Types of Warts: Symptoms, Removal, and Treatment

What Are Warts?

Warts are noncancerous skin growths that are often flesh-colored and contagious.

Warts are skin growths that appear on areas of the skin and body that are infected with a virus in the human papillomavirus (HPV) family of viruses. There are more than 100 different HPV types. Verruca is the medical term for a warts. The main symptom of human papillomavirus infection is that it triggers excessive growth of skin cells. This makes affected areas appear thickened, hard, and rough. Some types of warts are flat and smooth. You can get warts on any part of your body, but they commonly appear on the hands and feet. Warts are benign (noncancerous), but they are contagious. Most types of HPV cause non-genital warts. Other types cause genital warts. Some HPV types cause an increased risk of cervical cancer.

Who Gets Them and Are Warts Contagious?

Biting your nails causes skin wounds that increase the likelihood of contracting warts.

Human papillomaviruses that cause warts are very contagious. The virus is spread easily by skin-to-skin contact. Whether or not you develop a wart when you come into contact with someone else's warts depends on a variety of factors, including the strength of your immune system. You are more likely to catch warts if you have a wound on your skin. Children who frequently get cuts and scrapes are at risk for catching warts. So are people who shave or bite their nails or hangnails.

Weakened Defenses

Teenagers and people who have weakened immune systems are at increased risk for warts.

Some people are at increased risk for warts due to weakened immune systems. Teenagers and people who have conditions that weaken their immune systems, like HIV, are at increased risk for warts. So are people who take biologic drugs that suppress the immune system. Biologics may be prescribed for inflammatory bowel disease (IBD), rheumatoid arthritis (RA), psoriasis, and other autoimmune conditions. These medications suppress the immune system, so people who take them are at increased risk for viral infections and warts.

How They Spread

Wart-causing viruses thrive in warm, moist areas like around pools and locker rooms.

Skin-to-skin contact is one common route of transmission. Someone who touches the wart of an infected person may easily catch the virus and develop warts. The viruses may also be transmitted by objects that are shared among individuals such as razors and towels. The virus thrives in warm, damp areas, so locker rooms, shower stalls, and pool areas are locations where you can easily pick up warts on the soles of the feet and other parts of the body. Warts on the soles of the feet are called plantar warts.

Do Not Believe Fairy Tales

Kiss all the frogs you want; kissing frogs does not give you warts.

Many children's fairy tales refer to warts, but everything you have heard about them in the storybooks is wrong. You cannot get warts from kissing frogs. Witches in fairy tales are commonly depicted as having warts on their noses. People who have a wart on their nose are not witches or any other kind of supernatural creature that is featured in storybooks.

Common Warts

Common warts often appear on fingers and the backs of hands.

So-called common warts are a common skin problem. These flesh-colored, dome-shaped lesions are found most often on the fingers and the backs of the hands, especially around the nails. They may also be found on the feet. These types of warts are often rough and bumpy. Sometimes they have a little black dots that resemble seeds. These are small blood vessels with blood clots. Common warts may appear on areas of the skin that have small wounds, such as around the fingernails from nail biting. If you have the virus on your hands, it is also very easy to transfer it to your face. The official name for common warts is verruca vulgaris.

Plantar Warts

Plantar warts appear on the soles of the feet.

If you have the sensation that there are pebbles in your shoes, examine the soles of your feet. Plantar warts (verruca) appear on the soles of the feet, usually on weight-bearing areas like the heels, and grow into the skin due the pressure from walking and standing. If these foot warts appear in clusters they are called mosaic warts. Mosaic warts are tough, thick, and flat. They may resemble and be mistaken for calluses. Plantar warts may have black dots on them. The HPV virus that causes plantar warts thrives in warm, damp environments. Wear flip-flops when you are at the pool, locker room, or communal showers to reduce your risk of picking up the virus that causes plantar warts.

Flat Warts

Children may suffer from flat warts on their faces.

Flat warts are smaller than other different types, but they tend to occur in large numbers. It is not uncommon for someone affected by flat warts to have 20 to 100 of these warts at a time. Women may get these warts on their legs. Men tend to get them in beard areas. Children may suffer from these warts as well. Flat warts are unique compared to other different types of warts because as their name suggests they are flat.

