WARTS

General Information

DEFINITION--Benign tumors caused by a virus in the outer skin layer. Warts are not cancerous. They are mildly contagious from person to person and from one area to another on the same person.

BODY PARTS INVOLVED--Skin anywhere, but most likely on the fingers, hands and arms.

SEX OR AGE MOST AFFECTED--Most common in children and young adults between ages 1 and 30, but may occur at any age.

SIGNS & SYMPTOMS--

A small, raised bump on the skin with the following characteristics:

• Warts begin very small (1mm to 3mm) and grow larger.
• Warts have a rough surface and clearly defined borders.
• They are usually the same color as the skin, but sometimes darker.
• Warts often appear in clusters around a "mother wart."
• If you cut into the wart surface, it contains small black dots or bleeding points.
• Warts are painless and don't itch.
• Plantar warts appear on the soles of the feet.

CAUSES--Invasion of the outer skin layer (epidermis) by the papilloma virus. The virus stimulates some cells to grow more rapidly than normal. Warts are very common. By adulthood, 90% of all people have antibodies to the virus, indicating a history of at least one wart infection.

RISK INCREASES WITH

• Use of public showers.
• Skin trauma.
• Immunosuppression due to drugs or illness.

HOW TO PREVENT

• To keep from spreading warts, don't scratch them. Warts spread readily to small cuts and scratches.
• Protect the skin from injury and wash hands frequently.
• Don't touch warts on other people.
• Don't wear another person's shoes.
• Wear footwear in public locker rooms or showers.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Home care after diagnosis and treatment.
• Cryotherapy (freezing cells to destroy them). This is an office procedure that doesn't require anesthesia or cause bleeding. Freezing stings or hurts slightly during application, and pain may increase a bit after thawing. Two to 5 weekly treatments are sometimes necessary to destroy the wart.
• Electrosurgery (using heat to destroy cells). This treatment can usually be completed in one office visit, but healing takes longer, and secondary bacterial infections and scarring are more common.

POSSIBLE COMPLICATIONS

• Spread to other body parts.
• Secondary infection of a wart.
• Warts recur after treatment.

PROBABLE OUTCOME--20% of warts disappear spontaneously in 1 month. Without treatment, the remainder disappear in most children in 2 to 3 years.

How To Treat

GENERAL MEASURES--

• If you have cryotherapy, a blister (sometimes with blood) will develop at the treatment site. The roof of the blister will come off without further treatment in 10 to 14 days. You should have little or no scarring. Wash and use make-up or cosmetics as usual. If clothing irritates the blister, cover with a small adhesive bandage. If the blister breaks, the fluid may have active virus and spread to other areas; wash with hot water and soap, dry and cover the area.
• For plantar warts, insert pads or cushion in the shoe to make walking more comfortable.

MEDICATION--Your doctor may prescribe:

• Chemicals, such as mild salicylic acid, to destroy warts. If so, apply twice a day for 4 to 6 weeks.
• Tretinoin (retinoic acid) or benzoyl peroxide to help in treating warts.
• Several new methods are also available for treatment.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You or your child have warts and you want them removed.
• After removal by cryosurgery or electrocautery, signs of infection appear at the treatment site.
• After treatment, fever develops.
• Warts don't disappear completely after treatment.
• Other warts appear after treatment.