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Warts (or verruca) are a common nuisance that are mainly a cosmetic concern but can become problematic at times. Here is a quick idea:
(Note: for now, genital warts are excluded.)
Warts are common. An exact prevalence is not known, but they have been found to affect teens and young adults more than children and older adults.
The cause? Human Papilloma Virus (HPV). The virus causes the skin to thicken.
Warts are quite contagious. Broken skin and prolonged exposure to wetness predispose someone to warts. Infection can originate from another person or dead skin cells they disperse anywhere, such as on their towels, in their shoes, or in swimming pools. A person with a single wart can infect other parts of their body, and an infected finger in a nail biter can cause warts to appear around the lips. Feet that sweat a lot are more prone to warts. Jobs that requires constant exposure to wetness increase the chance of infection.
Warts can look different depending on the strain of HPV that caused them. They are usually not symptomatic, and mainly cause a cosmetic concern.
- Common warts are skin colored, elevated, round, and have a rough surface.
- Plane warts are flat, brown, and have a smooth surface.
- Plantar warts affect the underside of feet. These are quite painful, because they grow inwards.
- Tiny black dots can be seen on a wart, these represent thrombosed capillaries not dirt.
If a wart is prone to being touched or rubbed frequently, it might became inflamed or bleed, which could make it painful or itchy. Warts can also become fissured and bleed. If they grow around or under a nail they may disrupt nail growth.
Most warts resolve on their own (50% resolve within one year, 90% within five years). A “wait and see” approach is often used, especially if the warts are asymptomatic.
Treatment options are quite wide and varied. One thing that has to be very clear is that some forms of treatment require two months or more to see results. Treatment modalities include:
- Topical: such as salicylic acid plaster or paint, tretinoin.
- Cryotherapy: usually using liquid nitrogen. Cryotheapy is not suitable for everyone, especially those with a poor circulation or blood diseases affected by the cold.
- Curettage and cautery: this is less desirable than other methods as it can be painful and can cause scarring.
- Surgery or laser: are useful in stubborn warts.
Many other modalities are available. Treatment depends on the number of warts, their location, and whether the patient has had warts before, as well as what was successful in treating them.
Possible side effects of treatment: change of skin color, scarring.
Will they come back? Unfortunately, no matter what treatment is used, there is always a chance of recurrence.
Thank you for reading!
WD. James, TG Berger, DM. Elston. Andrew’s Diseases of the Skin: Clinical Dermatology. Tenth Edition. Elseiver Saunders 2006: 403-7.
T. Burns et al. Rook’s Textbook of Dermatology. Eighth Edition. Wiley Blackwell 2010; 33.39-33.51.