What are warts?
Warts are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance. They can be surrounded by skin that is either lighter or darker.
What causes warts?
Warts are noncancerous growths caused by an infection of the top layers of the skin by different forms of Human Papilloma Virus (HPV). They occur in people of all ages and can spread from person-to-person and from one part of the body to another. These bumps are benign (noncancerous) and generally painless. They may disappear without any treatment. However, in most cases eliminating warts takes time.
What are the types of warts?
There are several different types of warts and their appearance varies depending on their location. The location of a wart often characterizes its type:
Common warts can appear anywhere on the body, although they most often appear on the back of fingers, toes, and knees. These skin-colored, dome-shaped lesions usually grow where the skin has been broken, such as a scratch or bug bite. They can range in size from a pinhead to 10mm and may appear singly or in multiples.
Filiform warts look like a long, narrow, flesh-colored stalk that appears singly or in multiples around the eyelids, face, neck or lips. They are sometimes called facial warts. They may cause itching or bleeding, but are easy to treat with over-the-counter medications.
Flat (plane) warts appear on the face and forehead. They are flesh-colored or white, with a slightly raised, flat surface and they usually appear in multiples. These are more common among children and teens than adults.
Genital warts appear around the genital and pubic areas. It is also possible to get genital warts inside the vagina and anal canal or in the mouth. The lesions start small and soft but can become quite large. They often grow in clusters. They are both sexually transmitted and highly contagious. In fact, it is recommended you generally avoid sex with anyone who has a visible genital wart. This type should always be treated by a physician.
Plantar warts appear on the soles of the feet and can be painful since they are on weight-bearing surfaces. They have a rough, cauliflower-like appearance and may have a small black speck in them. They often appear in multiples and may combine into a larger wart called a mosaic wart. These can spread rapidly.
Subungual and periungual warts appear as rough growths around the fingernails and/or toenails. They start as nearly undetectable, pin-sized lesions and grow to pea-sized with rough, irregular bumps with uneven borders. Subungual and periungual lesions can impede healthy nail growth. Because of their location, they are difficult to treat and generally require medical attention.
How to treat warts?
There are a variety of modalities utilized in the treatment of these common lesions. Most commonly, warts are destroyed using cryosurgery (freezing), electrosurgery (burning), or application of an acid. An alternative approach is an immunotherapy, in which the body’s immune system is triggered to fight the wart using a variety of agents (e.g. imiquimod, cantharidin, candida antigen). Regardless of the modality employed, repeat treatments are usually required.
Most warts respond to over-the-counter treatments, including:
- Cryotherapy, which freezes off the wart using liquid nitrogen or nitrous oxide.
- Electrosurgery, which sends an electric current through the wart to kill the tissue.
- Laser surgery, which essentially heats up the wart until the tissue dies and the wart eventually falls off.
- Nonprescription freezing products (dimethyl ether), aerosol sprays that freeze warts and cause them to die off.
- Salicylic acid preparations, which dissolve the protein (keratin) that makes up the wart and the thick layer of skin that covers it. It comes in gels, pads, drops, and plasters and takes 4 to 6 weeks to eradicate warts.
Always contact the dermatologist if a wart is causing pain, changes in color or appearance and for all genital warts. We’ll assess your warts and recommend the best option.
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