Filiform Warts

Filiform warts have tiny projections that extend out from the lesion.

Filiform warts grow very fast and have a spiky appearance. Small projections coming out of these warts look like threads, finger-like projections, or even brushes. Common sites where these warts grow include the face around the eyes, nose, and mouth. These warts can make people feel self-conscious, but they are usually painless. These warts may be brown, yellow, pink, or flesh-colored. Avoid touching these facial warts and seek treatment to avoid getting them in new locations.

Genital Warts

Some HPV types cause genital warts and increase the risk of cervical cancer.

Genital warts are transmitted by having sexual contact with someone who already has them. These warts are caused by human papillomavirus (HPV). The warts may be on the outside of genitals. Some types that cause cancer result in growth of lesions on a woman's cervix. Genital warts look like flesh-colored bumps that have a cauliflower-like appearance. It is possible to get genital warts, HPV infection, even if they are not visible. Potentially cancer-causing HPV strains are spread by sexual intercourse, anal sex, and oral sex.

When Do Warts Go Away?

Most cases of warts last for a few months or for as long as 2 years.

Warts are caused by members of the human papillomavirus family. Once you get warts, your immune system will ramp up in an effort to inactivate the virus. Warts may last for a few months or up to 2 years before they disappear entirely. Warts in adults may last longer than those in children. Sometimes warts never go away completely. Doctors do not know why warts resolve in some people, but not in others.

How to Get Rid of Warts

There are many treatments for warts, but often warts go away on their own.

Oftentimes, warts will eventually go away on their own without you having to do anything. For warts that do not cause you pain or embarrassment, letting them run their course might be the best option. Just know that if you do not treat warts, they may get bigger or spread to new areas. You may also give them to someone else. Treatment for warts depends on the type of wart and the patient's age and health status. Sometimes warts, including those caused by HPV infection, go away and reoccur later on.

Salicylic Acid

Salicylic acid works by gradually dissolving warts.

Over-the-counter salicylic acid treatments gradually dissolve warts away, but the process takes time. You must consistently apply the product daily for many weeks. It helps to soak the wart in warm water first. Then pat the area dry. Use a disposable emery board to sand down the wart. Throw the emery board away and use a new one after each use. You do not want to spread the virus that caused the wart to new areas! After sanding the wart down, apply salicylic acid. Be consistent. It may take a few months, but the wart will go away. Salicylic acid is available in liquid and gel form. Salicylic pads are also available.

Duct Tape

Duct tape is an unusual, yet effective wart treatment.

Believe it or not you can find an effective remedy for warts at the hardware store. Some people find that covering warts with silver duct tape helps them gradually go away. Experts disagree how or even if this really works, but as long as you have your doctor's okay, go ahead and give it a try. Just place duct tape over a wart and leave it on for several days. When you go to peel it off, you may remove some layers of the wart. Soak the area and sand the wart down with a disposable emery board. Remember to throw the emery board away after use to avoid spreading the virus! Re-apply a new piece of duct tape over the wart.

Get Your Doctor's Help

Seek your doctor’s help if you need treatment for stubborn warts.

Warts are benign skin lesions, but they may resemble more serious skin conditions like skin cancer. How do you know when it is time to see your doctor? Make an appointment with your dermatologist if:

  • You are not sure that a wart is a wart and have concerns that it might be something more serious.
  • You notice warts on your genitals.
  • You develop a large number of warts.
  • You have warts that bleed, hurt, itch, or burn.

Do not attempt to self-treatment on a wart if you have a weak immune system or diabetes. This can be dangerous and do more harm than good.

Freezing

Cryosurgery uses liquid nitrogen to freeze warts off.

Cryotherapy is a procedure that doctors use to freeze off common warts with liquid nitrogen. The procedure is appropriate for older children and adults who have warts. Since it can be a little painful, cryotherapy is not performed on small children. You may need several sessions of cryotherapy to effectively freeze off warts. Freezing with liquid nitrogen works best when combined with other wart treatments. Allow the area to heal and then follow up by applying salicylic acid. People who have dark complexions may get light spots on areas treated with cryotherapy.

Cantharidin

Cantharidin is a medication that is painted onto a wart.

