A wart is a small growth on the skin that can appear anywhere on the body. Warts result from viruses of the human papillomavirus (HPV) family. The most common warts appear on the soles of the feet or on the hands, but other wart types are also known that lead to wart formation elsewhere on the body. Most warts disappear on their own. In some cases (e.g. pain and discomfort) medical treatment is necessary. Various treatment options can be used to remove the wart(s). The condition is rarely serious, but some types of viruses that cause genital warts may cause cancer. Finally, thanks to some advice, it is possible to reduce the formation of a wart.

• Synonyms
• Epidemiology of verrucae
• Causes of warts on skin
• Risk factors
• Types of warts

• Filamentous warts (verruca filiformis)
• Genital Warts
• Common warts (verruca vulgaris)
• Mosaic warts
• Plantar warts
• Flat warts (flat warts)

• Symptoms
• Diagnosis and examinations
• Wart treatments

• Candida antigen injections
• Cantharidin
• Surgery
• Cryotherapy
• Laser treatment
• Salicylic acid
• Other treatments

• Prognosis of skin growths
• Prevention of growths on skin

Synonyms

Verruca is the medical term for a wart. The plural of verruca is verrucae.

Epidemiology of verrucae

About one in three children and teenagers will have warts. About one in twenty to one in thirty adults suffer from a wart. The immune system of adults may often be better developed to prevent wart formation.The spread of the virus occurs through the sharing of personal objects / Source: Pexels, Pixabay

Causes of warts on skin

Warts are growths on the skin caused by an infection with the human papillomavirus (HPV). HPV viruses cause excessive and rapid growth of keratin (a hard protein on the top layer of skin). Different strains of HPV cause different warts. The wart-causing virus spreads through close skin-to-skin contact and through contact with personal objects such as towels or shoes. The virus spreads to other parts of the body by scratching or biting a wart, sucking on the fingers (finger sucking), biting the fingernails (when warts are around the nails) or by shaving the face or the legs.

Risk factors

Patients with a weak immune system (HIV/AIDS, use of immunosuppressants, after a transplant) are more likely to get warts. The risk of infection is also increased when patients have wet or damaged skin and come into contact with rough surfaces. For example, if a patient has a wound on the sole of his foot, he is more likely to develop a wart when he walks barefoot in a public swimming pool. The handling of raw meat as a profession (for example by slaughter workers or butchery workers) also increases the risk of developing warts. Finally, patients with eczema (chronic skin disease with dry skin and itchy skin) are also affected more often.

Types of warts

Filamentous warts (verruca filiformis)

Filamentous warts are long and thin in shape. They grow quickly on the eyelids (warts), the neck and the armpits.

Genital Warts

An HPV infection is the most common sexually transmitted disease. Some strains of HPV cause warts on, in or around the genitals. These are known as genital warts. They look like small flesh-colored, pink, or red growths. The warts sometimes look like the small parts of a cauliflower or they are very small and difficult to see. They often appear in clusters of three or four. Sometimes they grow very quickly and spread to other areas. The warts are usually not painful, although they cause mild pain, bleeding and itching in some patients. These warts are potentially serious. In women, they lead to cervical cancer (symptoms of abnormal vaginal bleeding), anal cancer (cancer in anus with anal bleeding and anal itching) or vulvovaginal cancer. In men, the warts sometimes cause anal cancer and penile cancer. All patients with genital warts should consult the doctor for a thorough assessment.

Common warts (verruca vulgaris)

Common warts are the most common type. Warts appear on knuckles, fingers, elbows, knees and any area with cracked skin, although they can occur anywhere on the body. They have a firm, raised, rough surface and a cauliflower-like appearance. Small, dark spots are located within the warts. These seed warts are clotted blood vessels that are often visible in normal warts.

Mosaic warts

Mosaic warts are multiple plantar warts in a large cluster. Unlike moles, warts are often the same color as the patient’s skin. Warts do not contain pus unless they become infected. If an infection occurs, antibiotic treatment is required.

Plantar warts

Plantar warts (plantar verrucae) appear on the soles of the feet, heels and toes. The flesh-colored or light brown nodules usually grow into the skin because the patient’s weight presses on the sole of the foot. They normally have a small central black dot surrounded by hard, white tissue. Plantar warts are often difficult to remove.

Flat warts (flat warts)

Flat warts are round, flat and smooth. They have a yellowish, brownish or skin-colored appearance. These warts usually grow on sun-exposed areas, such as the face and hands. Areas that the patient often shaves may also be affected. Multiple warts often occur, possibly between twenty and a hundred. Flat warts usually disappear without treatment. Children and teenagers are more likely to be affected by this type than adults.

