Warts

Warts are small, harmless growths caused by a viral infection on the top layer of the skin that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance.  Warts are caused by different forms of human papilloma virus (HPV). They occur in people of all ages and can spread from person-to-person and from one part of the body to another. Warts are benign (noncancerous) and generally painless. They may disappear without any treatment. However, in most cases eliminating warts takes time.

The location of a wart often characterizes its type:

Common warts can appear anywhere on the body, although they most often appear on the back of fingers, toes and knees. These skin-colored, dome-shaped lesions usually grow where the skin has been broken, such as a scratch which allows the virus entry. They can range in size from a pinhead to 10mm and may appear singly or in multiples.

Plantar warts are common warts that appear on the soles of the feet and can be painful since they are on weight-bearing surfaces. They often appear in multiples and may combine into a larger wart called a mosaic wart. Plantar warts can be quite painful when pressure is applied to them while walking.

Flat warts (verruca plana) are smaller and smoother than other warts.  They tend to grow in large number – 20 to 100 at any one time.  They can occur anywhere, but are most common on the face, in the beard area in men, and on the legs in women.  Irritation or microscopic cuts in the skin from shaving probably contribute to them.

Genital warts appear on the genitals, inside the vagina, on the cervix or around the anus.  These warts are sexually transmitted and can be spread by close physical contact and are highly contagious.  It is also possible to get genital warts inside the vagina and anal canal. The lesions start small and soft but can become quite large. They often grow in clusters. Viruses associated with certain types of genital warts (HPV) can cause cervical or penile cancer.  Genital warts should always be treated by a physician. 

Subungualand periungual wartsappear as rough growths around the fingernails and/or toenails. They start as nearly undetectable, pin-sized lesions and grow to pea-sized with rough, irregular bumps with uneven borders. Subungual and periungual warts can impede healthy nail growth. Because of their location, they are difficult to treat and generally require medical attention.

Warts can be very difficult to eradicate, often requiring multiple treatments.  Several different types of treatment may be required since no single treatment type can guarantee elimination of the wart. Occasionally they may resolve spontaneously.

Wart treatments include:

• Salicylic acid gels, solutions, or plasters may be prescribed for daily home treatments.  There is usually little discomfort but it can take many weeks of treatment to obtain favorable results.  Treatment should be stopped at least temporarily if the wart becomes sore.
• Cantharidin is a chemical that can be applied in the dermatologist’s office. It causes a blister to form under the wart. The dermatologist can then clip away the dead part of the wart in the blister roof in a week or so, and re-treat the remaining wart if necessary.
• Cryotherapy is freezing with a cold liquid gas called liquid nitrogen.  This treatment causes a blister to form which can be clipped in a week; repeat treatment at one to three week intervals is usually required.  Cryotherapy may be painful, and occasionally can result in scarring.
• Electrosurgery (burning) is performed in the dermatologist’s office with local anesthesia.  This treatment can also occasionally cause scarring.
• Laser treatment can also be used for resistant warts that have not responded to other therapies.
• Surgery or cutting may be used to remove the wart.
• Imiquimod is a cream that causes an inflammatory response which makes the wart go away.  It may be applied at home and is especially good for genital warts.
• Interferon is injected into warts to boost the immune reaction and cause rejection of the wart.  This may produce flu-like side effects, but can be used for stubborn warts.
• Immunotherapy attempts to use the body’s own rejection system.  Several methods of immunotherapy can be used.  With one method, the patient is made allergic to certain chemicals which are then painted on the wart.  A mild allergic reaction occurs around the treated warts and may result in their disappearance.

If self-treatments don't work after a period of about 4 to 12 weeks, please contact us. We'll assess your warts and recommend the best option.

Always contact the office if a wart is causing pain, changes in color or appearance and for all genital warts.