Cantharidin is an over-the-counter liquid wart treatment that you paint onto a wart and it stimulates the formation of a blister. In about a week the blister dries and falls off, taking the wart with it. Cantharidin is a good wart treatment for children because the application of the medication is painless. People treated with the topical medication may experience tingling, burning, swelling, or itching on the area a few hours after the application.

Cut and Burn

Doctors may use electrosurgery and curettage to treat plantar warts.

Some warts, particularly filiform warts, plantar warts, and common warts, may be treated by cutting and/or burning them. The official name of this kind of treatment is electrosurgery (burning) and curettage (scraping). The two procedures are often used together. First, the doctor numbs the area to be treated. Then, the physician uses an electrical tool to burn the wart. Sometimes laser treatment is used. Curettage involves the use of a knife or spoon-shaped tool to scrape the wart off. Excision refers to the process of cutting or slicing a wart off using a sharp instrument.

Prescription Topical Treatments

Severe warts are skin problems that may require prescription treatment.

Some warts may require prescription treatments. Topical creams like salicylic acid, tretinoin, and glycolic acid may help layers of the wart to peel off. Immune stimulating creams containing imiquimod (Aldara) and diphencyprone (DCP) may promote the shrinking and disappearance of warts. Topical 5-fluorouracil inhibits the growth of extra cells that make up a wart. It is a cancer drug that inhibits the growth of tumors. See your doctor if you have warts that do not respond to over-the-counter treatments. You may need something more aggressive for your condition.

Injectable Medications

Your doctor may try injections when other treatments have failed.

Bleomycin is an injectable drug a doctor may use to treat stubborn warts that have not responded to other kinds of treatments. Bleomycin is a cancer drug that interferes with the production of infected cells. Interferon is another medication that may be injected into warts that do not respond to other interventions. It may be used for genital warts, so they are better able to fight off HPV infection. These injectable medications are typically used when other treatments have failed. Your doctor may recommend using topical salicylic acid or duct tape on a wart as well.

Reduce Your Risk

Wear flip flops at the pool to reduce your risk of catching plantar warts.

You cannot protect yourself against warts entirely, but there are things you can do to decrease your risk of acquiring them and spreading them. Do not touch warts; you may catch them from someone else or spread them to new locations on your skin. Wash your hands thoroughly after applying wart treatment. If you suffer from plantar warts, keep your feet dry. Wear flip-flops when you spend time in warm, humid areas like public pools, public showers, and locker rooms.

Try Acupuncture

Acupuncture may be an effective treatment for warts.

Acupuncture involves the insertion of thin needles into meridian points on the body. In a small study, a little more than one-third of people who received weekly 30-minute acupuncture sessions for 4 weeks experienced complete clearance of persistent warts compared to those who received placebo (sham) treatment. The people who experienced clearance of their warts also did not experience a recurrence of the condition during the 3-month follow up period. Researchers think acupuncture's immune-boosting properties are responsible for the benefits. The study was small and larger studies are needed to confirm the effectiveness of acupuncture for warts.

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REFERENCES:

  • American Academy of Dermatology: "Genital Warts," "How to Get Rid of Warts," "Warts."
  • Annals of Dermatology: "New Alternative Combination Therapy for Recalcitrant Common Warts: The Efficacy of Imiquimod 5% Cream and Duct Tape Combination Therapy."
  • American Academy of Family Physicians: "Warts."
  • BMJ Clinical Evidence: "Warts (Non-Genital)."
  • The British Journal of Dermatology: "Recalcitrant Viral Warts Treated by Diphencyprone Immunotherapy."
  • Clinical Medicine & Research: "An Armamentarium of Wart Treatments."
  • Current Problems in Dermatology: "Human Papillomavirus and Immunosuppression."
  • Digestive and Liver Disease: "Screening, Prophylaxis and Counselling Before the Start of Biological Therapies: A Practical Approach Focused on IBD Patients."
  • The Journal of Clinical and Aesthetic Dermatology: "Glycolic Acid 15% Plus Salicylic Acid 2%: A New Therapeutic Pearl for Facial Flat Warts."
  • Journal of the Royal Society of Medicine: "'Wars and All' - The History and Folklore of Warts: A Review."
  • Medical Acupuncture: "Immune Modulation and Treatment of Human Papilloma Virus-Related Warts with Energetics of Living Systems Acupuncture."
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