Wart: Types, Causes, Treatment and Prevention


A wart is a small growth with a rough texture on your skin caused by the human papillomavirus (HPV).

May 18, 2018

A wart is a small growth with a rough texture on your skin caused by the human papillomavirus (HPV). The appearance of a wart depends on its location on the body and the thickness of the skin.
Generally warts aren't dangerous. But they are ugly in appearance, potentially embarrassing, and contagious. They can also be painful. People with a weakened immune system are more likely to have warts. Common warts, flat warts, pigmented warts, and plantar warts are different types of wart. Mostly these disappear in 1 to 5 years without medical treatment. But for warts that are large, numerous, or in sensitive areas treatment is necessary.

Types of Warts:

The most common types of wart include:

Common warts, or verruca vulgaris:

Common warts usually grow on your toes,knuckles, fingers, elbows, knees, and any area with broken skin, but can appear elsewhere. They have a rough, grainy appearance and a rounded top. Common warts are grayer than the surrounding skin.
Clotted blood vessels are often visible in common warts as small, darkened spots which are known as seed warts.

Plantar warts:

Plantar warts grow on the soles of the feet. As the person's weight pushes onto the sole of the foot, plantar warts grow into your skin, not out of it. If you notice the appearance of a small hole in the bottom of your foot that is surrounded by hardened skin, that could be a plantar wart. Plantar warts can make walking uncomfortable and is painful. They normally have a small central black dot surrounded by hard, white tissue which are often difficult to clear.

Plane warts or verruca plana:

Plane warts, also known as flat warts are round, flat, and smooth and most often grow on sun-exposed areas such as the face, thighs, or arms. They are small and not immediately noticeable. Flat warts have a flat top, as if they have been scraped. They can be yellowish, brownish, or skin colored, often tend to grow in larger numbers. The numbers could be between 20 and 100. However, of all wart types, they are most likely to disappear without treatment.

Filiform warts or verruca filiformis:

Filiform warts are long and thin in shape. They can grow rapidly on the eyelids, and armpits. These can also grow grow around your mouth or nose and sometimes on your neck or under your chin. Filiform warts are the same color as your skin.

Periungual warts:

Periungual warts grow under and around the toenails and fingernails. They can be painful and affect nail growth.

Mosaic warts:

Mosaic warts are multiple plantar warts in a large cluster. These are often the same color as your skin. Warts do not contain pus unless they become infected. They may require treatment with antibiotics when infection occurs.

Causes of Wart:

The warts commonly seen on the skin are caused by a viral infection. One of the HPVs (human papillomaviruses) can be spread from person to person or can be acquired through contact with a contaminated surface. HPV viruses cause the excessive and rapid growth of keratin, which is a hard protein on the top layer of the skin. Different warts are caused by different HPV strains. The virus can be spread by close skin to skin contact, and through contact with towels or shoes.
The virus can spread to other parts of the body through:

  • scratching or biting a wart
  • sucking fingers
  • biting fingernails, if there are warts around the nails
  • shaving the face or legs

Coming into contact with rough surfaces while the skin is wet or damaged increase the risk of infection. For example, a person with scratches or cuts on the soles of their feet is more likely to develop a verruca in and around public swimming pools. This risk can be prevented by wearing shower shoes or flip flops while using public showers or walking near public swimming pools.
The risk of spreading warts from another person is low. However, they can be passed on, if the person has a compromised immune system. This includes people with HIV or AIDS, and those using immunosuppressants following a transplant. Genital warts are more contagious. Handling meat as an occupation will also increase the risk of contracting warts.

Genital warts:

Almost all types of HPV cause relatively harmless warts that appear on your hands or feet. But some strains of HPV can cause warts on, in, or around the genitals which can be more serious.
In women, they can lead to cervical, anal, and vulvovaginal cancer which could be fatal, where as in men, anal cancer and cancer of the glans penis can also occur as a result of infection with some types of genital warts. Anyone who develops genital warts should see their doctor for a proper diagnosis.

Treatment of Warts:

Most warts usually go away on their own without any treatment. It can take from a few weeks to several years, depending on the location and number of warts. They usually disappear faster in children.
If they do not disappear, or if a wart causes concern, treatment can be done to irritate the skin and get the own infection fighting cells of the body to clear the warts.The wart can be examined by a doctor. He/She may ask about family history, and may take some tissue for biopsy test before starting any treatment plan.
Several treatment options are available which include:

Salicylic acid:

Most of the over the counter creams, gels, paints, and medicated Band-Aids contain salicylic acid. Salicylic acid is a keratolytic medication, which dissolves skin protein keratin. Keratin is responsible for making most of the mass of the wart and the thick layer of dead skin that often surmounts it. Because salicylic acid may destroy healthy skin , it is important to protect the skin around the wart before applying this treatment. Do not apply it to the face.
Applying petroleum jelly or a corn plaster to the skin around the wart can protect it from damage. Rubbing dead tissue from the surface of the wart weekly using a pumice stone or emery board can help soften the wart. This can enhance the effectiveness of salicylic acid treatment. But, make sure that the pumice stone or emery board is not used on any other part of the body or by another person. Soak the wart in water for about 5 minutes before applying the medication to make it more effective. Apply this treatment daily for about 3 months to see the results. Treatment should be stopped if the skin becomes sore.

