What Are Warts?

Warts are a skin growth that occur as a result of the human papillomavirus (HPV) infecting the skin. The growths are non cancerous but are contagious by contact with the wart or something that came into contact with the wart. While warts can appear all over the body, warts most commonly grow on the hands and feet. The wart itself tends to be small, grainy, and rough to the touch. 

There are many kinds of warts a person can develop, and each type of wart has its own characteristics. Knowing the symptoms and causes of each type can help you determine which kind you may have. Since warts can be uncomfortable, many people seek treatments to help the warts go away and manage the effects.   

What Causes Warts?

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The root cause of warts is exposure to the human papillomavirus (HPV). HPV infects the body through a cut or opening in the skin or through skin-to-skin contact with the virus. The HPV family of viruses includes more than 100 types of HPV, but only some types of HPV cause warts. When the virus spreads through direct contact with a wart, indirect contact with contaminated items like towels, or a break in the skin, the virus can live in the body for some time before developing into a visible wart on the skin. 

The most common sources of an HPV infection that lead to warts and the spreading of warts are the following:

  • Contaminated towels or shoes
  • Areas surrounding swimming pools and communal changing areas 
  • Hangnails and biting nails 
  • Shaving 
  • Biting or scratching warts

What Are Symptoms of the Main Types of Warts?

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Since there are different types of warts, it is good to know symptoms of each kind to help determine which kind of wart you have. 

Common. Common warts are small, grainy bumps that appear primarily on the hands, toes, and knees. These warts spread easily and will go away on their own in most cases. 

Plantar. Plantar warts are warts that grow into the skin of your feet. You will notice hardened skin and small holes in the skin. You can distinguish between mosaic-type and myrmecia-type warts by their appearance and pain level. 

Flat. Flat warts grow in large groups and have the appearance of a flat, oval mark on the skin. This type of wart is common in children. 

Filiform. Filiform warts grow mostly on the face and appear like a flap of skin projecting from the face. Usually, filiform warts are not painful and grow quickly. 

Periungual. This type of wart grows under fingernails and toenails. Periungual warts start small but grow quickly and can impact healthy nail growth. These warts can be very painful, especially when the nail becomes surrounded by warts.

Are There Any Risk Factors or Groups for Warts?

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Warts are very common, and anyone can have warts. There are no particular conditions or other genetic factors that predispose a person to warts. Those who are at a higher risk of developing warts are children and teens as well as people with weakened immune systems. Since an HPV infection causes warts, people with compromised immune systems are at a higher risk because their body can not as readily fight off that infection as others may be. However, even people with strong immune systems can develop warts. For the same reason, people who have had organ transplants have a higher risk factor. 

Children and teens are at a higher risk of developing warts because of their susceptibility to cuts in the skin and poor hygiene behaviors. In addition, younger people are still building their immunity to infections as they grow, making warts very common for this age group. 

These activities and factors contribute to the likelihood of warts:

  • Nail biting
  • Swimming in public pools
  • Skin injuries and skin infections 
  • Constantly wet hands or feet (hyperhidrosis)
  • Scratching or shaving pre-existing warts 

How Are Warts Diagnosed?

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In most cases, a doctor will be able to diagnose warts by sight. Doctors will examine the warts and determine the type of wart based on the visual characteristics and the location of the warts. If the doctor is unsure if a growth is a wart, they may scrap off the top layer of the wart to see if the growth has dark, pinpoint dots. The dots are clotted blood vessels and are a common occurrence with warts, which can help the doctor confirm the diagnosis. 

Doctors will only perform a biopsy in rare cases. For a biopsy, the doctor will remove either a small section or the entire wart to send to a laboratory for closer analysis. This process helps the doctor test the wart for HPV and to rule out other skin growths. 

How Are Warts Treated?

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There are many treatment options to remove warts and many warts go away on their own without treatment. The right treatment plan depends on the type of wart and the main goal of treatment. Some people choose to utilize home treatment options to manage the symptoms on their own while others go to the doctor for prescription-strength medication or in-office procedures. 

At-Home Treatments 

  • Freezing treatments: One of the most common at-home treatments is over-the-counter wart removal products that work to dissolve warts. Salicylic acid is the active dissolving agent in these products. You can typically find these products at the drug store in liquid, gel, or patch form. 
  • Duct tape: Especially for children with warts, duct tape can be an effective home treatment for warts. Parents can apply a piece of duct tape directly on their child’s wart(s) and change the duct tape after about a week, making sure to thoroughly clean the wart of any dead skin or debris with a new, disposable emery board each time and reapply duct tape after 12 hours. This method works by using the adhesive nature of duct tape to remove layers of the wart over time. 

It is important to note that at-home treatments may not be effective for everyone. Do not use these treatments on warts in sensitive areas, like the face, mouth, or genitals. In addition, people with warts who are diabetic should consult with a doctor before attempting home treatments, as impacted nerves in the hands and feet could lead to injury. Proper hygiene is essential with home treatments, so be sure to dispose of any tools such as emery boards or razors after each use to prevent the warts from spreading.

Treatments from the Doctor

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Wart treatment aims to remove and destroy the wart or enable the immune system to fight the wart. Even with prolonged treatment, warts can still spread or recur. Because of the tendency for warts to resist at-home remedies, your doctor may recommend a stronger treatment since warts can spread, be painful, and can cause embarrassment. 

Doctors use each of the following approaches to treat warts depending on the patient’s status and needs. 

  • Freezing: Using cryotherapy, doctors apply liquid nitrogen to the wart to create a blister around the wart. The wart tissue will die and then fall off after about a week. Freezing the wart can be painful and is typically reserved for treating adults. 
  • Acids: Doctors can prescribe stronger medications with salicylic acid that work to dissolve layers of the warts. If ineffective alone, doctors may combine salicylic acid with freezing treatments. 
  • Laser: Laser therapy works by burning the blood vessels in the wart to cut off blood supply, causing the wart to die and fall off over time. The laser treatments can leave behind scars in the affected area. 

Should You See a Doctor for Warts?

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Warts often go away on their own. So if your warts go away, you do not need to see a doctor. You should see a doctor for warts if the warts are persistent and numerous, the warts are painful, or if the warts bother you cosmetically. 

Some cases of warts warrant attention from a doctor when you notice them. People who have warts on the face or other sensitive part of the body should seek specialized wart treatment for these areas. Warts have the potential to become infected, so if you notice signs of infection like pus or scabbing you should seek medical attention. Finally, people with diabetes or other immune deficiency who develop warts should consult with their doctor for a safe treatment option.  

What Is the Outlook for People Living with Warts?

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The outlook for people living with warts is positive. Warts are generally harmless and go away with time. People may find warts annoying or displeasing aesthetic-wise, but with good hygiene and proper care, warts are easy to manage. It is especially important to clean your hands often and sanitize any tool or towel that comes into contact with warts to prevent new warts from forming. Exposure to some types of HPV can increase a person’s risk of developing cancer, but your doctor can talk with you about your risk and if your case of warts puts you at risk.