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Warts

Warts

Common warts are local growths in the skin that are caused by human papillomavirus (HPV) infection. Although they are considered to be contagious, it is very common for just one family member to have them. In addition, they often affect just one part of the body (such as the hands or the feet) without spreading over time to other areas.

 

What are some types of common warts?

 

  • There is the familiar type of dome-shaped warts on the backs of fingers, toes, and knees.
  • Plantar warts are found on the bottom of the foot. (The "plantar" part of the foot. These are not "Planter's warts").
  • Flat ("plane") warts may arise on the face, legs, and other parts of the body, often in large numbers.
  • Periungual warts are warts around or under the nail.
  • Filiform warts typically appear as a single long stalk, often on the face.

Symptoms

The 3 most common types of nongenital (not appearing on the genitals) warts are these:

  • Common warts (verrucae vulgaris): These common warts typically develop on the hand, especially around the nail. Common warts are gray to flesh colored, raised from the skin surface, and covered with rough, hornlike projections.
  • Plantar warts (verrucae plantaris): Plantar warts , by definition, occur on the plantar surface, or bottom, of the foot. They usually occur in high-pressure areas such as the heel and the metatarsal heads (just behind the toes).Plantar wartsusually grow into the skin, not outward like common warts. This growing into the skin makesplantar wartsmore difficult to treat.
  • Flat warts (verrucae plana): Flat warts are most commonly seen on the face and the back of the hands. They usually appear as small individual bumps about 1/4 inch across. Flat warts may spread rapidly on the face from the activities involved in shaving.

Causes

Warts are caused by the DNA-containing human papillomavirus (HPV). There are at least 63 genetically different types of HPVs.

 

  • The virus enters the skin after direct contact with recently shed viruses kept alive in warm, moist environments such as a locker room, or by direct contact with an infected person. The entry site is often an area of recent injury. The incubation time-from when the virus is contracted until a wart appears-can be 1-8 months.
  • Contrary to popular mythology, touching a frog will not give you warts.

Treatment

Self-Care at Home

 

Home care is effective in making the wart or warts go away. No matter what technique you use, warts will disappear 60-70% of the time. Techniques may be done withor without medication.

 

The ultimate goal of the medical therapies (not the surgical treatments) is to get your body to recognize the wart as something foreign and to destroy it, much like the body destroys a coldvirus.

 

  • Adhesive tape therapy 
  1. Place several layers of waterproof adhesive tape over the wart region (even duct tape). Do not remove the tape for 6 1/2 days. Then take off the tape and open the area to the air for 12 hours. Reapply tape for another 6 1/2 days. 
  2. The tape works best in the region around the fingernail. This area may scar if cryotherapy with liquid nitrogen is used. Scarring could lead to permanent nail disfiguration. 
  3. Tape works because the airtight, moist environment under the tape does not allow the virus to grow and reproduce.
  • Salicylic acid therapy 
  1. Salicylic acid is available by many different trade names at the drug store. It comes either as a liquid to paint on the wart or as a plaster to be cut out and placed on the wart tissue. 
  2. The area with the wart should be soaked in warm water for 5-10 minutes. The wart should then be pared down with a razor. A simple plastic razor works fine for this, then throw it away. Do not shave far enough to make the wart bleed. 
  3. Apply the salicylic acid preparation to the wart tissue. Do not apply it to other skin because of salicylic acid's potential to injure normal tissue. 
  4. Follow directions on the package for how long to apply the acid.
  • If you have genital warts, see a doctor. The treatments described here are not appropriate for genital warts and should not be used.

 

Medical Treatment

 

In addition to recommending the home care treatments, such as taping and salicylic acid, the doctor may typically choose to treat the wart more aggressively.

  • Liquid nitrogen: Liquid nitrogen or cryotherapy is used to deep freeze the wart tissue. With liquid nitrogen applied to the wart, the water in the cells expands, thus exploding the infected tissue. The exploded cells can no longer hide the human papillomavirus from the body's immune system. The immune system then works to destroy the virus particles.
  • Laser therapy: Lasers are simply very intense light sources. This light has an enormous amount of energy that heats the tissue enough that it vaporizes.
  • Surgical removal: Surgery may be necessary when other treatment methods fail. This would involve numbing the region around the wart and cutting out the wart.
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