Warts

Warts are common lesions that frequently grow on the hands and feet, but can affect any part of the body. They can be subtle and smooth, or large with a rough cauliflower-like surface. Warts are caused a by an infection of the Human Papilloma Virus (HPV) and can affect people of all ages and backgrounds. There are various strains of the human papilloma virus which can have different presentations on the skin. Different types of warts include:

Common warts: Also referred to as “verruca vulgaris.” Present as rough pebbly growths that commonly appear on the hands and knees, but can affect any part of the body. Patients may have one or multiple lesions.
Filiform warts: Warts with “finger-like” projections that usually present on the face, especially near the eyelids and lips.
Flat warts: Small skin-colored warts with a smooth flat surface.
Plantar warts: Thick rough warts that are found on the bottom of the feet. These warts can often be painful as they press against the bottom of the foot.
Genital warts: Soft pebbly bumps that are found around the genital and pubic areas. These lesions are sexually transmitted and can be highly contagious.

The HPV virus is acquired through physical contact and causes localized infections of the skin only. It does not circulate in the blood. However, touching or picking at these lesions can spread them to other body parts which is why it is important to avoid picking at warts. Females with warts on their legs should avoid shaving until all lesions are completely resolved, otherwise they can spread the virus across their legs. Warts can go away on their own over time, but may also spread to other body parts from repeat contact. Treatment options for warts include:

Cryotherapy (Cryosurgery): Very common treatment in which Liquid Nitrogen is used to “freeze” and destroy affected skin. Treatment often results in blisters which gradually crust and heal in 2-3 weeks. Warts may often require a few treatments before complete resolution. Lesions that are on the palms or bottom of the feet tend to be more resistant and may require multiple treatments.
Cantharidin: Chemical derived from a type of beetle which is applied to the skin and results in blistering and destruction of the affected area. Similar to cryotherapy, blisters gradually crust and heal in 2-3 weeks.
Electrosurgery: Electrical current is used to destroy the lesion.
Surgical excision: The lesion is anesthetized and surgically excised. Often reserved for larger or hard-to-treat warts.
Bleomycin injection: Chemotherapy injection which is injected into the lesion and causes direct destruction of the affected area.
Candin injection: Yeast extract which is injected into the skin. Works by drawing the body’s immune system to the wart, helping the body fight the wart. Results may vary.
Imiquimod cream: A topical cream that helps the body’s immune system fight the wart. Often a good treatment option for genital warts. Side effect incudes inflammation and irritation of the skin.
Salicylic acid: Over-the-counter and prescription-strength salicylic acid preparations can be applied directly to warts which cause resolution and peeling of the lesion. Often requires multiple daily treatments.

Depending on the size and location of the lesion, repeat treatments may be necessary for complete resolution. Our dermatologist can help determine which treatment options are best for you.