Family doctor

Overview:

• Warts are caused by the human papilloma wart virus (HPV virus)
• There are 70 different known types of warts
• Planter warts (verrucas) are ingrown in the foot and common warts have a raised cauliflower surface
• Genital warts are caused by the same virus but this article covers only the common variety
• Warts are common in childhood and are spread by direct contact with another wart
• It may take up to one year for a wart to appear
• They can be removed but most warts in children have usually disappeared within two years

What are warts?

Warts are caused by the human papilloma wart (HPV) virus and there are several different types of warts.

Planter warts are ingrown in the feet and are also known as verrucas. Common warts have a raised surface with a cauliflower-like head. Mosaic warts are tiny and can spread all over the sole of the foot.

Genital warts are also caused by the HPV virus but this subject is dealt with in a separate article (see genital warts - human papilloma wart virus).

Common warts are spread from contact with another wart. If the wart is touched or scratched the virus can spread to another area of skin. But it can take up to one year for a new wart to appear.

Warts can grow anywhere on the body but are most common on the hands. It is estimated one in 20 school children have warts.

Warts are no threat to health and do not lead to any illness, however, they can cause embarrassment and are painful in some cases.

How are warts removed?

Warts can be removed by several different methods, or they can also go away of their own accord.

Fifty percent of childhood warts disappear within six months and 90 percent within two years. However, they may last up to seven years in adults.

Some warts do not respond to treatment, even if another wart on the same person is easily removed. However, often they will eventually disappear spontaneously in time.

Planter warts (verrucas) may take longer to disappear and removal may be recommended for these. Warts on the face may also require professional advice.

Wart paint:

• Soak the wart in warm soapy water.
• Rub the wart with a pumice stone or emery board.
• Apply the wart paint carefully on top of the wart. Be careful not to get the paint on healthy skin - you can protect skin around it with Vaseline.
• Use the wart paint every second day and remove the dead skin in between applications.

Do not use wart paint on the face.

Stop treatment for a few days if the skin becomes sore.

Most wart paints contain salicylic acid which works by removing skin cells. Those containing podophyllin must not be used by pregnant women or those planning to conceive.

The paint works in about 70 percent of cases but can take up to three months for the wart to go. The wart is usually reduced in size even if the treatment is not successful.

Cryotherapy (freezing)

Liquid nitrogen is used to freeze the wart. The treatment is repeated at one to two week intervals. This method has a 70 percent success rate, and limited scarring.

Electrosurgery

The wart is scraped away and then burned by diathermy or cautery using a needle heated with electricity. This works in most cases. However, 20 percent of warts can return within a few months, and a repeat treatment is sometimes required.

The wound may take up to six weeks to heal and can leave a scar.

Excision

Cutting out the wart is generally not recommended because the incision leaves a scar and is not any more effective than other methods which don't. The wart virus can extend through the scar and cause a bigger area of warty skin.

Bleomycin injections

This treatment is also a cancer treatment that is only used to get rid of stubborn warts in adults. The wart is injected with the cytotoxic chemical after a local anaesthetic is used to numb the skin. The wart turns black and then disappears. This is usually a last resort and done under specialist dermatologist guidance.

Laser

A carbon dioxide laser is used to destroy warts. This is mainly used for multiple planter warts. Repeat treatments are likely to be necessary,

Getting help

Your family doctor will be able to discuss the best options for treating your wart(s).