Cryotherapy:

In this technique freezing liquid nitrogen , is sprayed onto the wart, destroying the cells. Freezing results in developing a blister under and around your wart. This lifts the wart away from the skin within about a week, which eventually scabs and falls off a week or so later. This treatment must be carried out by a healthcare professional. If the wart is large, this may require a local anesthetic and several sessions. This can be a bit painful, but usually works well. Dimethyl-ether or propane spray for self-administration is available as over-the-counter products. But, these should not be used on the face, and they are less effective than cryotherapy that is done by a dermatologist.

Surgery:

Surgery is considered as an option only if a wart has not responded to other treatments. Your doctor can cut away your wart with a surgical knife or shaved off with a surgical razor or burn it with electricity under local anesthesia. Shot of anesthetic can be painful. Surgery may also cause scarring. Applying a topical cream to the site even after the removal of the wart is recommended to improve the chances of it clearing.
Laser treatment uses a precise laser beam to destroy the wart. Unless warts are very large and uncomfortable, surgical removal or aggressive laser surgery to remove the warts is generally avoided because of the likelihood of scarring.   

Cantharidin:

In this method a substance containing an extract from an insect called a blister beetle and other chemicals are applied to the warts by a doctor. The area is then covered with a bandage. This is painless, but it creates a blister that may be uncomfortable. The blister lifts the wart from the skin, and the dead part of the wart will be removed by the doctor.

Duct tape:

In this method the warts can be covered with duct tape or other nonporous tape, such as electrical tape. The tape must be left in place all the time and removed only a few hours once per week and should be replaced frequently.
These treatment  are used for common warts and does not apply to venereal or genital warts.

Other treatments:

If warts do not respond to standard treatments, a dermatologist or skin specialist, may recommend other options which include:

  • Candida antigen shots can be given as an immunotherapy attempt to make the patient's immune system destroy the warts. Usually the human immune system is not able to recognize a wart. But if the system is stimulated locally, some activated immune cells in the area will recognize it and fight against it. This procedure leaves no scarring. This treatment may not be suitable during pregnancy.
  • Bleomycin, or Blenoxane, can be injected into the wart to kill the virus. Bleomycin is also used for treating some types of cancer.
  • Retinoids, derived from vitamin A, disrupt the skin cell growth of wart.
  • Antibiotics are only effective in the case of infection.

Common warts, especially around the fingernails and toenails, may be difficult to eliminate completely or permanently. Mosaic warts which are tiny warts can proliferate by the dozens or hundreds all over the sole of the foot. Usually they do not hurt or cause any pain, but they rarely respond to any sort of treatment.
Warts may recur if the wart is gone but the virus remains. Flat warts are common example of recurrence.
It require medical attention if the wart:

  • causes pain
  • bleeds easily
  • changes appearance
  • spreads easily to other parts of the body
  • comes back after prior removal
  • appears in an area that leads to constant bumping and bleeding so as to affect daily activities, such as shaving, sports, and so on

Individuals who want the wart removed for cosmetic reasons should consult a dermatologist.

Things to remember while treating a wart:

  • You can spread warts to other parts of your body, and they are contagious to others. If a treatment requires that you rub the wart with a fingernail file or a pumice stone, don't use that on any other part of your body, and don't allow anyone else to use it.
  • Don't try to treat warts on your feet if you have diabetes. See your doctor. Diabetes can cause loss of sensation in your feet, so you can easily injure yourself without realizing it.
  • Don't try to remove warts on your face or another sensitive part of your body, such as your genitals, mouth, or nostrils with home treatments.

Prevention of Wart:

There are several ways to reduce the risk of catching or spreading warts. The following guideline should be kept in mind when you already have one.

  • Do not touch warts of other people.
  • Do not use towels, washcloths, or other personal items of anyone else.
  • Do not share shoes and socks with others.
  • Do not scratch warts or verrucae, as this can cause them to spread.
  • Wear sandals when entering and exiting communal showers and pools.
  • Cover warts or verrucae with a waterproof covering when swimming, and socks or gloves elsewhere, for example at the gym.
  • Do not brush, comb, shave, or clip hair in areas that have warts.
  • When filing or cutting nails do not use the same nail cutter on the infected nail and the healthy nails.
  • Do not bite fingernails if warts are near them.
  • Keep hands as dry as possible.
  • Wash hands thoroughly after touching a wart.