Warts

Warts are common benign growths (not cancer). Warts are caused by the human papillomavirus. They are contagious and spread easily.

Many people get a wart when they have skin-to-skin contact with someone else who has a wart. You also can get a wart by touching something that touched another person’s wart, such as a towel or locker room floor. You cannot get a wart from touching a toad or a frog.

WHAT TYPES OF WARTS ARE THERE?

The type of wart you get depends on the type of HPV you have and where it is located.

• Common warts

These usually form on the fingers, around the nails or on the back of the hands. They can appear in places where the skin was broken, such as near a bitten fingernail or a hangnail, because it is easier for the virus to enter the body in these places. A common wart often looks like a rough bump. You may see black dots in the wart that look like seeds; these are blood vessels. For this reason, common warts are often called “seed warts.”

Common warts

• Plantar warts

When common warts form on the soles of the feet, they are called plantar warts. “Plantar” is the medical term for the bottom of the foot. Left untreated, these warts can grow quickly. Most plantar warts are flatter than other common warts because walking pushes the warts into the skin. This can make plantar warts painful. If you have this type of wart, it may feel like you have pebbles in your shoes.

Plantar warts

• Flat warts

These can be found anywhere on the skin, but they are most common on the face. Shaving seems to cause these warts to spread, so dozens or hundreds of flat warts are sometimes seen in the beard area in men and on the legs in women. Flat warts are smaller and smoother than common warts.

• Genital warts

These warts usually appear in or around the genital region. People get genital warts through sexual contact, and they can be transmitted from the genitals to any skin that is contacted during a sexual encounter. This may include the skin surrounding the genitals, or the abdomen, groin folds, anus, buttocks, fingers or mouth. In some cases, a mother can spread the virus that causes genital warts to her baby during childbirth. Any pregnant woman who has had genital warts should tell her doctor so that steps can be taken to prevent the virus from spreading to her baby.

Genital warts are flesh-colored. They may feel rough or smooth, and they can be large or small. Some people get a single wart, while others get clusters of warts that are easily irritated.

Certain strains of genital warts can cause cancer, so it is important to treat genital warts early, before cancer has a chance to develop. People with HIV, men who have sex with men and those with low immune systems are at particular risk of cancer from HPV. Women who have been exposed to genital warts should see a gynecologist to get screened for cervical cancer. Anyone with anal warts should have an anoscopy for screening and visualization of warts inside the rectum. These screening tests allow doctors to find early signs of the disease.

The HPV vaccine can prevent both males and females from getting some of the most common types of HPV that can cause genital warts and cancer. This vaccine does not protect against other types of warts. The vaccine is given in three shots, and it is important to get all three for the best protection. The vaccine should be administered before a person becomes sexually active.

Flat warts on the face

DO I NEED TO SEE A DOCTOR IF I HAVE WARTS?

Most warts are harmless, and they can go away on their own. However, it may take a long time for warts to disappear from a few months to more than a year. Treatment can reduce the risk of the virus spreading to other parts of your body or to others. It is also easier to treat warts when they are fewer in number and smaller in size.

While you may be able to treat your warts at home with an over-the-counter treatment, you should see a board-certified dermatologist if you:

• Have warts in your genital area, anus or
• Notice that a wart hurts, itches or
• Have more than a few warts or large
• Cannot get rid of the warts with the treatment you are
• Are not sure if a growth on your skin is a wart or something

Dermatologists offer many wart treatments. The treatment you receive will be based on your age, the type of wart you have and many other considerations. No one treatment works for everyone, and it often takes a number of treatments to get rid of warts. For stubborn warts, your dermatologist may use more than one type of treatment.

Many over-the-counter wart treatments contain salicylic acid. While you can get these treatments without a prescription, your dermatologist can prescribe a medicine that contains a stronger dose. If you use a medicine with salicylic acid, you will likely need to apply it every day after bathing or soaking the wart. It can take many weeks to see results. You should stop treatment, at least for a short time, if the wart or the skin around it becomes sore.

Another treatment that can stimulate the immune system is occlusion. This word means to shut off or close up. Covering a wart with duct tape is a type of occlusion. Occlusion is often used along with another treatment, such as salicylic acid.

HOW DO DERMATOLOGISTS TREAT WARTS?

A board-certified dermatologist may treat your warts by performing one or more of the following procedures in his or her office. Warts can grow deep into the skin, so some patients will need multiple treatment sessions.

• Cryotherapy: Cryotherapy is a common treatment for warts. Your dermatologist will freeze the wart with liquid nitrogen, causing the wart to blister or scab and fall off in two to three weeks. Patients often need more than one treatment. Some people see a light or dark spot form on skin treated with cryotherapy. This is more common in people who have darker skin.
• Cantharidin: Your dermatologist may treat a wart by painting it with cantharidin, a chemical that causes a blister to form under the wart. You may need to return to the office about a week after this treatment so that your dermatologist can clip away the dead part of the wart and retreat any remaining
• Electrosurgery: This treatment destroys the wart by burning it
• Excision: Your dermatologist may surgically remove the wart by cutting it

Some warts are more difficult to treat than others. Plantar warts, for instance, are hard to treat because the bulk of the wart lies below the surface of the skin. Your dermatologist may use one or more of the following therapies for hard-to- treat warts:

• Laser treatment: Advances in technology have made laser treatment an effective therapy for some warts, but laser treatment is not necessarily the best option for all warts. A number of different lasers can be used, and the number of treatment sessions needed can
• Chemotherapy: When a wart remains despite many treatments, your doctor may recommend a chemotherapeutic This does not mean that you have cancer; these medicines also can slow the growth of HPV. Studies show that the chemotherapy drug bleomycin is effective in clearing warts. This medicine is injected into the wart; these shots can be uncomfortable.
• 5-fluorouracil: This is a cream, also known as 5-FU, that can treat warts. Patients can apply it at home, usually once or twice a
• Immunotherapy: This type of therapy stimulates the patient’s immune system so that it can more effectively fight HPV. There are a number of medicines used to stimulate the immune system, such as imiquimod, which is a cream you can apply at home. When these creams are effective, they cause an intense skin reaction. Other agents can be injected into a wart to help your body’s immune system fight

Common warts

HOW CAN I PREVENT NEW WARTS?

• Do not pick or scratch at warts. This can spread the virus to other parts of your
• Do not touch someone else’s
• Keep your feet dry, as moisture helps warts
• Wear flip-flops or pool shoes in locker rooms, pool areas and showers used by many people, such as those in hotels and health clubs. HPV spreads easily in warm, humid conditions.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about warts or to find a board-certified dermatologist in your area, visit aad.org/warts or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

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