: McGraw Hill.
  • El-khayat R., Hague J. (2011). “Use of acitretin in the treatment of resistant viral warts.” Journal of Dermatological Treatment, 22. Pp 194-196.
  • “Treatment of Warts.” (2004). The New England Journal of Medicine.
  • Habif TP, et al. (2011). “Herpes simplex section of viral infections.” Skin Disease: Diagnosis and Treatment, 3rd ed. pp 224-229. Edinburgh: Saunders.
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