Warts
 

1. What are warts?
Warts are skin growths caused by a viral infection in the top layer of the skin or mucous membranes. The appearance of a wart depends on where it is growing.

2. How many kinds of warts are there?
There are several different kinds of warts including:

  • Common warts
  • Plantar warts
  • Flat warts
  • Genital warts

Common warts usually grow around the nails, on the fingers and on the backs of the hands.

Plantar warts grow on the bottom (plantar surface) of the feet. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Plantar warts have a bad reputation because they can be deep and painful, feeling like a stone in the shoe.

Flat warts are smaller and smoother than other warts. They tend to grow in great numbers, 20 to 100 at any one time. In adults they are often found in the beard area in men and on the legs in women.

Genital warts look different than other warts because of their location. These warts tend to be small and flat but can be thin and tall. These are soft and are not rough or scaly like other warts. Certain genital warts have been linked to cancer of the genital area.

3. How do you get warts?
Warts probably are passed from person to person. The risk of catching hand, foot and flat warts is small. Genital warts seem to be more contagious. It is important to use precautions to limit the spread of genital warts to one’s sexual partner.

4. Why do some people get warts and others don’t?
Some people are just more likely to catch the wart virus than are others, just as some people catch colds very easily. Wart viruses enter the skin more easily if cuts, cracks or hangnails have damaged the skin.

5. Do warts need to be treated?
In children, warts often disappear without treatment after several months to years. However, since warts can be spread to others and can be spread to new areas, it is reasonable to treat most children, especially if the warts are painful.

Warts in adults often do not disappear as easily or as quickly as they do in children. There is increased possibility of skin cancer at the site of long-standing genital warts. Women with genital warts also have an increased risk of cervical cancer. Women should have regular PAP tests, even after treatment. All adults with genital warts should be treated.

6. How do dermatologists treat warts?
Common warts in young children can be treated at home by their parents on a daily basis by painting on a low strength salicylic acid. There is usually little discomfort but it can take many weeks of treatment. Frequent "painting" with cantharidin in the dermatologist’s office causes a blister to form under the wart.

For adults and older children cryotherapy (freezing) is generally preferred. This treatment is not too painful and rarely results in scarring. However, repeat treatments at one to three-week intervals are often necessary.

Plantar warts are difficult to treat because the bulk of the wart lies below the skin surface. Treatments include the use of salicylic acid plasters, applying other chemicals to the wart, or one of the surgical treatments including cryotherapy or laser surgery.

Flat warts are often too numerous to treat with methods mentioned above. As a result, "peeling" methods using daily applications of salicylic acid, tretinoin or other surface peeling preparations are often recommended.

Genital warts are perhaps the most difficult to treat. First, all warts must be located. This may require an examination of the vagina and cervix in women and the rectum in both sexes. Periodic office treatments with acids and freezing may be needed to get rid of the visible warts. Genital warts can be very difficult to cure. The dermatologist may prescribe a form of podophyllin that can be used at home. Recently topical immunotherapy has become available. With very stubborn or very large genital warts, surgical removal may be needed. The patient’s sexual partner should also be examined for warts by a dermatologist.

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