Warts Or Verrucas
By Dr Syed Hidayathulla
A wart is a small growth with a rough texture that can appear anywhere on the body. It can look like a solid blister or a small cauliflower.
Warts are caused by viruses in the Human Papilloma Virus (HPV) family.
The appearance of a wart depends on its location on the body and the thickness of the skin, like for example Palmar warts appear on the hand. Plantar warts affect the feet. Black dots in the wart are blood vessels that can lead to bleeding.
As many as 1 in 3 children and teenagers are estimated to have warts, but only 3 to 5 percent of adults. This is because the immune system becomes better able to prevent their development over time. People with a weakened immune system are more likely to have warts.
Unlike moles, warts are often the same colour as the person’s skin. Warts do not contain pus unless they become infected. If infection occurs, they may require treatment with antibiotics.
Most warts disappear in 1 to 5 years without medical treatment, but treatment is available for all types of warts.
Types: Most common types of Warts include Common warts, Plane warts, Filiform warts, Mosaic warts, Genital warts, Palmar and plantar warts.
Common Warts: Common warts have a firm, raised, rough surface and may appear cauliflower-like.They can occur anywhere, but they are most common on the knuckles, fingers, elbows, knees, and any area with broken skin. Clotted blood vessels are often visible in common warts as small, darkened spots. These are known as seed warts.
Plane Warts: Plane warts are round, flat, and smooth. They can be yellowish, brownish, or skin coloured. Also known as flat warts, they grow most often on sun-exposed areas. They tend to grow in larger numbers, possibly between 20 and 100. However, of all wart types, they are most likely to disappear without treatment.
Filiform Warts: Filiform warts are long and thin in shape. They can grow rapidly on the eyelids, neck, and armpits.
Palmar Warts: These warts feel firm and rough. They can appear on palms, knuckles and fingers.
Plantar Warts: These painful warts appear on the soles of the feet, heels, and toes. They usually grow into the skin because the person’s weight pushes onto the sole of the foot. They normally have a small central black dot surrounded by hard, white tissue. Plantar warts are often difficult to clear.
Mosaic Warts: Mosaic warts are multiple plantar warts in a large cluster.
Genital Warts: These are warts on, in, or around the genitals. These warts can be more serious. In women, they can potentially lead to cervical, anal, and vulvovaginal cancer. In men, anal cancer and cancer of the glans penis can also occur as a result of infection with some types of genital warts. Anyone who develops genital warts should see their doctor for assessment.
Causes: HPV viruses cause the excessive and rapid growth of keratin, which is a hard protein on the top layer of the skin. Different HPV strains cause different warts. The wart-causing virus can be passed on by close skin-to-skin contact, and through contact with towels or shoes.
The virus can spread to other parts of the body through:
• scratching or biting a wart
• sucking fingers
• biting fingernails, if there are warts around the nails
• shaving the face or legs
Having wet or damaged skin, and coming into contact with rough surfaces increase the risk of infection. For example, a person with scratches or cuts on the soles of their feet is more likely to develop a wart in and around public swimming pools.
Wearing shower shoes or flip flops while using public showers or walking near public swimming pools can help prevent this.
The risk of catching warts from another person is low, but they can be passed on, especially if the person has a compromised immune system. This includes people with HIV or AIDS, and those using immune suppressants following a transplant. Genital warts are more contagious.
Handling meat as an occupation will also increase the risk of contracting warts. A study carried out by the American Academy of Family Physicians showed that 33 percent of slaughterhouse workers and 34 percent of retail butchers have warts on the hand.
When should I see a Doctor ?
It is a good idea to see a doctor if the wart:
• causes pain
• bleeds easily
• Changes appearance
• spreads easily to other parts of the body
• comes back after prior removal
• appears in an area that leads to constant irritation and bleeding so as to affect daily activities, such as shaving, sports, and so on
• Individuals who want the wart removed for cosmetic reasons should see a doctor.
To reduce the risk of catching or spreading warts:
• Do not touch other people’s warts.
• Do not use other people’s towels, wash cloths, or other personal items.
• Do not share shoes and socks with other people.
• Do not scratch warts or verrucae, as this can cause them to spread.
• Wear sandals when entering and exiting communal showers and pools.
• Cover warts or verrucae with a waterproof covering when swimming, and socks or gloves elsewhere, for example at the gym.
• Do not brush, comb, shave, or clip hair in areas that have warts.
• Do not bite fingernails if warts are near them.
• Keep hands as dry as possible.
• Wash hands thoroughly after touching a wart.
Treatment: Warts are common, and they can cause embarrassment. May disappear alone, but if they do not, treatment can often help eliminate them.
Medical help is available if they do not disappear, or if a wart causes concern.
Treatments include salicylic acid, duct tape, topical creams, cryotherapy, surgery, laser, electrocautery, photodynamic therapy.
All wart treatments are designed to irritate the skin and get the body’s own infection-fighting cells to clear the warts.
Of all the treatments, Cryotherapy is one of the safest & more definitive treatment in which a freezing liquid, often Nitrogen or Nitrous oxide, is sprayed onto the wart, destroying the cells. A blister develops, which eventually scabs and falls off a week or so later.
This treatment must be carried out by a healthcare professional. If the wart is large, this may require a local anaesthetic and more than one session.
At Primecare hospital, we have a very good facility for cryotherapy & can help you get rid of your annoying warts.
Dr Syed Hidayathulla,
is Consultant Family Physician & Cosmetologist, Primecare Hospital, Bangalore.
He can be reached at [email protected]