Warts are small, benign growths on the skin caused by the human papillomavirus (HPV). They are typically rough to the touch and can appear anywhere on the body, though they are most common on the hands, feet, and face.

Warts are contagious and can spread through direct contact with the wart or surfaces that have been exposed to the virus. There are several types of warts, including common, plantar (on the soles of the feet), flat warts, and genital warts, each with distinct characteristics.

While most warts are harmless and may resolve on their own over time, some can be painful or cosmetically bothersome, leading individuals to seek treatment options such as salicylic acid, cryotherapy, or surgical removal.

What Causes Warts?

These are the causes.

Human Papillomavirus (HPV) Infection

They are caused by an infection with the human papillomavirus (HPV). There are over 100 different strains of HPV, and specific strains are responsible for different types of warts. The virus enters the body through tiny cuts, breaks, or weak spots in the skin, leading to the growth of them.

Skin-to-Skin Contact

Warts are highly contagious and can spread through direct skin-to-skin contact with someone who has the virus. This is particularly common in environments where people share close quarters, such as gyms, swimming pools, or schools.

Contact with Contaminated Surfaces

The virus can also spread indirectly through contact with surfaces or objects that have been exposed to HPV, such as towels, shoes, or shared equipment. Walking barefoot in public areas like locker rooms can increase the risk of contracting plantar warts.

Weakened Immune System

Individuals with weakened immune systems, whether due to illness, stress, or certain medications, are more susceptible to developing warts. A compromised immune system may struggle to fight off the HPV infection, allowing them to form more easily.

Personal Habits

Habits like biting nails or picking at hangnails can create openings in the skin, making it easier for the virus to enter and cause warts. Similarly, shaving can spread the virus to other areas of the skin, leading to the development of additional warts.

Types of Warts

These are the different types of warts.

Common Warts

Common warts typically appear on the hands, fingers, and around the nails. They are characterised by their rough, raised surface and may have small black dots, which are clotted blood vessels. These warts are most frequently caused by HPV types 2 and 4.

Plantar Warts

Plantar warts develop on the soles of the feet and can be painful due to the pressure exerted while walking. They often grow inward and may appear flat with a hardened surface. These warts are commonly caused by HPV type 1 and are often contracted in moist environments like locker rooms or swimming pools.

Flat Warts

Flat warts are smaller and smoother than other types of warts, with a flat or slightly raised appearance. They often occur in large numbers and are most commonly found on the face, neck, hands, or legs. HPV types 3, 10, and 28 are typically responsible for flat warts.

Filiform Warts

Filiform warts have a distinctive thread-like or finger-like projection and usually appear on the face, particularly around the mouth, eyes, or nose. They grow quickly and are caused by HPV types 1, 2, 4, 27, and 29. These warts are more common in older adults.

Genital Warts

Genital warts are a sexually transmitted infection caused by specific strains of HPV, primarily types 6 and 11. They appear in the genital or anal area and can vary in size and shape, ranging from small, flat bumps to larger, cauliflower-like growths. Genital warts require medical attention due to their association with certain cancers.

Periungual Warts

Periungual warts develop around or under the nails, both on the fingers and toes. They can be painful and may interfere with nail growth. These warts are often caused by HPV types 1, 2, 4, and 7 and are more common in individuals who bite their nails or have frequent exposure to water.

Mosaic Warts

Mosaic warts are clusters of plantar warts that form in a concentrated area, usually on the soles of the feet. They are less painful than single plantar warts but can be more challenging to treat due to their grouped nature. HPV type 2 is often responsible for mosaic warts.

How to Identify a Wart

Warts can be identified by their distinct appearance and texture, typically presenting as small, rough, raised bumps on the skin, though their characteristics vary depending on the type.

Common warts often have a grainy surface with tiny black dots (clotted blood vessels), while plantar warts on the feet may appear flat and hardened due to pressure from walking. Flat warts are smoother and smaller, often appearing in clusters, and filiform warts have a thread-like or finger-like projection, commonly found on the face.

