Warts

A wart is a small growth with a rough texture that can appear anywhere on the body. It can look like a solid blister or a small cauliflower.

Warts are caused by viruses in the human papillomavirus (HPV) family.

The appearance of a wart depends on its location on the body and the thickness of the skin.

Palmar warts appear on the hand. Plantar warts affect the feet.

As many as 1 in 3 children and teenagers are estimated to have warts, but only 3 to 5 percent of adults. This is probably because the immune system becomes better able to prevent their development over time.

People with a weakened immune system are more likely to have warts.

Fast facts on warts

Here are some key points about warts. More detail is in the main article.

  • A wart is a small growth on the skin that may look like a solid blister or a small cauliflower.
  • Types of wart include common warts, flat warts, pigmented warts, and plantar warts.
  • Black dots in the wart are blood vessels that can lead to bleeding.
  • Most warts disappear in 1 to 5 years without medical treatment, but treatment is available for warts that are large, numerous, or in sensitive areas.
  • Treatments include salicylic acid, duct tape, cryotherapy, surgery, laser treatment, electrocautery, photodynamic therapy, chemical treatments, topical creams, cantharidin, and antigen shots.
  • Warts or verrucae should be covered up with a waterproof Band-Aid when swimming.

The following are the most common types of wart.

Common warts, or verruca vulgaris

Common warts have a firm, raised, rough surface and may appear cauliflower-like.

They can occur anywhere, but they are most common on the knuckles, fingers, elbows, knees, and any area with broken skin.

Clotted blood vessels are often visible in common warts as small, darkened spots. These are known as seed warts.

Plantar warts

Painful verrucae appear on the soles of the feet, heels, and toes.

They usually grow into the skin because the person's weight pushes onto the sole of the foot. They normally have a small central black dot surrounded by hard, white tissue. Plantar warts are often difficult to clear.

Plane warts, or verruca plana

Plane warts are round, flat, and smooth. They can be yellowish, brownish, or skin colored.

Also known as flat warts, they grow most often on sun-exposed areas.

They tend to grow in larger numbers, possibly between 20 and 100. However, of all wart types, they are most likely to disappear without treatment.

Filiform warts, or verruca filiformis

Filiform warts are long and thin in shape. They can grow rapidly on the eyelids, neck, and armpits.

Mosaic warts

Mosaic warts are multiple plantar warts in a large cluster.

Unlike moles, warts are often the same color as the person's skin. Warts do not contain pus unless they become infected.

If infection occurs, they may require treatment with antibiotics.

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HPV viruses cause the excessive and rapid growth of keratin, which is a hard protein on the top layer of the skin.

Different HPV strains cause different warts. The wart-causing virus can be passed on by close skin-to-skin contact, and through contact with towels or shoes.

The virus can spread to other parts of the body through:

  • scratching or biting a wart
  • sucking fingers
  • biting fingernails, if there are warts around the nails
  • shaving the face or legs

Having wet or damaged skin, and coming into contact with rough surfaces increase the risk of infection.

For example, a person with scratches or cuts on the soles of their feet is more likely to develop a verruca in and around public swimming pools.

Wearing shower shoes or flip flops while using public showers or walking near public swimming pools can help prevent this.

The risk of catching warts from another person is low, but they can be passed on, especially if the person has a compromised immune system. This includes people with HIV or AIDS, and those using immunosuppressants following a transplant.

Genital warts are more contagious.

Handling meat as an occupation will also increase the risk of contracting warts. A study carried out by the American Academy of Family Physicians showed that 33 percent of slaughterhouse workers and 34 percent of retail butchers have warts on the hand.

Genital warts

Most warts are harmless, but some strains of HPV can cause warts on, in, or around the genitals.

These warts can be more serious. In women, they can potentially lead to cervical, anal, and vulvovaginal cancer.

In men, anal cancer and cancer of the glans penis can also occur as a result of infection with some types of genital warts.

Anyone who develops genital warts should see their doctor for assessment.

People at higher risk of developing common warts include:

  • Children and young adults, because their bodies may not have built up immunity to the virus
  • People with weakened immune systems, such as those with HIV/AIDS or people who've had organ transplants
  • There are familiar type of dome-shaped warts on the backs of fingers, toes, and knees. These warts often have small black dots on their surfaces, which represent multiple thrombosed (clotted) capillaries. These dots have been called "seed warts."
  • Plantar warts are found on the sole (plantar surface) of the foot (not to be mislabeled as a planter's wart). Similar in appearance are warts on the palms (palmar warts). Small warts growing in clusters on the plantar surface of the foot have been called mosaic warts.
  • Flat ("plane") warts may arise on the face, legs, and other parts of the body, often in large numbers.
  • Periungual warts are warts around or under the nail.
  • Filiform warts have a single long stalk, often on the face.
  • Most warts have a rough surface, as well as a number of black pinpoint spots that represent small clotted capillaries.
  • Traumatized warts occasionally bleed and have been called blood warts.

In most cases, your doctor can diagnose a common wart with one or more of these techniques:

  • Examining the wart
  • Scraping off the top layer of the wart to check for signs of dark, pinpoint dots — clotted blood vessels — which are common with warts
  • Removing a small section of the wart (shave biopsy) and sending it to a laboratory for analysis to rule out other types of skin growths

Most common warts go away without treatment, though it may take a year or two and new ones may develop nearby. Some people choose to have their warts treated by a doctor because home treatment isn't working and the warts are bothersome, spreading or a cosmetic concern.

The goals of treatment are to destroy the wart, stimulate an immune system response to fight the virus, or both. Treatment may take weeks or months. Even with treatment, warts tend to recur or spread. Doctors generally start with the least painful methods, especially when treating young children.

Your doctor may suggest one of the following approaches, based on the location of your warts, your symptoms and your preferences. These methods are sometimes used in combination with home treatments, such as salicylic acid.

  • Stronger peeling medicine (salicylic acid). Prescription-strength wart medications with salicylic acid work by removing layers of a wart a little bit at a time. Studies show that salicylic acid is more effective when combined with freezing.
  • Freezing (cryotherapy). Freezing therapy done at a doctor's office involves applying liquid nitrogen to your wart. Freezing works by causing a blister to form under and around your wart. Then, the dead tissue sloughs off within a week or so. This method may also stimulate your immune system to fight viral warts. You'll likely need repeat treatments.

Side effects of cryotherapy include pain, blistering and discolored skin in the treated area. Because this technique can be painful, it is usually not used to treat the warts of young children.

  • Other acids. If salicylic acid or freezing isn't working, your doctor may try trichloroacetic acid. With this method, the doctor first shaves the surface of the wart and then applies the acid with a wooden toothpick. It requires repeat treatments every week or so. Side effects are burning and stinging.
  • Minor surgery. Your doctor can cut away the bothersome tissue. It may leave a scar in the treated area.
  • Laser treatment. Pulsed-dye laser treatment burns (cauterizes) tiny blood vessels. The infected tissue eventually dies, and the wart falls off. The evidence for the effectiveness of this method is limited, and it can cause pain and scarring.

To reduce your risk of common warts:

  • Avoid direct contact with warts. This includes your own warts.
  • Don't pick at warts. Picking may spread the virus.
  • Don't use the same emery board, pumice stone or nail clipper on your warts as you use on your healthy skin and nails. Use a disposable emery board.
  • Don't bite your fingernails. Warts occur more often in skin that has been broken. Nibbling the skin around your fingernails opens the door for the virus.
  • Groom with care. And avoid brushing, clipping or shaving areas that have warts. If you must shave, use an electric razor.

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