Warts

Warts are skin growths that appear when a virus called human papillomavirus (HPV) infects the top layer of the skin. HPV is contagious and easily spread by contact with the someone who has a wart or something that touched the wart, such as a towel or the floor of a locker room.

Types of warts

Different HPV viruses produce different types of warts in different locations on the body.

  • Common warts: These usually form around the fingernails where the virus can easily enter the body, such as near a hangnail. They also form on the back of the hands and often look like a rough bump which may have black dots that look like seeds.
  • Plantar warts: Common warts on the soles of the feet are called plantar warts. Most plantar warts are flatter than other common warts because walking pushes the wart into the skin which can be painful.
  • Flat warts: Flat warts are smaller and smoother than common warts. They can appear anywhere on the body, but are most common on the face. Because shaving seems to spread flat warts, they often appear on men in the beard area or on women’s legs. Flat warts usually occur in large numbers.
  • Genital warts: These warts appear in or around the genital area and are spread through sexual contact or, in some cases, from a mother to baby during childbirth. Tell your doctor if you are pregnant and have or have had genital warts. Genital warts are flesh colored, may have a rough or smooth texture and can be large or small. They can appear as a single wart or in clusters. 

Certain strains of HPV that cause genital warts can also cause cancer in men and women, so early treatment is important. Women should be screened for early signs of cancer, which can be treated before the disease develops. HPV vaccines can prevent infection with the most common types of HPV viruses that cause genital warts and cancer. The vaccine is given in three shots before a person becomes sexually active.

Learn more about Genital Warts.

Treatment

Warts often go away without treatment, but it may take a few months to longer than a year for warts to disappear. Treatment gets rids of warts quickly and reduces the risk of spreading the virus to other parts of the body or other people.

Non-prescription products are available to treat warts yourself and these may be effective. However, it is important to see your dermatologist if you have any of the following:

  • Warts in the genital area or anus
  • A wart that hurts, itches or bleeds
  • More than a few warts
  • Warts that have not responded to over-the-counter treatment
  • Warts you think may be something else

There is no one treatment for all types of warts and all patients. Your dermatologist will recommend the treatment option that is most appropriate depending on the type of wart, your age and health and other considerations. Some warts may require more than one type of treatment.

Many wart treatments available without a prescription contain salicylic acid. Your dermatologist can prescribe a medicine with a stronger dose. Medicine is usually applied daily after bathing or soaking the wart and results can take many weeks. Stop treatment, at least temporarily, if soreness develops in the wart or skin around it. 

Your dermatologist may recommend other treatment options for faster results.

In-Office Procedures

  • Cryotherapy: With cryotherapy, your dermatologist will freeze the wart with liquid, causing it to blister and later fall off. More than one treatment is often necessary.
  • Cantharidin: A dermatologist paints the wart with cantharidin which causes a blister to form under the wart. In a week or so, you may need to return to the office so the dermatologist can clip away the dead wart and retreat any remaining wart.
  • Electrosurgery: This treatment destroys the wart by burning it off. 

Options for hard-to-treat warts

Your dermatologist may recommend one or more of the following therapies for hard-to-treat warts:

  • Excision: The dermatologist surgical removes (cuts out) the wart.
  • Laser treatment: Laser therapy can be effective for some types of warts. The number of treatment sessions required can vary between patients.
  • Chemotherapy: When warts don’t respond to other treatments, a chemotherapy medication may be recommended to slow the growth of the HPV virus. This does not mean you have cancer. Studies have shown that one of the medicines, Bleomycin, is very effective at clearing warts that have been injected with the medication.
  • 5-Fluorouracil (5-FU): This is a cream that patients apply once or twice daily to treat warts at home.
  • Immunotherapy: Different medicines can be used to stimulate the immune system so it can fight HPV more effectively. Some are creams to be applied at home, which, if the cream is effective, cause an intense skin reaction.
  • Occlusion: Meaning to shut off or close up, occlusion treatments, such as covering the wart with tape, can also stimulate the immune system. Occlusion is often combined with another treatment, such as salicylic acid.

Preventing new warts

The following advice can help prevent warts from forming or spreading.

  • Do not pick at or scratch warts to avoid spreading the virus to other parts of your body.
  • Wear flip-flops or pool shoes in areas where many people are barefoot, such as locker rooms, pool area, and showers or bathtubs in hotels or health clubs.
  • Do not touch someone else’s wart.
  • Keep feet dry as moisture helps the virus spread.

Warts are very common and usually can be treated effectively. For the best outcome, consult your dermatologist at Dermatology and Skin Surgery to ensure that your warts are treated properly