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Warts
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
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.
Exams 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.
Outlook (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.
Possible Complications
- Spread of warts
- Return of warts that disappeared
- Minor scar formation if the wart is removed
- Formation of keloids after removal
When to Contact a Medical Professional
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: 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.
