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Warts

By Apollo 24|7, Published on- 22 November 2022 & Updated on -

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  • Symptoms: Small, grainy and fleshy bumps, rough to touch, tiny black pinpoints which are blood clots
  • Causes: Human papillomavirus (HPV), spread by skin contact, shared objects, sexual contact, etc.
  • Risk Factors: Young children and adults, individuals with weak immune systems such as organ donors and HIV/AIDS patients
  • Severity: Mild to moderate (dependent on the type of wart, symptoms, and health of the person)
  • Which doctor to consult: Dermatologists

Overview

Warts are rough skin growth that feels like tiny grains and usually grows on the fingers, legs and hands. They also feature small black dots, which basically are clotted blood vessels.

Common warts are caused by human papillomavirus, or HPV, which spreads via human touch. The HPV virus triggers excessive cell growth, which causes the skin to become stiff and thick in a particular spot.

It may take 2-6 months to develop if your skin is exposed to the virus. Generally, these are non-cancerous and harmless and disappear after a while on their own.

That said, not everyone exposed to the virus is prone to warts. Only individuals with weakened immune systems usually become the victim of warts. Or, if someone has any skin damage or cuts, then the virus might attack him/her easily. Perhaps this is why people with chronic skin conditions like eczema are at higher risk of warts.

When to consult a doctor?

An individual must see a dermatologist for common warts situations if:

  • Several warts begin to show up on the skin which might serve as an indication of poor functioning of the immune system
  • One is unsure whether the skin growths are warts or not
  • An individual has skin growth or warts on his/her face or other sensitive body parts like genitals, nostrils or mouth
  • An individual observes any pus or scabbing or signs of bleeding around the wart
  • The warts are hampering a person’s day-to-day life and general activities
  • Home remedies are not helping at all
  • Even after managing and treating warts, these continue to persist and recur
  • An individual has diabetes or any other autoimmune diseases that would point to a weak immune system
  • The warts are painful and keep changing their colour and appearance

Diagnosis

  • Physical examination: A dermatologist or general physician will conduct a quick physical exam to diagnose warts. The doctor will distinguish warts from other conditions like calluses, moles, skin tags, corns or cancer.
  • Diagnostic tests:

  1. Lab tests: Women with genital warts should go for a pap smear or pap test. The sample of cells are collected from the cervix with a small brush. It's then sent for a lab examination to determine any abnormalities. The doctor may also recommend an HPV test. A small sample is taken from a relevant site and undergoes a PCR method to confirm whether it's a particularly low-risk or high-risk virus. A DNA test is also helpful in recognising if a person has strains of the high-risk HPV virus which may lead to genital cancer. For men, a wart sample is taken from the anus, urethra or any other visible wart site.
  2. Advanced tests: Sometimes, for proper diagnosis, the doctor might also conduct a biopsy wherein a tiny tissue sample is taken. It is to determine if the genital wart has an infection that may turn cancerous or not. 

Treatment

  • Home treatment: Warts generally get better with time, although it might take a few weeks or months. If a person doesn't want to spend money on expensive and conventional treatments, he/she can first give a shot at home remedies.
  1. Take a cotton ball soaked with apple cider vinegar and water and put it on the wart for 3-4 hours
  2. Tape a piece of banana peel over the wart and leave it overnight
  3. Apply aloe vera gel on the wart
  4. A layer of clear nail polish over the wart may help prevent the virus from spreading
  5. Stick duct tape on the wart for 3-6 days, then soak the wart in warm water and scrub it with a pumice stone
  6. Rub orange peel against the wart every day for 2-3 weeks
  7. Give a rub down on the warts with crushed garlic
  • Medications: The medications for warts are directly applied over the lesion and it is still advisable to take a handful of applications before it works. Here are some valuable medicines:
  1. Trichloroacetic acid helps burn off all warts on the soles, palms and genitals. It can cause some skin irritation though.
  2. Imiquimod is a cream that may boost the immune system so it can fight against HPV. It may cause some swelling and redness on the site of application.
  3. Podofilox is a topical prescription that destroys the tissues that cause genital warts. It can cause some itching and burning when applied.
  4. Salicylic acid removes the wart layers one by one. It can cause irritation and shouldn't be used on the face.
  • Surgical treatment: If the prescribed medication fails to improve the condition, doctors may suggest one of the following surgical methods to remove warts:
  1. Excision: The doctor might cut the wart out by making a small incision at the site.
  2. Laser treatment: If no other therapies are helpful, a dermatologist might opt for laser treatment. The doctor will first inject a shot of anaesthesia to numb the wart before eradicating it.
  3. Electrosurgery and curettage: Electrosurgery or burning is one of the best treatments for foot warts, common warts and filiform warts. Before electrosurgery, the doctor will scrape away the wart with a small, sharp knife or spoon. This is called curettage.
  • Alternative management: Besides all the medications, home remedies and surgical procedures, there are some alternative therapies to cure warts:
  1. Cryotherapy: This method is also known as the freezing treatment. It's not too painful and is quite a popular method for treating warts. However, it can cause some dark spots. You may need the therapy on a repeated basis.
  2. Cantharidin: In this method, a dermatologist paints the wart with cantharidin. It leads to blisters under the wart, and then within a week, the doctor clips off the dead wart.
  3. Chemical peels: If an individual has a lot of flat warts, dermatologists may suggest a peeling method. They will prescribe peeling medications like tretinoin, salicylic acid and glycolic acid. It will help peel away warts.

