
Warts – no one likes them, but a lot of people get them.
Why?
As a board-certified dermatologist, I am often asked by patients why they have warts and what they can do to get rid of them. Fortunately, we have many treatment approaches that work well to get rid of these frustrating skin growths.
What causes warts?
Warts are triggered by a viral infection by human papilloma virus (HPV). The virus enters the skin through tiny cuts and infects the top layer of the skin, causing the top layer to grow quickly and a wart to form.
Warts are contagious. They can spread through direct skin-to-skin contact, such as during intimacy and sexual contact. Warts can also spread through indirect contact, such as by sharing towels, in a locker room or in a public swimming pool. Warts can also spread to other places on your own body, called self-inoculation.
People who are immunocompromised are at high risk of developing warts because they have a weakened immune response to fight off viruses. Children also are at high risk of developing warts because they tend to have cuts and scrapes on their skin where the virus can enter.
Getting the HPV vaccine can help in the prevention of warts, particularly genital warts.
What do warts look like? Where do warts appear on the body?
There are many subtypes of warts, caused by different strains of the human papilloma virus. Warts can appear as a single skin growth or in clusters. Some examples of warts include:
- Common warts. Common warts usually appear on the hands and have black dots, which are small blood vessels. Common warts are hard, bumpy and usually rough and raised, resembling a dome. They usually vary in size, from a few millimeters up to a few centimeters.
- Filiform warts. Filiform warts have a filiform appearance, meaning it appears as if a finger or long threads are sticking out of the skin growth. They often grow near the mouth, eyes and nose but can occur anywhere on the body.
- Plantar warts. Plantar warts form on the feet. They are characterized by rough, hard, thick patches of skin with black dots. Mosaic warts are a type of plantar wart. They are white and flat and look like mosaic tiles. Warts on the feet cause pain when walking.
- Periungual warts. Periungual warts form around the fingernails and toenails and can hide under the nail itself.
- Genital warts. Genital warts appear in or around the vagina, cervix, penis, scrotum or anus. They are usually flat and may have a cauliflower-like appearance. If you have genital warts, please tell your partner(s) and avoid unprotected sex until the warts clear up. Some strains of HPV can lead to cervical cancer, so seek treatment if you have genital warts.
Do warts hurt?
Most warts don’t hurt, but they can be painful if they are in an area that rubs against something. Warts may be itchy, and they may bleed. Don’t pick or scratch warts because this can lead to infection and potentially spread warts to other parts of your body.
How are warts treated?
Sometimes warts go away on their own, but they may take months or even years to clear up. I recommend having a doctor look at any unusual skin growth to ensure the growth isn’t cancerous or another serious skin condition, and I strongly recommend going to the doctor if there are multiple warts, if the warts bleed or if the warts are on the face or genitals. Children with warts should be seen by a doctor.
If the skin growth truly is a wart, we have many treatment options. To determine the best option for each patient, we consider whether the patient is immunosuppressed, whether the patient is an adult or child, how many warts the person has, the size of the warts, and whether there are cosmetic concerns, such as warts on the face.
Treatment options for warts include:
- Over-the-counter medications. I usually recommend salicylic acid, available in strengths from 17 percent to 40 percent. Over-the-counter freeze treatments work well for some people but may lead to skin discoloration.
- Prescription creams. Imiquimod and 5-Fluorouracil can be applied to warts to clear them up.
- Cantharidin. A doctor can apply cantharidin to the wart. A blister will form under the wart, and the wart will fall off.
- Cryotherapy. Using this approach, a doctor can freeze off the wart. The liquid nitrogen destroys the skin’s outer layer. Cryosurgery can cause skin discoloration on people with dark skin.
- Immunotherapy. Using this approach, we inject candida (yeast) antigen into the skin, causing an immune response that attacks the HPV virus and clears up the warts.
Patients sometimes ask me whether putting duct tape on a wart can help. Though more research is needed, I can say that anecdotally, duct tape does help clear up warts in some people!
Reach out to your doctor to understand the best treatment option for you.
How can you tell the difference between warts and skin cancer?
Most warts are not cancerous and do not lead to cancer. Skin cancer lesions tend to be painful; warts tend to be itchy. If you are concerned about whether a skin growth may be cancerous, get it checked out, especially if it is painful or bleeds.
Though having warts can be frustrating, rest assured that they are treatable. If over-the-counter remedies don’t help, see a doctor for further medical treatment options.