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Warts

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Introduction

The term wart refers to the non-cancerous growth of the top layers of the skin caused due to a viral infection. Warts are common in children and adolescents and usually spread by direct contact. The greatest incidence of warts is noticed between 12 and 16 years of age. Warts have been noted to occur with greater frequency in girls than boys. Adults may also be affected by the virus resulting in similar symptoms. Hands, legs, face, inner areas of the mouth and the genital areas are some of the areas where warts may be observed.1

Causes

Warts are caused by an viral infection. This virus is known as human papilloma virus (HPV). This virus has over 80 subtypes and has been attributed to cause various manifestations including cancer. Warts are a minor manifestation of the HPV virus that causes non-cancerous growth of the skin. The virus can spread by direct contact with the infected area and one may get warts from using towels or other objects used by an individual who has warts. Touching the warts or scraping them with fingers can also result in the spread of the warts.

Signs and Symptoms

Warts are areas of overgrown skin that are skin colored and feel rough to touch. They may also be flat and smooth at times. Based on its appearance and the part of the body, where it appears, warts have been categorized as:

  • Common warts (Verruca vulgaris)
  • Plantar warts (Verruca plantaris)
  • Flat or planar warts (Verruca plana)
  • Genital warts (Condyloma acuminata)

Common warts are raised surfaces of skin noted on the fingers, around the nail bed and the palms. These may at times have a black dot in the centre giving them the appearance of a seed. The common warts may also be noted on the toes.

Plantar warts are noted on the soles of the feet and are similar to common warts but may be pushed in making them appear flat due to the pressure applied on the foot while walking. These warts are sometimes associated with pain while walking and one may feel as if he/she is walking with a pebble in the shoe.

Flat or planar warts are smaller and smoother when compared to other types of warts. These warts are usually observed to appear in large numbers at the same areas in contrast to other warts, which are usually single or a cluster of 2–3 warts. In children, the flat warts are observed on the face more commonly while in adults, it may be noted in the beard area in case of men and the legs in case of women.

Warts in areas other than the genital areas are quite harmless in healthy people and are known to resolve spontaneously within a few months or years.1–3

Diagnosis

The diagnosis of warts is generally based on the signs and symptoms observed. The doctor may at times excise the wart to rule out the possibility of any other similar condition.

Treatment

Numerous treatment modalities ranging from home remedies to electrosurgery have been tried to remove the wart completely and avoid recurrence. Although persistent treatment can completely clear the wart, the wart may recur in certain cases.

Salicylic acid preparations are available over-the-counter lotions or creams and when applied on the warts are known to reduce the size of the wart and at times complete removal. Before applying the salicylic acid preparation, the wart should be soaked in warm water to soften it. Then, it must be rubbed with pumice stone, pat dried and then apply the preparation. Preferably after such an application, the wart must be covered with a tape. This procedure may be required to be repeated daily for a minimum of twelve weeks for complete resolution.

Procedures performed by the doctor include mechanical removal of the wart using procedures known as electrocautery, cryosurgery or laser therapy. The doctor may also apply some sensitizing agents on the warts or inject certain medications such as bleomycin into the wart to soften them or cause their removal.3,4   

Complications  

Warts are generally not associated with any major complications other than pain and cosmetic concerns.

Prevention

Spread of the infection from one part of the body to the other can be prevented by avoiding the urge to scratch the wart. Use of clothes or towels of the infected individual must be avoided.  

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Written by: Saptakee sengupta
Date last updated: April 13, 2015