Warts

Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin, called human papillomavirus (HPV). Warts are usually skin-colored and feel rough to the touch, but they can be dark, flat and smooth. The appearance of warts varies, depending on where they’re growing.

How many kinds of warts are there?

There are several different kinds of warts including:

Common warts usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, for example where fingernails are bitten or hangnails picked. These are often called "seed" warts because the blood vessels to the wart produce black dots that look like seeds.

Foot warts are usually on the soles (plantar area) of the feet and are called plantar warts. When plantar warts grow in clusters they are known as mosaic warts. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Like common warts, these warts may have black dots. Plantar warts have a bad reputation because they can be painful, feeling like a stone in the shoe. 

 

Flat warts are smaller and smoother than other warts. They tend to grow in large numbers - 20 to 100 at any one time. They can occur anywhere, but in children they are most common on the face. In adults they are often found in the beard area in men and on the legs in women. Irritation from shaving probably accounts for this. 

 

Genital warts may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. In men, genital warts can grow on the penis, near the anus, or between the penis and the scrotum. In women, genital warts may grow on the vulva and perineal area, in the vagina and on the cervix. Genital warts vary in size and may even be so small that you can't see them. They can lead to cancer of the cervix in women or cancer of the penis in men. 

 

Warts are passed from person to person, sometimes indirectly. The time from the first contact to the time the warts have grown large enough to be seen is often several months. The risk of catching hand, foot, or flat warts from another person is small.

Some people get warts depending on how often they are exposed to the virus. Wart viruses occur more easily if the skin has been damaged in some way, which explains the high frequency of warts in children who bite their nails or pick at hangnails.

Treatment Options:

  • Cryotherapy (freezing) is generally preferred. This treatment is not too painful and rarely results in scarring. However, repeat treatments at one to three week intervals are often necessary.
  • Electrosurgery (burning) is another good alternative treatment
  • Excision of warts in the office is effective when the bulk of the wart lies below the skin surface (particularly in Foot/Plantar warts)
  • Laser treatment (Vbeam pulsed dye laser) can also be used for resistant warts that have not responded to other therapies.
  • For Flat Warts, topical application of salicylic acid, tretinoin, glycolic acids, and other surface peeling preparations are effective.