Understanding Warts: Types, Causes, and Treatments

Warts and verrucas are small lumps on the skin that can appear in various sizes and shapes. Most people have them at some point in their life, especially children and adolescents, as they are quite common. These growths are caused by a virus known as the human papillomavirus (HPV), which can enter the skin through tiny cuts or lesions. While they usually go away on their own, it may take months or even years, leading to concerns about their appearance and any potential discomfort they might cause. In some cases, people may seek treatment options to remove them, especially if they are located in bothersome areas, but it is essential to consult a healthcare professional before trying any home remedies or over-the-counter solutions.

Types of warts and verrucas

• Common warts (verruca vulgaris) — these are small, raised areas of skin that can vary in size. They typically appear round with a rough surface, making them easily recognizable. The skin surface often looks like the top of a cauliflower, which gives them a distinct texture. These warts are often found on the hands, elbows, and knees but can also appear on other parts of the body. Although they are generally harmless, they can sometimes cause discomfort or irritation, especially if they are located in areas that are prone to friction.
• Plane or flat warts — these are flat warts that are usually yellow in colour. They can be found on the hands and face, appearing as small, smooth, and slightly raised areas on the skin’s surface. These warts can often spread and group together, especially in areas that are frequently touched or scratched. They are most common in children, who tend to have more active immune systems, making them more susceptible to viral infections that cause warts.
• Plantar warts — these are warts that appear on your feet, specifically on the areas that bear weight, such as the sole, heel, or toes. The weight of your body causes the wart to be pushed into the skin, resulting in a flatter appearance compared to other types of warts. This unique characteristic means that a plantar wart is usually not raised; instead, it might feel almost like a callus. You may experience pain or discomfort, especially when walking or standing for long periods. Visually, you may notice a distinctive white area of skin that is slightly thickened, often accompanied by tiny black dot or dots in the center, which are small blood vessels that have clotted.
• Filiform warts — these are clusters of long, thin warts that frequently manifest on the face, particularly around the mouth, eyelids, and nose. Their elongated structure gives them a distinctive appearance, making them easily recognizable and often leading to concern about their cosmetic impact.
• Mosaic warts — when different types of warts grow together in a clustered formation, often creating a mosaic-like appearance. They are most commonly found on the hands and feet, where pressure and friction can promote their development. These warts can be bothersome and may require treatment for removal, especially if they become painful or spread.
• Subungual or periungual warts — these are warts that form under or around the cuticle, typically appearing as small, raised bumps that may cause discomfort or pain, particularly when pressure is applied, and can often be mistaken for other skin conditions.
• Mucosal warts — these can appear on your lips, or inside your cheeks and nose. They are sometimes found in the airways and genital areas.

What causes warts?

You can get the HPV virus from direct contact with the skin of another person who has the virus. This transmission can occur through intimate skin-to-skin contact, which is common during sexual activity. It’s important to note that HPV can infect individuals regardless of whether or not they exhibit visible symptoms, meaning that a person can unknowingly spread the virus.

Additionally, you can also get the virus indirectly through contaminated surfaces such as swimming pools, communal showers, or gymnasiums. While the likelihood of transmission in these settings is lower compared to direct contact, it is still a possibility, particularly if the virus is present on surfaces that come into contact with your skin or mucous membranes.

HPV infects the cells in the outer layer of the skin. Once the virus enters the body, it begins to replicate within these cells. The virus causes the infected skin cells to grow and form a wart, which may present as an elevated, rough, or flat lesion. This growth is a result of the virus’s interference with normal cell division and maturation processes. It can take up to a year for the wart to appear for the first time after infection. During this incubation period, some individuals may feel anxious or concerned about potential transmission to partners. Regular check-ups and open communication with healthcare providers can help manage these concerns and offer guidance on prevention strategies.

There are more than 150 types of HPV. Most of these viruses cause no symptoms at all.

How are warts treated?

Many people choose not to treat warts because treatment can be uncomfortable and time-consuming. Additionally, it’s worth noting that most warts will get better on their own within a span of about two years due to the body’s immune response. During this period, many individuals opt for the “watchful waiting” approach, allowing time for the wart to resolve naturally without intervention.

However, if warts cause discomfort, embarrassment, or if they occur in areas that are prone to irritation or infection, seeking treatment can be beneficial. There are several ways to treat warts, and it’s essential to evaluate which method works best for you. Some of these treatments can be effectively done at home using over-the-counter medications, which often contain salicylic acid that gradually removes the wart tissue.

In contrast, some treatments are performed by a healthcare professional and can include options like cryotherapy, where the wart is frozen off with liquid nitrogen, or laser therapy, which targets the wart with high-energy light. Another method is electrosurgery, which uses electrical currents to burn off the wart.

It’s important to remember that consistency is key when it comes to wart treatment. Sticking with a chosen wart treatment until the wart is completely gone is crucial; otherwise, there is a chance that the wart may return or that new warts may develop. It’s advisable to consult with a healthcare provider for guidance on the most suitable treatment option based on the type and location of the wart, as well as personal health considerations.

Can warts be prevented?

There are several effective steps you can take to prevent warts from spreading, including maintaining good hygiene by washing your hands regularly, keeping your feet dry and clean, avoiding walking barefoot in communal areas, and refraining from sharing personal items such as towels or razors. Additionally, it’s essential to avoid picking at or scratching warts, as this can lead to further infection and transfer of the virus to other areas of your skin. Regularly moisturizing your skin and using protective barriers can also help minimize the risk of developing warts in the first place.