Symptoms

A wart is a local thickening of the epidermis (rough texture) with the formation of papillae (nipples). The appearance of a wart depends on its location on the body and the thickness of the skin. For example, warts often look like a firm blister or a small cauliflower. A wart contains black dots. These are blood vessels that may cause bleeding. One or sometimes many warts appear in the patient at the same time. These may or may not be painful.

Diagnosis and examinations

A doctor examines the wart(s) and is able to make a diagnosis based on their appearance. Occasionally he removes tissue (biopsy) for further examination.

Wart treatments

Treatment for warts is indicated:

• in patients with cosmetic problems
• in patients with a weak immune system
• in patients with signs of infection (pus, crusting)
• for warts that are large
• for warts that cause pain and discomfort
• in case of warts that are numerous
• for warts located in sensitive areas (genitals, mouth, nostrils)
• for warts with color changes

Candida antigen injections

The human immune system does not detect a wart. When there is local stimulation of the immune system, some activated immune cells in the area will recognize this and take action. The doctor does not use this procedure on pregnant women. Scarring does not occur.

Cantharidin

The doctor sometimes uses Cantharidin, a substance containing an extract of an oil beetle (blister beetle). The doctor covers the treated area with a bandage. A painless blister then develops in the area, which is sometimes somewhat uncomfortable. The blister essentially removes the wart from the skin, after which the doctor can remove the dead wart part four to six hours later.

Surgery

Surgery for warts is rare. Sometimes surgery is necessary if other treatments are not effective. The doctor shaves away most warts with a surgical razor under local anesthesia (local anesthetic medicines). To ensure complete removal of the wart, patients often need to apply topical cream to the skin even after the surgical procedure. Often the patient develops scars after surgery that do not disappear.

Cryotherapy

With cryotherapy, the doctor sprays freezing fluid, often nitrogen, on the wart, which destroys the cells. A blister then develops, on which a crust gradually forms. This blister eventually falls off the skin after about a week. A large wart often requires a local anesthetic and can be removed in several sessions. A pharmacist sells dimethyl ether or propane spray for self-administration. The patient should not use this on the face. The self-administration method is generally less effective than cryotherapy used by the doctor.

Laser treatment

Laser treatment uses a precise laser beam to destroy the wart.

Salicylic acid

Most over-the-counter topical (applied to the skin) creams, gels, and medicated patches contain salicylic acid. The patient protects the skin around the wart before starting treatment. Salicylic acid may destroy healthy skin. Applying Vaseline or a corn plaster to the skin around the wart provides protection against damage. Applying salicylic acid to the face is not recommended. Some tips improve the effectiveness of salicylic acid treatment. By rubbing the wart weekly with a pumice stone or nail file, it is possible to rub dead tissue from the wart surface. This softens the wart. The patient should not use the pumice stone or nail file on another part of the body or pass it on to another person because the viral infection is contagious. Before applying the medicine, the patient first immerses the affected part of the body in water for five minutes. The patient normally applies the treatment daily for about three months. If the skin becomes painful, he should discontinue the treatment.

Other treatments

The doctor uses other possible techniques to remove wart-like growths when standard treatments are ineffective, such as:

• Bleomycin or Blenoxane (injection of this medication into the wart kills the virus; Bleomycin can also be used to treat some types of cancer)
• duct tape
• electrocautery
• photodynamic therapy
• immunotherapy (the patient’s immune system tries to destroy the warts)
• retinoids, derivatives of vitamin A (disrupt the skin cell growth of the wart)

Prognosis of skin growths

In children, warts often go away on their own without medical treatment within a few weeks to five years, depending on the location and number of warts. In adults they usually last longer than in children. Chemical skin treatments are usually effective for treating these skin growths. If these treatments do not work, the doctor will use various other therapies. Typically, common warts, especially around the fingernails and toenails, are difficult to remove completely or permanently. If the wart is removed but the virus is still present in the body, the wart may return.Washing hands thoroughly after touching a wart is necessary / Source: Gentle07, Pixabay

Prevention of growths on skin

To reduce the risk of getting or spreading warts, the following tips are useful:

• replace the socks daily
• wash hands thoroughly after touching a wart
• keep hands as clean and dry as possible
• wear shower shoes or slippers when using public showers or walking near public swimming pools
• use a different nail clipper than on the infected nail
• do not brush, comb, shave or cut areas with warts
• not sharing other towels, washcloths or other personal items
• do not share shoes and socks with other people
• Don’t bite your nails when warts are nearby
• do not scratch warts (may spread the infection)
• practice safe sexual intercourse
• covering warts with a waterproof plaster while swimming, and wearing socks or gloves elsewhere (for example, at the gym)
• do not touch other patients’ warts

read more

• Genital warts: STD due to human papillomavirus (HPV)
• Thread-shaped warts (filiform warts): Treatments
• Age warts: Benign, painless growths on the skin
• Eye warts: Warts on or around the eye caused by a virus
• Plantar warts: Treatments for warts on foot