Risks & Complications if Left Untreated

Most warts get resolved on their own, with time. But if it doesn’t and the individual fails to avail proper treatment for the same, it may lead to the following issues:

  • Infection: If an individual cuts or picks on the wart, it may cause the wart to break open. This will allow bacteria to enter the wart and cause further infection, irritation and pain.
  • Pain: Most warts are not painful. That said, if one develops plantar warts, it might cause pain because warts begin to grow inwards in the foot. So, walking will become troublesome as the person will start feeling like there is a pebble under his/her foot.
  • Disfigurement: People with weak immunity may get unappealing wart clusters on their face, hands or body.
  • Cancer: Genital warts and HPV are closely linked to anal, throat, and cervical cancers. Always use precaution while indulging in sexual activities and get the HPV vaccine to minimise risk of genital warts.

Additional information

  • What are the different types of warts?

Warts can be categorised into 5 different types, depending on what body part it appears on and its appearance.

  1. Common warts: These usually grow on the knees, toes and back of the fingers and have a thick, rough, grain-like appearance. It may resemble a cauliflower and has a grey colour. Common warts are not painful and go away with time.
  2. Flat warts: These are also called juvenile warts and can be mainly spotted on arms, thighs and face. These are caused due to HPV types 3, 10 and 28. Flat warts look flat on the top and are usually unnoticeable. These grow in bunch of 20 to 200 and are flesh-coloured, brownish, pink or yellow in colour. These flat warts may develop if an individual has cuts on the skin.
  3. Plantar warts: These warts develop under the foot, and in the soles. Unlike other kinds of wart, this one does not grow out of the skin, instead grows inside the skin, creating a small hole with hardened skin around it. It can make an activity as simple as walking, difficult.
  4. Periungual warts: These kinds of warts grow around the fingernails and toenails and can impact nail growth. These start as small but spread due to contact and grow larger. These are also quite painful.
  5. Filiform warts: If an individual finds warts around his/her nose or mouth, under the chin and around the neck, it could be filiform warts. These are not painful but can quickly spread to other body parts due to their rapid growth. 
  • How to prevent warts?

While there is no sure-shot way to void the breakout of warts, one can certainly minimise the risk of contracting the virus by:

  1. Avoiding shaving over the warts
  2. Not sharing personal items like towels, clothing, washcloths, razors and nail clippers
  3. Making sure to use condoms to avoid genital warts
  4. Getting HPV vaccine
  5. Not scratching, picking or cutting a wart
  6. Breaking the habit of picking at cuticles or biting nails
  7. Not touching someone else’s wart
  8. Keeping the feet free of moisture to prevent plantar warts
  9. Wearing shoes or flip-flops in public pool areas, showers or locker room
  • What are the symptoms of warts in young children?

Let’s take a look at how different kinds of warts can present different symptoms in young children:

  1. Plantar warts: A group of plantar warts is known as mosaic and grows in the palms or the sole of the feet. These are sometimes really painful.
  2. Common warts: These warts have rough exteriors and look brown or greyish-yellow in colour. These may develop on the elbows, face, knees and fingers.
  3. Filiform warts: These warts look long and small with narrow growths and usually occur on lips, eyelids, neck or face.
  4. Flat warts: Flat warts are tiny and smooth and usually appear on the kids' faces.
  5. Periungual warts: If a kid has thickened skin around his/her nails, it could be periungual warts. It can lead to painful fissures or splits in the child’s skin.
     

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Frequently Asked Questions

Once an individual contracts the virus, there is no definite way of preventing warts from happening again. After the proper treatment, warts can still reappear either on a different body part or at the exact location of previous warts. Some people who get cured of warts may never get another one again.

When the HPV virus gets into a person's skin via a cut, it leads to a skin infection. These eventually turn into highly contagious warts and can spread from one body part to another and from one person to another.

Warts can quickly spread from one body part to another and even from one individual to another if there is direct contact with it. If one touches any virus-contaminated doorknobs, towels or shower floors, has intercourse with an infected person, consistently bite nails or shave skin – it may cause warts to spread.

There are 5 different types of warts, and it can impact different body parts such as hands, face, feet, genitals, subungual and periungual (around toenails and fingernails).