Warts

Answer 1

Definition

Warts are small, usually painless growths on the skin caused by a virus called human papillomavirus (HPV). They are generally harmless. However, warts can be disfiguring and embarrassing, and occasionally they itch or hurt (particularly on the feet).

The different types of warts include:

• Common warts usually appear on the hands, but can appear anywhere.
• Flat warts are generally found on the face and forehead. They are common in children, less common in teens, and rare in adults.
• Genital warts(condyloma) are usually found on the genitals, in the pubic area, and in the area between the thighs, but they can also appear inside the vagina and anal canal. (See: Genital warts for more information)
• Plantar warts are found on the soles of the feet.
• Subungual and periungual warts appear under and around the fingernails or toenails.

Alternative Names

Plane juvenile warts; Periungual warts; Subungual warts; Plantar warts; Verruca; Verrucae planae juveniles; Filiform warts; Verruca vulgaris

Causes, incidence, and risk factors

The typical wart is a raised round or oval growth on the skin with a rough surface. Compared with the surrounding normal skin, warts may appear light, dark, or black (rare). Most adults are familiar with the look of a typical wart and have little trouble recognizing it. Unusual warts with smooth surfaces or flat warts in children may be more difficult for parents to recognize.

Common warts tend to cause no discomfort unless they are in areas of repeated friction or pressure. Plantar warts, for example, can become extremely painful. Large numbers of plantar warts on the foot may cause difficulty walking or running.

Some warts will disappear without treatment, although it can sometimes take a couple of years. Treated or not, warts that go away often reappear. All warts can spread from one part of your own body to another.

Unsightly or painful warts can be treated. Warts around and under your nails are much more difficult to cure than warts in other places.

Symptoms

• Abnormally dark or light skin surrounding the lesion
• Numerous small, smooth, flat (pinhead sized) lesions on forehead, cheeks, arms, or legs
• Rough growths around or under fingernails or toenails
• Rough, round, or oval lesions on soles of feet -- flat to slightly raised -- painful to pressure
• Small, hard, flat or raised skin lesion or lump

Signs and tests

Warts can generally be diagnosed simply by their location and appearance. Your doctor may want to cut into a wart (called a biopsy) to confirm that it is not a corn, callus, skin cancer, or other similar-appearing growth.

Treatment

Over-the-counter medications can remove warts. These are applied to the wart every day for several weeks. DO NOT use these medications on your face or genitals. It helps to file the wart down when damp (for example, after a bath or shower) before applying these medications. DO NOT treat warts on your face or genitals yourself. See your health care provider.

Pain and pressure from plantar warts can be treated with special cushions that are available at drug stores.

Your health care provider may use stronger (prescription) medications, such as podophylin or salicylic acid, for removal of persistent warts. Surgical removal or removal by freezing (cryotherapy), burning (electrocautery), or laser treatment may be needed.

Immunotherapy, done by injecting a substance that causes an allergic reaction, may also be considered by your health care provider. A topical medication called imiquimod may also be used.

A vaccine called Gardasil prevents infection against the strains of viruses that often cause genital warts and Cervical cancer in women.

DO NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or any other method.

Expectations (prognosis)

Warts are generally harmless growths that often go away on their own within 2 years. They can be contagious, but transmission from person to person is uncommon. Warts may be unsightly or cause discomfort, especially on the feet.

Complications

• Spread of warts
• Return of warts that disappeared
• Minor scar formation if the wart is removed
• Formation of keloids after removal

Calling your health care provider

Call for an appointment with your doctor if:

• There are signs of infection (red streaking, pus, discharge, or fever) or bleeding. Warts can bleed a little, but if bleeding is significant or not easily stopped by light pressure, see a doctor.
• The wart does not respond to self-care and you want it removed.
• You have pain associated with the wart.
• You have anal or genital warts.
• You have Diabetes or a weakened immune system (for example, HIV) and have developed warts.
• There is any change in the color or appearance of the wart.

Prevention

• Avoid direct skin contact with a wart on someone else.
• After filing your wart, wash the file carefully since you can spread the virus to other parts of your body.
• After touching any of your warts, wash your hands carefully.

References

Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 12.

Gibbs S, et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2006;(3):CD001781.

Answer 2

Definition

Warts are small, usually painless growths on the skin caused by a virus called human papillomavirus (HPV). Most, but not all, are generally harmless.

Warts can be disfiguring and embarrassing. Sometimes they itch or hurt (particularly on the feet). Some warts spread through sex.

Alternative Names

Plane juvenile warts; Periungual warts; Subungual warts; Plantar warts; Verruca; Verrucae planae juveniles; Filiform warts; Verruca vulgaris

Causes, incidence, and risk factors

All warts can spread from one part of your own body to another. They may spread from one person to another, but this is uncommon.

Treatment is available if you do not like how the wart looks or if it is painful.

Symptoms

The typical wart is a raised round or oval growth on the skin with a rough surface.

• The spot may be lighter, darker, or black (rare) colored compared to other skin.
• Some warts have smooth or flat surfaces.
• Some warts cause pain, others do not.

