Warts are benign skin growths that appear when a human papillomavirus (HPV) infects the top layer of the skin. Warts are not cancerous, but they are contagious, and can spread by contact with the wart or with something that touched the wart. Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth.
Signs & Symptoms
There are a few different types of warts, depending on where it grows on the body and what it looks like. The following describes the signs and symptoms for some of the different types of warts.
Common warts (verruca vulgaris) have these traits:
- Grow most often on the fingers, around the nails, and on the backs of the hands.
- Are more common in broken skin from biting fingernails or picking at hangnails.
- Can have black dots that look like seeds (often called “seed” warts).
- Most often feel like rough bumps.
Foot warts (plantar warts) have these traits:
- Grow most often on the soles (plantar surface) of the feet.
- Can grow in clusters (mosaic warts).
- Often are flat or grow inward.
- Can hurt and feel as if you have pebbles in your shoe.
- Can have black dots.
Flat warts have these traits:
- Can occur anywhere on the body, but are especially common on the face in children, on the beard area in men, and on the legs in women.
- Are smaller and smoother than other warts.
- Tend to grow in large numbers — 20 to 100 at a time.
Filiform warts have these traits:
- Looks like long threads or thin fingers that stick out.
- Often grows on the face: around the mouth, eyes, and nose.
- Often grow quickly.
Who gets warts?
Anyone can get warts, but some people are more prone to getting the HPV virus than others, such as:
- Children and teens.
- People who have broken skin from biting their nails or picking at hangnails.
- People with a weakened immune system (the body’s defense system).
Children who have warts often see them go away without treatment, but a dermatologist should treat warts that are painful or bothersome.
What causes warts?
Viruses called human papillomavirus (HPV) cause warts. It is easier to catch the HPV virus when you have a cut or scrape on your skin. Warts also are more common on parts of the body that people shave, such as the beard area in men and the legs in women.
Warts can spread from person to person. You can get warts from touching a wart on someone’s body or from touching something that was in contact with the wart, such as a towel. It often takes a few months for warts to grow large enough to see.
Diagnosis & Treatment
How do dermatologists diagnose warts?
A dermatologist can usually tell whether you have a wart by looking at it. Rarely, a skin biopsy may be necessary to look for something more serious, such as skin cancer. If a dermatologist needs to perform a biopsy, the wart will be removed and sent to a lab for evaluation under a microscope. A skin biopsy is a safe and quick procedure that is easily performed in the office. It helps your dermatologist determine what type of treatment is needed.
How do dermatologists treat warts?
Treatments for warts vary depending on the patient’s age and the type of wart:
- Cantharidin: Your dermatologist may treat a wart in the office by “painting” it with Cantharidin. Cantharidin causes a blister to form under the wart and kills it. This is a painless procedure.
- Cryotherapy: For common warts in adults and older children, cryotherapy (freezing) is the most common treatment. This treatment is not too painful and may require multiple treatments. It can cause dark spots in people who have dark skin.
- Electrosurgery and curettage: Electrosurgery (burning) is a good treatment for common warts, filiform warts, and foot warts. Curettage involves scraping off the wart with a sharp tool. These are often used together as the same treatment.
- Excision: The dermatologist may cut out, or excise the wart.
If the above treatments do not fully remove warts, then further treatment will be needed:
- Laser treatment: Laser treatment is an option, primarily for warts that have not responded to other therapies.
- Chemical peels: When flat warts appear, dermatologists often prescribe “peeling” methods to treat these warts. This means you will apply a peeling medicine at home every day that contains salicylic acid, tretinoin, glycolic acid, or a combination.
- Bleomycin: The dermatologist may inject each wart with an anti-cancer medicine, bleomycin. The shots may hurt and can have other side effects, such as nail loss if given in the fingers.
- Immunotherapy: This treatment uses the patient’s own immune system to fight warts. This treatment is used when warts remain despite other treatments.
There is no cure for warts and they can return at any time. Sometimes, even old warts that were removed will still leave behind virus cells in the skin, causing new warts to develop. The best advice is to contact your dermatologist as soon as there are signs of new warts growing.
To prevent warts from spreading, dermatologists recommend the following:
- Do not pick or scratch at warts.
- Wear flip-flops or pool shoes in public showers, locker rooms, and pool areas.
- Do not touch someone’s wart.
- Keep foot warts dry, as moisture tends to allow warts to spread.
These services may need to be repeated frequently. To slow down the growth of the HPV virus, it may be necessary to schedule repeat visits with your dermatologist.
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