Warts are raised bumps on the skin caused by the human papillomavirus (HPV). Warts have plagued humans for thousands of years — they have been discovered on a 3,000-year-old mummy and were mentioned by Shakespeare. Although warts generally aren’t dangerous, they can be uncomfortable, potentially embarrassing, and contagious. They can also be painful. However, warts can be treated, either at home or by a medical professional.
CAUSES
There are more than 100 types of HPV, the virus that causes warts. Almost all types of HPV cause relatively harmless warts that appear on the hands or feet.
However, there are a few strains of HPV that cause warts on, in, and around the genitals. These warts are called “genital warts.” If you have a cervix, genital warts can eventually lead to cervical cancer, a potentially fatal disease.
TYPES OF WARTS
There are five major types of warts. Each type appears on a different part of the body and has a distinct appearance.
1. Common warts
Common warts can develop on the palm of the hand. Common warts usually grow on the backs of the fingers and toes and on the knees. But they can appear elsewhere. They can have a rough, thick, grainy appearance and a rounded top. They may appear cauliflower-like. Common warts are often grayer than the surrounding skin. These warts are usually not serious or painful and can go away on their own.
Signs and symptoms of common warts can include:
• Small bumps that can be hard, rough, and grainy
• Flesh-colored bumps with small black spots of clotted blood vessels
• Ability to spread to other areas through direct contact
2. Plantar warts
Plantar warts occur on the sole of the foot. Unlike other warts, plantar warts grow into the skin, not out of it. It appears as a small hole in the bottom of the foot that is surrounded by hardened skin. Plantar warts can make walking uncomfortable.
There are two types of plantar warts that can appear on the sole of the foot.
• Myrmecial-type plantar warts
These warts are caused by HPV type 1. Signs and symptoms can include:
• Deep, tender warts that grow inward due to standing or walking
• Pain with direct pressure
• Feeling like stepping on pebbles
• Yellowish skin that appears callus-like
• Can have black dots
• Mosaic-type plantar warts
These warts are caused by HPV type 2. Signs and symptoms can include:
• Small surface-level warts
• A mosaic pattern of multiple warts appearing in clusters
• Less painful than myrmecial-type plantar warts
3. Flat warts
Flat warts can develop on fingers. Flat warts, also known as juvenile warts, usually grow on the face, thighs, or arms. They are often caused by HPV types 3, 10, and 28. They are small and not immediately noticeable. Flat warts have a flat top as if they’ve been scrapped. They can be fresh-colored, pink, brownish, or slightly yellow. Flat warts are not typically painful and tend to appear in areas where there is a cut or break in the skin, such as from shaving the face or legs.
Signs and symptoms of flat warts can include:
• Small flat, round, or oval marks on the skin
• Flesh-colored marks
• Usually not painful
4. Filiform warts
Filiform warts can occur on the eyelid, around the mouth or nose, and sometimes on the neck or under the chin. They are contagious and can also spread to other parts of the body. Filiform warts are small and shaped like a tiny flap or tag of skin. They can project off the skin is thin, finger-like strands.
Filiform warts are the same color as skin. They are typically painless unless they occur in a sensitive area like a fold in the skin.
Signs and symptoms of filiform warts can include:
• Small growth that extends off the skin
• Flesh-colored flap
• Quick growth
• Usually not painful
5. Periungual warts
Periungual warts occur around fingernails or toenails. They can be painful and affect nail growth. They start small — about the size of a pinprick — but can grow larger and spread to other areas through direct contact. They may be rough to touch and have a cauliflower-like appearance.
Signs and symptoms of periungual warts can include:
• Rough growth around or under the nail
• Painful when size increases
• Split skin around the nail
• The appearance of nails and cuticle may be affected
TREATMENT
• At-home treatment
Although warts usually go away on their own, they may be embarrassing or uncomfortable. Many warts respond well to treatments available at the drugstore.
• Freezing treatments
Some over-the-counter treatments spray concentrated cold air (a mixture of dimethyl ether and propane) onto the wart. This kills the skin and allows people to scrape away the surface of the wart. These treatments are a good choice when trying to remove a wart quickly, but they aren’t strong enough to remove all warts.
• Treatments and patches containing salicylic acid
These products may be used every day, often for a few weeks. They’ll work best if by soak the wart in water for about 15 minutes before applying the treatment and follow the directions on the package.
• Duct tape
Some people have had success treating warts with duct tape. The process involves:
• Covering the wart with a small piece of duct tape for several days
• Soaking the wart
• Rubbing the wart to remove the dead skin
This approach can take several rounds of treatments to work. However, according to the American Academy of Dermatology (AAD), research conflicts on whether this approach is effective.
Medical Treatment
• Liquid nitrogen
Freezing the wart with liquid nitrogen. This can be a bit painful but usually works well. More than one treatment may be required. Freezing causes a blister to form under and around the wart. This lifts the wart away from the skin within about a week.
• Surgery
Surgery is usually only considered if a wart hasn’t responded to other treatments. This is done by cutting away the wart with a surgical knife or burning it with electricity. Surgery may also cause scarring.
Prevention
There are ways to prevent warts or keep them from spreading to other parts of the body. Follow these simple guidelines:
• Wash the hands regularly
• Don’t pick at warts.
• Cover warts with a bandage.
• Keep the hands and feet dry.
• Wear shower shoes (flip-flops) when in a locker room or communal bathing facility.
Warts generally aren’t dangerous, but they can be uncomfortable and sometimes painful. Many types respond to over-the-counter treatment, but it is best to make an appointment with a doctor if the wart changes in color, becomes painful, or if it is suspect the wart may not be a wart. Warts are contagious.