Warts are usually painless unless located in areas subjected to pressure or friction, such as the soles of the feet. If you notice a persistent growth that matches these descriptions, especially if it spreads or changes over time, it is likely a wart, though consulting a healthcare professional can confirm the diagnosis and rule out other skin conditions.

Symptoms of Warts

These are the symptoms.

Raised or Flat Growths

Warts typically appear as raised or flat growths on the skin, depending on the type. Common warts are often raised with a rough texture, while flat warts are smoother and may be slightly elevated.

Rough or Grainy Texture

Many warts, especially common warts and plantar warts, have a rough or grainy surface. This texture is a key characteristic that helps distinguish warts from other skin conditions.

Small Black Dots

Some of them, particularly common warts and plantar warts, may have tiny black dots within them. These dots are clotted blood vessels and are often referred to as “wart seeds.”

Pain or Discomfort

Warts located on weight-bearing areas, such as the soles of the feet (plantar warts), can cause pain or discomfort, especially when walking or applying pressure. Warts on other parts of the body are usually painless unless irritated.

Clustered or Single Growths

Warts can appear as single growths or in clusters. Flat warts and mosaic warts, for example, often appear in groups, while common warts may develop individually.

Changes in Skin Color

Warts may cause localised changes in skin color, appearing lighter, darker, or the same color as the surrounding skin. This variation depends on the type of wart and the individual’s skin tone.

Itching or Irritation

Some warts, particularly those in areas prone to friction or moisture, may cause itching or irritation. This is more common with genital warts or warts in skin folds.

Interference with Nail Growth

Periungual warts, which develop around or under the nails, can interfere with normal nail growth, causing the nail to become misshapen or detached from the nail bed.

Rapid Growth or Spread

Warts caused by certain strains of HPV may grow quickly or spread to other areas of the body, especially if the skin is damaged or the immune system is compromised. This is particularly common with flat warts and filiform warts.

How to Treat Warts

This is how you treat them.

Over-the-Counter Treatments

Over-the-counter treatments, such as salicylic acid or lactic acid solutions, are commonly used to treat warts. These products work by gradually breaking down the wart tissue and stimulating the immune system to fight the virus. They are available in various forms, including gels, pads, and liquids.

Cryotherapy

Cryotherapy involves freezing the wart with liquid nitrogen, which destroys the wart tissue. This treatment is often performed by a healthcare professional but can also be done at home using over-the-counter freezing kits. Multiple sessions may be required for complete removal.

Prescription Medications

For stubborn or recurring warts, a healthcare provider may prescribe stronger medications, such as topical creams containing imiquimod or retinoids. These treatments work by boosting the immune response or promoting skin cell turnover to eliminate the wart.

Surgical Removal

Surgical options, such as excision, laser therapy, or electrosurgery, may be recommended for warts that do not respond to other treatments. These procedures are performed by a healthcare professional and involve physically removing or destroying the wart tissue.

Duct Tape Occlusion

Duct tape occlusion is a home remedy where duct tape is applied to the wart for several days, followed by soaking and gentle scraping of the wart. This method is thought to irritate the wart and stimulate the immune system to attack the virus.

Immunotherapy

Immunotherapy is used for persistent or recurrent warts and involves stimulating the immune system to fight the virus. This can include treatments like topical sensitisers (e.g., diphencyprone) or injections of antigens to trigger an immune response.

Natural Remedies

Some people opt for natural remedies, such as applying tea tree oil, apple cider vinegar, or garlic to the wart. While these methods are not scientifically proven, they may help in some cases by irritating the wart and promoting its removal.

Prevention and Aftercare

Preventing the spread of them is crucial during and after treatment. This includes avoiding picking or scratching warts, keeping the affected area clean and dry, and avoiding sharing personal items like towels or razors. Proper aftercare ensures the wart does not return or spread to other areas.

Consultation with a Healthcare Professional

If they are painful, spreading rapidly, or located in sensitive areas like the face or genitals, it is important to consult a healthcare professional for proper diagnosis and treatment. They can recommend the most effective approach based on the type and location of the wart.