Different types of warts include:

• Common warts usually appear on the hands, but can appear anywhere. They usually do not cause pain unless they are repeated rubbed against.
• Flat warts are generally found on the face and forehead. They are common in children, less common in teens, and rare in adults.
• Genital warts(condyloma) are usually found on the genitals, in the pubic area, and in the area between the thighs, but they can also appear inside the vagina and anal canal.
• Plantar warts are found on the soles of the feet. They can be very painful. Many of them on the foot may cause difficulty walking or running.
• Subungual and periungual warts appear under and around the fingernails or toenails.

Signs and tests

Your doctor or nurse can usually diagnose warts by looking at your skin.

A biopsy may be done to confirm it is not another type of growth, including skin cancer.

Treatment

Do NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or any other method.

Over-the-counter medications are available to remove warts. Do NOT use over-the-counter wart medications on your face or genitals. Warts on the face or genitals need to be treated by your doctor or nurse.

• First, use a nail file (emery board) to file the wart when your skin is damp. (For example, after a bath or shower). This helps remove dead tissue. Do not use the same emery board on your nails.
• Apply the medicine to the wart every day for several weeks or months. Follow the instructions on the label.
• Cover the wart with a bandage to prevent spreading it.

Other treatment depends on the type of wart you have.

• Special foot cushions can help ease the pain due to plantars warts. You can buy these at drug stores without a prescription. Use socks. Wear shoes with plenty of room. Avoid high heels.
• Your doctor or nurse may need to trim away thickened skin or callus that form over warts on your foot or around nails.

Your health care provider may recommend the following treatments if your warts do not go away:

• Stronger (prescription) medications, such as podophyllin or salicylic acid
• A blistering solution
• Freezing the wart (cryotherapy) to remove it
• Burning the wart (electrocautery) to remove it
• Laser treatment for difficult to remove warts
• Immunotherapy, which gives you a shot of a substance that causes an allergic reaction and helps the wart go away
• Skin medicine called imiquimod

A new medicine called veregen may be used on genital warts as well as other warts. Two vaccines are available to prevent infection against the strains of viruses that cause genital warts and cervical cancer in women.

Expectations (prognosis)

Warts are generally harmless growths that often go away on their own within 2 years. Warts around and under your nails are much more difficult to cure than warts in other places. Warts can recur, even when they appear to be fully treated. Minor scars can form after removal.

Complications

• Spread of warts
• Return of warts that disappeared
• Minor scar formation if the wart is removed
• Formation of keloids after removal

Calling your health care provider

Call for an appointment with your doctor if:

• There are signs of infection (red streaking, pus, discharge, or fever) or bleeding. Warts can bleed a little, but if bleeding is significant or not easily stopped by light pressure, see a doctor.
• The wart does not respond to self-care and you want it removed.
• You have pain associated with the wart.
• You have anal or genital warts.
• You have diabetes or a weakened immune system (for example, HIV) and have developed warts.
• There is any change in the color or appearance of the wart.

Prevention

• Avoid direct skin contact with a wart on someone else.
• After filing your wart, wash the file carefully since you can spread the virus to other parts of your body.
• After touching any of your warts, wash your hands carefully.

References

Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 12.

Gibbs S, et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2006;(3):CD001781.

Reviewed By

Review Date: 11/22/2011

Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 3

If you're a nature lover and find warts on your hand, you don't have to stop picking up frogs or toads. Actually, you have a virus that is pretty harmless, except for your warts being unsightly.

Warts are small, usually painless growths on your skin, caused by a type of virus called human papillomavirus (HPV). Even though they're generally harmless, they can be disfiguring and embarrassing, and occasionally they itch or hurt, particularly on your feet.

The typical wart is a raised or oval growth on your skin. It has a rough surface. Warts may look light, dark, or black. Most adults are familiar with the look of a typical wart and have little trouble recognizing one. Unusual warts in children, however, may be more difficult for parents to notice.

The different types of warts include: Common warts, which usually appear on your hands. Flat warts, which are generally found on your face and forehead. They are most common in children. Genital warts. Plantar warts, found on the soles of your feet. And, Subungual and periungual warts, which appear under and around your fingernails or toenails

Your doctor will generally diagnose your warts simply by their location and appearance. Even so, your doctor may want to cut into a wart to confirm that it is not a corn, callus, or skin cancer. This is called a biopsy.

Over-the-counter medications can often remove warts. You'll need to apply them to the wart every day for several weeks. It helps to file the wart down when it's damp (for example, after a bath or shower) before applying these medicines. Do NOT treat warts on your face or genitals yourself. See your doctor instead.

You can treat pain and pressure from plantar warts with special cushions you can find at a drug store. If your warts keep coming back, or don't go away, your doctor may use stronger prescription medicines, like podophylin or salicylic acid. Some warts may need to be surgically removed or frozen. Some warts will disappear without treatment, but it may take a couple of years.

Treated or not, warts that go away often reappear, and all warts can spread from one part of your own body to another. They can be contagious, but it's uncommon to spread them to another person. Just don't remove a wart yourself by burning, cutting, or tearing at it. Call your doctor, and get the right treatment.

Reviewed By

Review Date: 10/25/2011

Alan Greene, MD, Author and Practicing Pediatrician; also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.