Warts

What are warts?

Warts are among the most common skin complaints. Warts are caused by the human papilloma viruses (HPV), of which at least 60 types are known. Common warts can appear anywhere on the body, but are most commonly found on the hands, fingers, elbows, forearms, knees, face and the skin around the nails. Warts may appear singly or in clusters and are benign. Common warts may be flat or raised, dry or moist, and have a rough and pitted surface that is usually the same colour as the surrounding skin. They can vary in size from as small as a pin head to as large as a small bean.

What causes warts?

Warts are caused when HPV enters the skin through a cut or scratch and then causes the cells to multiply rapidly. Usually, warts spread through direct contact, exposure to friction, trauma or abrasion, but the virus may also be spread in moist environments, such as showers and sports change rooms. They may be spread to other parts of the body by touching them or shaving around infected areas.

Living with warts

Warts are not usually a problem unless they itch or are in a place where they are frequently knocked or cause cosmetic concern. Some warts persist for years but most go away eventually. It is thought that children and young adults may be more prone to getting warts because their immune defence mechanisms may not be fully developed, but it is possible to get a wart at any age.

Warts do not lead to skin cancer. However, some flat, brownish wart-like spots may not actually be warts but melanomas and should be checked by your doctor. If a wart changes shape or colour, bleeds, or is painful, consult your doctor. If you are unsure whether you have warts, consult your doctor.

Treatment for warts

The best treatment for warts is often no treatment at all. Most people will develop an immune response and this will cause the warts to go away themselves. However, if they do not go away, or are unsightly or uncomfortable, you may want to have them removed. There are a number of medicines available from your pharmacy that can be applied to soften the abnormal skin of the wart and then dissolve it. Your doctor can also remove warts by freezing or burning them off.

Types of warts

  • 'Common warts’ are the most common and are small, hard, rough lumps that are generally round and elevated. They generally appear on the hands and fingers and are skin coloured. However, they may also be white or pink and smooth or granulated.
  • Digitate or filiform warts are thin and threadlike. These most commonly appear on the face and neck.
  • Flat, or plane, warts appear in groups, and it’s possible to have up to several hundred in a cluster. These are usually found on the face, neck, chest, knees, hands and wrists or forearms. They have a slightly raised appearance with smooth, flat or rounded tops.
  • Plantar warts are small, bumpy growths that appear on the soles of the feet, and can vary in size from 5 mm to 5 cm in diameter. They sometimes have small black dots on the surface.
  • Periungual warts are rough, irregular and elevated in appearance. They are generally found on the edges of fingernails and toenails and may extend under the nails and can cause pain.
  • Genital warts are small flesh-coloured or greyish white growths that appear on the vulva, anus, or penis and have a cauliflower-like appearance. They may appear in clusters as well as singly. They are sexually transmitted and highly contagious. They can be treated with medicines, freezing, burning or surgery. Certain types of HPV are associated with genital cancer, including cervical cancer, so regular cervical cancer screening tests are advisable for women. HPV tests have replaced Pap tests for cervical cancer screening.

References

1. Therapeutic Guidelines. Human papillomavirus (warts) (revised February 2009). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 July. Available from: http://online.tg.org.au/complete/tgc.htm# (accessed 9 September 2012).
2. DermNet NZ. Viral warts (revised 12 August 2012). New Zealand Dermatological Society, 2012. Available from: http://www.dermnetnz.org/viral/viral-warts.html (accessed 9 September 2012).
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