Identifying Different Types of Warts
Warts are common skin symptoms associated with the human papillomavirus (HPV). While many people associate HPV with sexually transmitted diseases, there are over 100 different strains of HPV. Only a few of these strains are sexually transmitted, but they can all cause the development of warts. According to Dr. Chase Kwon of U.S. Dermatology Partners in Fairfax, Virginia, “Warts often present as small, raised bumps on the skin that are most prevalent among children and adolescents (seen in up to 1/3 of primary schoolchildren) and frequently appear on the face, hands, legs, and feet, but they can show up on any part of the body in patients of any age. In many cases, warts go away on their own, but when they’re painful, itchy, or unsightly, a dermatologist can help you remove them.” In this blog, Dr. Kwon will review the different types of warts as well as treatment options.
The scientific name for common warts is verruca vulgaris. Like most warts, common warts are hard bumps on the skin. They have a rough surface, and there may be small, black dots speckled throughout, which represent clotted blood vessels. Common warts can develop on any part of the body, but they are most likely to grow on the hands, elbows, and knees. They develop as a bodily response to HPV, and it can take as long as six months for them to develop after the skin is exposed to the virus. Common warts are contagious, meaning they can be transmitted by touch. However, they typically are not painful or itchy, often clearing up on their own, usually within 1 to 2 years.
The scientific name for flat warts is verruca plana. As you may notice, this name is very close to the scientific term for common warts (verruca vulgaris). The main difference between these two skin conditions is the texture. Flat warts, unlike common warts, have a smooth, flat surface or plane. While they can develop anywhere, sites of predilection include the face, backs of the hands, and arms. They tend to develop in clusters, sometimes in a linear array, rather than as individual warts. Like common warts, flat warts are transferrable through touch.
Filiform warts usually develop on the face and present as long, slender projections. Dr. Kwon says “Because filiform warts frequently arise on cosmetically sensitive areas like around the eyes or lips, patients are more likely to seek removal of these warts. To minimize scarring and other damage to the surrounding areas, it’s highly recommended that filiform warts be professionally removed by your local dermatologist.”
Plantar warts characteristically develop on the balls and heels of feet that are subject to the most pressure when walking. This pressure can cause the warts to develop and dig deeper into the skin, leading to discomfort while walking and also making this type of wart more challenging to remove. Sometimes, corns and calluses are mistaken for plantar warts, given that they also tend to form on the bottoms of the feet and can look similar. Your dermatologist can help to distinguish these growths and provide appropriate treatment.
Plantar warts can develop in tight clusters and coalesce, merging into large growths called mosaic warts. Mosaic warts may cause significant discomfort while walking, and unfortunately, they can be challenging to clear, often recurring after successful treatment.
Genital warts, also known as condyloma acuminata, are a symptom of sexually transmitted HPV. These cauliflower-like warts develop around the genitals and anus. Unlike other types of warts, genital warts can be hazardous to general health and are a significant risk factor leading to cervical cancer in women. For this reason, it’s important to have genital warts examined and treated by a professional healthcare provider.
Causes of & Risk Factors for Warts
According to Dr. Kwon, “Anyone can develop warts as a symptom of HPV, but they are typically transmitted through person-to-person contact or from contact with surfaces that contain active HPV particles. They can also be self-inoculated, meaning that you could transmit warts from one part of your body to another through seemingly benign acts like scratching your skin. Because of this contact transmission, individuals without a healthy, intact skin barrier are at a higher risk of developing warts. Moreover, individuals with a compromised immune system are not able to fight off this virus as easily and are susceptible to warts that are more treatment-resistant, although the mere presence of warts should not be a reason to undergo extensive and expensive immunologic testing.”
Treatments for Warts
When it comes to the treatment of warts, Dr. Kwon shares, “The vast majority of warts seem to resolve on their own and don’t require any active treatment. However, if you’re unhappy with the appearance of your warts or experience any discomfort, there are many treatment options to help jumpstart the healing process.” With respect to the treatment of warts in the pediatric population, Dr. Kwon reminds parents, “Self-esteem begins to form around age 4, and while warts are highly prevalent among kids, if your child has a wart and appears to be bothered by it in one way or another, your friendly neighborhood dermatologist can help treat the wart.”
Common treatments for warts include:
- Chemical removal – Certain chemicals such as salicylic acid can be applied to the affected skin to dissolve warts. Salicylic acid is frequently found in over-the-counter wart treatments that are packaged as pads or plasters. While these products may work for smaller or thinner warts, they are often ineffective for ones that are larger or thicker. There are more potent chemicals like higher-concentration salicylic acid and trichloroacetic acid that can be prescribed or applied in the clinic. Because these products are corrosive and can harm healthy skin, it’s best to pursue these treatments under the guidance of a dermatologist.
- Immune system stimulation – Topical medications may be prescribed to stimulate your own immune system to detect and fight HPV, the viral infection that leads to warts, more effectively. There are similar medications that can be injected directly into warts in a dermatologist’s office.
- Cryotherapy – Liquid nitrogen is among the first-line treatments used to freeze and destroy the wart. This is a quick and safe procedure that can be performed without the need for anesthesia (numbing) in a dermatologist’s office. It should be noted that the temperatures required to destroy warts are as cold as -25°C (or -13°F). For reference, the average temperature at the peak of Mount Everest is -19°C in the summer and -36°C in the winter. The over-the-counter freeze sprays sold in stores are incapable of achieving these extreme temperatures, and so, they often result in irritation of the skin without clearance of the wart.
- Surgical treatment – Warts that are resistant to medications and freezing may be surgically removed. This is a quick and safe procedure that can be performed in a dermatologist’s office, in which the affected area is anesthetized, and after ensuring that the site is numb, a surgical instrument called a curette is used to essentially scrape away the wart. Alternatively, the wart may be excised with surgical scissors or a blade. The main drawback to the surgical approach is the potential for scarring. While scars can’t always be prevented, there are skincare products like Sente Dermal Repair Cream that promote wound healing and may reduce the risk of scarring.
- Laser treatment – In extreme cases, certain lasers may be employed to destroy the wart as well, but care should be taken to ensure that this is performed in a dermatologist’s office with the appropriate safety measures to avoid inhalation of the HPV that is vaporized.
Interested in Working with a Dermatologist for Wart Treatment?
If you have warts you would like to remove or other skin concerns that require professional intervention, the U.S. Dermatology Partners team is here to help. We offer a wide range of dermatologic treatments to heal, improve appearance, and help you feel more confident in your own skin. If you’re interested in learning more, simply take a brief moment to complete our scheduling request form. One of our local team members will be in touch to answer your questions and get your upcoming appointment on the books with one of our board-certified dermatologists like Dr. Chase Kwon.
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