Warts

What is a wart?

A wart is a small growth with a coarse surface caused by the human papilloma virus (HPV). Warts are usually found on the hands, feet, face, arms, legs and under the fingernails, but they can develop anywhere on the skin. One in three children develops warts, and three in five adults develop warts. Warts spread easily from person to person.  A wart’s appearance depends upon its location.

What causes a wart?

A wart is a skin infection caused by the human papilloma virus (HPV). The HPV virus enters the skin through a break in the skin, a cut, scrape or a hangnail. Warts are contagious but are harmless, and can be difficult to treat. Warts can spread through contact with other people and from touching a surface, like a towel, that was recently used by a person with a wart. However, most warts will disappear on their own within five years.

What are the types of warts?

• Common warts are easily diagnosed by their appearance. They are flesh colored, firm, rough, raised and lobed, and may contain black dots (blood vessels). They usually affect the fingernails and the knuckles, back of the hands, knees, elbows and wherever the skin is broken. People who pick at their nails, or bite their nails are at risk. Warts around the fingernails and toenails are notoriously difficult to permanently eliminate.
• Plantar warts are found on the soles of the feet, the heels and toes (called the “plantar” surface of the feet). The virus can live in the soil and in public bathrooms and showers. Walking barefoot can increase the chance the infection. Plantar warts are flat and grow into the skin. They do not look like common warts. A plantar wart may look like a callus with a black dot in the middle. A plantar wart on the bottom of the foot can cause pain when walking, feeling like stepping on a piece of glass. Plantar warts often grow in clusters. These warts are difficult to treat.
• Genital warts are a sexually transmitted disease. They can cause anal and penile cancer in men, and cervical, anal and vulvar cancer in women.
• Flat warts are round, small and smooth, and tend to grow in large numbers and typically grow on skin exposed to the sun and areas that are frequently shaved, like a man’s beard or a woman’s legs. They can be flesh colored, yellowish or brownish flat-topped lesions.
• Filiform warts do not look like common warts. They are fast growing and look like long, thin threads. This type of wart is often found on the eyelids, neck, and around the mouth and nose.

When should I see Dr. Higgins about a wart?

When a wart changes in appearance, spreads, causes pain, bleeds or is located in an area that is constantly irritated, it is important to have it checked by Dr. Higgins.

What are the treatment options for warts?

Many warts will disappear without treatment within five years. However, it the appearance of the wart is unacceptable, or causes concern it can be treated. Over the counter treatments that contain salicylic acid are available.

Most in-office and prescription wart treatments are designed to stimulate the immune system, so that the body recognizes the wart infection and sends in special cells to clear it.  Therefore, most treatments involve irritating and inflaming the wart to “wake up” your immune system.

Dr. Higgins can treat your warts with cryotherapy, using liquid nitrogen to freeze the wart. Other treatments include the use of a topical drug called Cantharidin, which is applied in the office and washed off at home a few hours later.  This painless treatment is often used to treat children with warts because it is well tolerated.  Lasers are sometimes used to destroy warts, and immunotherapy injections that stimulate the immune system to kill the wart may be used. Occasionally stubborn, difficult to treat warts may be surgically removed.  While the wart is killed, the virus remains which means the wart can reoccur.

Dr. Heather Higgins is a board-certified dermatologist in Asheville, North Carolina. Contact her to schedule a consultation.