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Warts

What are warts?

Most people have had a wart on their body somewhere at some time in their life. Warts are harmless, but most people don’t like the way they look.  Warts are extra layers of skin caused by the human papilloma virus (HPV) family. The virus is spread by skin-to-skin contact and close physical contact in places such as public showers and pools. Only certain types of HPV cause genital warts and cervical problems. There are more than 100 specific types of HPV; most of them cause the harmless but unsightly warts on other (non-genital) parts of the body.

What are the different types of warts?

  • Common warts: Where: Usually on fingers, hands, knees and elbows. What they look like: small hard bumps, darker than other skin, top is rough like cauliflower with black or red-brown dots inside.
  • Plantar warts: Where: on the bottom (plantar) surface of the foot. What they look like: might appear to be a callous, but grow larger than normal and eventually feel similar to walking on small rocks. Looks like a common wart.
  • Filiform warts: Where: often on eyelids, nose or around the mouth. What they look like: finger-like in shape, skin-colored.
  • Flat warts: Where: in groups on arms, hands, knees, abdomen or back. What they look like: pinhead sized; flat topped; smoother surface (than other warts); pink, tan or yellow in color.

How can warts be prevented?
Warts are caused by infection with HPV. Wearing flip-flops in the shower or at public pools can help decrease the risk of contact with the virus. Ragged cuticles from dry skin, nail biting or small cuts on  hands and feet allow the virus a way into the body. Skin usually acts as a barrier, although genital strains of HPV can be spread by skin-to-skin contact. Keeping feet clean and dry also helps because the virus grows in a moist environment.

How long does it take before warts appear after exposure to the virus?
Depending on the health of the immune system that helps fight disease, a person may or may not develop a wart after exposure to HPV. Warts grow slowly, often taking weeks or months to grow to a noticeable size. Most people have been exposed to many of the HPV family in childhood. Sometimes the stresses of college suppress the immune system’s ability to keep the virus under control, and a wart may develop many years after initial exposure to the virus.

What are those little black dots in the wart? Are they the seeds of the wart?
There are many myths about warts; this is one of them. Since the wart is caused by a virus, digging out the black dots in the bottom will only cause injury. The black or red-brown dots are smothered capillaries (the tiny blood vessels that turn  fingertips back to pink after pressure is applied). As the wart virus causes layers of extra skin to pile up, the capillaries get “smothered” and die, leaving the black dots.

They are still irritating and not cosmetically appealing. About 25% of warts will go away  on their own in 12-24 months, most in 2-3 years. If you are impatient, or they are uncomfortable, there are many ways to treat them. There is about a 30% rate of treatment failure with any type of  treatment. Treatment causes surface irritation to the skin to stimulate an immune system response to the virus that is causing the wart. Maintaining general good health helps the immune system to function better.

Over the counter treatments containing salicylic acid (Compound W, etc.), when used properly, can be effective. Soaking the wart area in warm water for 10 minutes before treatment and using a pumice stone or nail file to remove the excess rough skin allows the medication to be more effectively absorbed.

Covering a wart with a small piece of duct tape may help get rid of it although this can take up to 6 weeks. There is lack of agreement about the efficacy of duct tape in the limited studies that have been done.

Office therapies: Cryotherapy (freezing the wart with liquid nitrogen) typically takes two to four treatments which are administered every one to three weeks. Treatments may cause some discomfort but are not usually painful. Some dermatologists use laser therapy.

In some cases the wart may be cut out--this is a more drastic treatment and leaves a scar. Some warts are resistant to treatment, and no treatment at this time kills the virus that causes common and plantar warts.

If you’re not sure whether you have a wart or some other skin problem, it’s always a good idea to ask your health care provider for an expert opinion.

You can search the “Up to Date” resource on our website to see pictures of warts.

For further questions or for wart treatment, please make an appointment with an IU Health Center provider by calling 855-7688.  For questions about genital warts and HPV as it relates to sexually transmitted infections, see http://healthcenter.indiana.edu/answers/hpv.shtml