By Connie Colbert
GCU Director of Health Services
Warts are benign (noncancerous) skin growths caused by the human papilloma virus (HPV).
The virus, acquired through cracks in the skin, causes a thickening of the outer layer of skin. Warts affect 7-10% of the population, and young people are more commonly affected.
Most warts are not worrisome, medically speaking, and are primarily of cosmetic concern except when causing discomfort, particularly on the bottom of the feet.
Common warts usually occur on your fingers or hands and may be:
- Small, fleshy, grainy bumps
- Flesh-colored, white, pink or tan
- Rough to the touch
- Sprinkled with black pinpoints, which are small, clotted blood vessels
Transmission
Warts are transmitted by direct contact or indirect contact (e.g., public showers or swimming pool areas). They can be transmitted to one’s self or others. Picking or scratching at warts can increase the risk of transmission.
Nail biting, cuticle picking and shaving also can predispose you to develop warts. Trauma may play a role in the development of warts because they often occur at pressure points – for example, on the bottom of the foot.
Types of warts
Each type of wart is caused by a slightly different virus, and treatment may vary. The common forms include the following:
- Common warts (verruca vulgaris) are flesh-colored, small, raised spots on the skin with a rough surface. The size of the wart varies and may appear anywhere on the skin, particularly on the elbows, knees, hands, fingers and around the nails. The black dots found in these warts, often called seeds, are superficial blood vessels and not actual seeds.
- Plantar warts (verruca plantaris) are no different than common warts except that their location on the bottom of the foot may result in a flat appearance from being pressed into the foot by the weight of the person. Plantar warts may occur singly or in a pattern, grouped closely together. They may cause pain, redness and swelling.
- Flat warts (verruca plana) have a smaller, smoother surface than common warts. They may appear in great numbers on the face and also may occur elsewhere, particularly on the arms and legs.
- Periungual and subungual. These warts form under or around fingernails and toenails.
Self-care
You can treat warts, except genital warts, without visiting a doctor. Apply salicylic acid liquid or plasters (available without prescription) according to package directions.
If using liquid, cover the wart with a waterproof adhesive tape such as duct tape or white athletic tape. After 2-3 days, soak the area in warm water, then scrape away the dead gray/white skin with a pumice stone or metal nail file. Repeat until the wart has disappeared.
Duct tape alone as an occlusive dressing has been effective at resolving warts
If the wart does not completely disappear, see a clinician for medical treatment.
Medical treatment
Warts often go away on their own, without treatment, over several years.
Treatment depends on the size, location and number of warts as well as the activities of the infected person. Warts may be very difficult to cure; often, multiple treatments are needed, but treatment success cannot be guaranteed.
Types of treatment include:
- At-home wart removal: Over-the-counter wart removal medications, such as Compound W, contain salicylic acid. This chemical dissolves the wart one layer at a time. These products come in liquid, gel and patch form. You may need to apply the medication every day for several months to get rid of the wart completely.
- Cryotherapy (liquid nitrogen)is used on many warts at Canyon Health and Wellness Clinic. First, any dead skin surrounding the wart may be scraped off. Next, liquid nitrogen is applied, producing an uncomfortable blister within two days of treatment. Many warts require more than one treatment, with the second treatment being performed 2-4 weeks after the first.
- Electrodessication (electrocautery)is usually used only after warts have not responded to other procedures. It consists of burning the wart with a high frequency current, followed by scraping the surface. It should be used cautiously because it may cause scarring.
- Salicylic acid applied in the clinic setting is often used for plantar warts. A 40% salicylic acid plaster is cut to the size and shape of the wart and covered with an occlusive tape (e.g., duct tape). Alternatively, a 17-20% liquid may be applied. After 24 hours, the wart is pared down. This is repeated every day if the area is not too irritated.
Prevention
- Remove warts that are present.
- Do not pick at warts. It could spread them.
- Wear footwear in public showers and other public areas to avoid plantar warts.
When should I see a doctor?
- If the warts are painful or change in appearance or color
- If you have tried treating them without success and they persist, spread or come back
- You are unsure if the growth is a wart
- The wart is in a place on your body that it interferes with activities
