Warts

Warts are non-cancerous skin growths caused by a viral infection in the top layers of skin.  The virus that causes warts is called the Human Papilloma Virus (HPV).  People can contract the virus by direct contact (touching others warts or spreading your own through scratching), or indirect contact.  Warts are usually skin-coloured and feel rough to touch, but they can be dark, flat and smooth.  The appearance of a wart depends upon where it is growing. 

Signs and Symptoms of Warts:

The most common types of warts, along with their symptoms, include:

• Common warts:  usually have a rough surface, are greyish/yellow or brown in colour, and may be on your fingers, elbows, knees or face.
• Hand and foot warts:  located on the soles of the feet (plantar warts) or the palms of the hand (palmar warts) with black dots (clotted blood vessels that once fed them).  Clusters of plantar warts are called mosaic.
• Periungual warts:  appear as thickened skin around the nails and can cause painful splits in the skin.
• Flat warts:  are smaller and smoother than other warts.  They tend to grow in large numbers – 20 – 100 at any time.  They can occur anywhere, but are most common on the face, in the beard in men and on the legs in women.  Irritation or microscopic cuts in the skin from shaving probably contribute to them.

 

How do Dermatologists Treat Warts?

A dermatologist may use one of the following treatments:

• Cryotherapy:  For common warts in adults and older children, cryotherapy (freezing with a cold liquid gas called liquid nitrogen) produces a localised freezing of the warts and a smaller area of surrounding skin.  The freezing wears off within minutes of treatment, but the pain and burning sensation from it usually persists for around ten minutes and results in redness of the treated area.  The full effects of the freezing are not seen for 8 – 72 hours.  Patients can expect the area to be tender for several days, especially if on the bottom of the foot.  Within 24 hours, a clear to red/purple blister may appear.  The treated area will then scab over within 7 – 10 days.  The scab will eventually fall off, but the area will be pink for several weeks.
• Electrosurgery and curettage:  Electrosurgery (burning) is a good treatment for common warts, filiform warts and foot warts.  Curettage involves scraping off (curetting) the wart with a small spoon-shaped tool.  These two procedures are used together.
• Excision:  The dermatologist may cut out the wart (excision). 

If the warts are hard to treat, the dermatologist may use one of the following treatments:

• Laser treatment:  Laser treatment is an option, mainly for warts that have not responded to other therapies.  Depending on the choice of appropriate laser treatment, the dermatologist will numb the wart with an anaesthetic injection prior to treatment. 
• Chemical Peels:  When flat warts appear, there are usually many warts.  Because so many warts appear, dermatologists often prescribe “peeling” methods to treat these warts.  This means you will apply a peeling medicine at home every day.
• Bleomycin:  Bleomycin is an anticancer drug that may be injected into each wart.  This may be painful and may produce other side-effects.  A local anaesthetic injection is required prior to Bleomycin.  The benefit of Bleomycin injection is that it does not create an open wound and the wart dies within the treated area.  Only a specialist dermatologist should use this product to ensure the benefits of the treatment are achieved.

Should I See a Dermatologist?

You should see a dermatologist if:

• You cannot get rid of the warts
• The warts hurt
• You have many warts
• If you are having no success after two treatments by your practitioner, seek a specialist dermatologist for their opinion and management.

Each wart treatment depends on the patient’s age and health, as well as the type of wart. 

The Skin Specialist Centre’s dermatologists are able to treat the most challenging cases that can be presented and are here to help you.