Dermatology

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Warts

Overview:

A wart is a small benign (non-cancerous) skin growth that occurs due to a viral infection.
There are several types of warts that are classified according to their shape and location on the body.
Most warts are asymptomatic, unless they are on the feet, or any part of the body that is constantly touched or pressed.
Warts are usually harmless and eventually disappear on their own; however, this may take a long time.
The most significant prevention methods include avoiding direct contact with or shared objects of patients.

What is a wart?

A wart is a small benign (non-cancerous) skin growth that occurs due to a dermal viral infection. It is often rough and skin-colored. It also can be darker than the color of the skin (brown or almost black), flat and smooth.
A wart can occur on any part of the body, especially in warm and moist areas, such as small wounds on the fingers, hands and feet.

Other Names:

Common warts, plantar warts, flat warts, periungual warts

Difference between a wart and a boil:

A wart occurs due to a viral infection, while a boil is caused by a bacterial infection. See: Boils.

Types:

There are several types of warts that are classified according to their shape and location on the body:

Common warts.
Plantar warts.
Flat warts.
Genital warts.

Some warts are sexually transmitted and occur in the genital areas; however, most of warts appear on fingers, hands and feet.

Causes:

Warts occur due to infection with human papillomavirus (HPV).

Transmission:

Touching an infected person's wart does not necessarily lead to infection; however, the virus generally can be transmitted from one person to another via direct contact, or by touching the surface that has been exposed to another person's wart, such as the shower floor.
Minor wounds are more prone to warts, such as nibbled skin around fingernails, scrapes and the skin around them, shaving areas such as men’s beards and women’s legs. In addition, warts can spread from one body part to another in the same person.

Incubation period:

It can take a wart as long as several weeks or more to develop and appear clearly on the skin after exposure to the virus.

Symptoms:

Most warts are asymptomatic, unless they are on the feet, or any part of the body that is constantly touched or pressed. Symptoms differ according to the type of the wart:

Common warts:

Common warts occur most often on fingers, hands and around fingernails, especially in skin that has been broken such as nibbled skin after biting fingernails.
They are small, grainy, rough to touch and grayish brown in color.
Their surface is rough and may have a cauliflower-like appearance with black dots inside.

Plantar warts:

Plantar warts usually appear on the bottom of the feet.
They occur in clusters or a group of warts in one area.
They may be flat or grow inward beneath a hard, thick layer of skin, due to the pressure caused by walking.
When walking, you feel uncomfortable as if you were walking on small pebbles or having pebbles inside your shoes.
They may contain black pinpoints.

Flat warts:

Flat warts may appear on any part of the body. They generally occur on the face of children. In adults they occur in shaving areas such as men’s beards and women’s legs.
They are as small as a pinhead. They are even smaller and smoother than other warts and have flat heads.
They may be pink, light brown or yellow in color.
They appear as clusters in large numbers, ranging from 20 to 100 warts at the same time.

Genital warts:

They look like a long thread of intertwining pointed heads.
They are often reddish pink in color.
In most cases, they develop in or around the mouth or on the eyes or nose.
They often grow rapidly.

When to see a doctor?

It is advisable to see a doctor in the following cases:

Growth of a strange mass on the surface of the skin.
You've tried treating the warts, but they persist, spread or recur.
The warts are large and painful.
The wart bleeds or changes in appearance.
The growth of warts on the face or in the genital area.
The warts are numerous.
The immune system is malfunctioning, as in persons with HIV/AIDS.
Diabetic persons should never mess with plantar warts.

Children:

Before attempting to remove a wart with an over-the-counter medication, see a doctor if:

The wart appears on any part of the body of a newborn.
The child developed a wart on the face, genital area, or anus.

The doctor should also be seen if the wart is growing rapidly, or if the skin around the wart is:

Painful.
Flesh-colored.
Bleeding.
Swelling.
Producing pus.

Diagnosis:

The doctor can distinguish a wart with an abstract look; however, in some rare cases he/she may need to scrap off the top layer of the skin to check whether it is a wart.

Who is at risk?

All people are susceptible to developing warts, but some categories are more susceptible than others, including:

Children and young adults.
People who constantly bite their nails or exfoliate the skin around them.
People with weakened immune systems.

Complications:

Self-confidence may be affected if the wart is large and affects the outer appearance.
Warts are often harmless to those with strong immune systems. In addition, they rarely turn into malignant tumors, unless the patient’s immune system is weak.

Treatment:

Most warts do not cause any other problems and go away without treatment, though this may take several months to two years. However, warts can be removed with the following methods:

Cantharidin treatment: The dermatologist may apply such substance to the wart, causing a blister to form underneath. After nearly a week, the doctor removes the dead wart.
Freezing (cryotherapy).
Surgery using an electric needle (electrodesiccation and curettage)

If warts are difficult to treat, the dermatologist may resort to one of the following methods:

Laser treatment.
Stronger peeling medicine (salicylic acid).
Bleomycin treatment.
Immune therapy.

Post-treatment:

There is no cure for the virus that causes warts, which means it may reappear in the same area that was previously infected. Therefore, a wart should be treated immediately after it reappears.

Methods to prevent the spread of warts:

Wash your hands thoroughly after touching a wart.
Change socks daily if you have plantar warts.
A person with warts should not walk barefoot in public places.
Warts should be covered while swimming.
Avoid sharing towels, clothes, socks, shoes, etc. if you have warts.
Avoid scratching or trying to mess with the wart.
Be careful not to scratch the wart while shaving.
Avoid biting warty fingernails or fingers.
Avoid clipping healthy nails with the same clipper that was used to trim the warty nail.
Keep warts dry, because moisture helps them spread.

Prevention:

Avoid touching the warts of infected people.
Wear insoles or pool shoes when walking around public swimming pools, and in changing rooms, etc.
Avoid sharing personal items such as nail clippers, towels, etc.
Pay attention to abnormal growths and other changes in the baby's skin.

FAQ:

Can persons with warts swim?

Yes, they can swim, but they should dry their feet and toes well, and wear pool shoes when walking around.

Is it possible to reduce or prevent the spread of warts after treatment?

Yes, it is possible by following the previously-mentioned prevention methods. However, it is difficult for people with deficiency of the immune system.

Health Promotion General Department

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