What is a Wart?
A wart is a small, highly contagious bulge on the surface of the skin. It is the result of a skin infection caused by the human papillomavirus (HPV).
There are hundreds of types of HPV which can cause warts. Fortunately, most are manageable and may resolve within a few months without treatment.
A wart can occur following minor trauma to the skin, exposing the first layer thereby creating a gateway for infections. It can develop anywhere, even in the genitalia which can be distressing for those who are sexually active. (1)
Children are particularly prone to developing a specific variety of HPV skin infection called flat warts. These are commonly seen on the face and temples and are rarely observed in adults. (2)
Symptoms
HPV can spread very quickly upon exposure and can cause a large variety of warts. It works by entering through a gateway in the skin and triggering unusual cell growth. (3)
This cell growth becomes noticeable from the outside and can come in different shapes and sizes. It begins by hardening the skin, creating a thicker surface until it bulges out and forms a wart.
People are most likely to contract this virus through skin contact. However, it can also linger on the surfaces of floors or in fabrics such as towels and may infect a person upon contact. Young children and adolescents have an increased risk of incurring this infection, as do those who work with raw meat. (4)
For otherwise healthy people, a wart is usually nothing more than an inconvenience.
However, those with an immunity weakening disorder such as AIDS, or suffer from eczema, are not only at higher risk for infection by HPV but may experience serious consequences.
Very rarely does a wart carry cancer, but recent studies have shown that women who incur HPV near the cervix have a significantly higher risk of cervical cancer. (5)
A wart can also spread from one section of the body to another, therefore it is essential to resist the desire to scratch.
It may not provoke any symptoms other than itching and tightness. Sometimes the only indicator is the wart itself. Although some might cause discomfort and slight pain in the affected area, it’s typically nothing severe.
Below are explanations of different types and their respective characteristics: (6)
Common Wart
A skin growth with a hard texture can be identified as a common wart. (7)
These can range in size; some might be as small as a pinhead, while others may resemble a pea. Those affected might encounter them on the back of hands or fingers, around the nail or on the feet.
The area affected by the wart may harden and appear scaly or rough to touch.
Plantar Wart
A plantar wart will usually grow on the ankles and soles of the feet or toes. (8)
Dermatologists or physicians might refer to a wart on the sole as verrucas. When the virus affects this area, it can become quite large which leads to issues when the affected stands. Since the body places all its weight on the soles of the feet, this may cause a wart to grow inward as opposed to outwards.
When a wart expands inward it can create internal pressure or tightness which might be painful. It may cause discomfort for the sufferer while walking or standing.
Mosaic Wart
A growth which is white and flat is generally classified as a mosaic wart. (9)
This type will affect the soles of the feet as well. However, in contrast to a plantar wart, these are usually not painful and don’t cause as much discomfort.
A mosaic wart is generally seen around the balls of the feet or underneath the toes. These are usually quite small, approximately the size of a pinhead, but they can spread and appear larger.
Filiform Wart
A filiform wart may have a more unique appearance, with a spikey, almost thread-like exterior. Some might even describe it as a tiny brush. (10)
This type, in particular, has a habit of striking the face. It can be quite bothersome, mainly as it can spread around the eyes and lips.
Flat Wart
A slightly raised, small bulge can be defined as a flat wart. (11)
These appear to be rather small and are usually found around the face, especially on the temples or cheeks.
As we established earlier, this type is more prevalent during childhood. As the child grows, chances of acquiring a flat wart reduce significantly.
Genital Wart
A genital wart is a sexually transmitted disease which may only affect the genital area. These can be defined as small, hard bulges and can affect both genders. (12)
This type has the potential of being much more dangerous, especially towards women. (13)
A genital wart has been found to play a significant role in cervical cancer. Research reveals that traces of HPV are found in almost 99.7 percent of all cases of this disease.
Stages
A wart does not generally develop through stages and is not always in need of a diagnosis. Typically it may resolve on its own. Unless it remains persistent, is painful or if several warts appear, medical advice may not be needed. (14)
Any skin problem is typically assigned to a dermatologist, who specializes in skin-related problems.
A dermatologist can generally identify a wart by merely looking at it. If the wart seems to be potentially dangerous, a skin biopsy might be requested. This involves taking a small specimen from the blemish to be viewed under a microscope in a lab.
From here a dermatologist can identify causes for concern and thereby determine the next step in treatment.
Treatment
There are various treatments available for warts, depending on the type of wart and personal preferences. (15)
Treatment is usually not required in children as the wart will likely clear up quickly without leaving any traces. (16)
The treatment options for a wart include:
Topical
These typically include chemical lotions or creams such as salicylic acid. (17)
Topical medication might contain a substance called lactic acid. It is generally used to treat skin problems such as acne and psoriasis, but can also manage various warts.
Cryotherapy
During this therapy, a dermatologist will apply liquid nitrogen onto the wart. This will damage cells which formed the blemish. It should be repeated until healed and may cause slight pain at first contact. (18)
Laser Therapy
During laser therapy, heat will be focused on the wart until cells are destroyed. However, this may cause scarring. This treatment is generally used in cases where the growth proves hard to remove. (19)
Injections
Different drugs can be used which work to kill the cells and prevent them from growing out of control. These may include bleomycin and 5-fluorouracil.
A dermatologist will examine the wart and evaluate which medicine will produce the best end result. The doctor will then proceed to inject the dose directly into the growth. (20)
Removal
Some may prefer to remove the wart. This can be done from home with over-the-counter medicines and a nail file or emery board. However, always consult a physician prior, and never try to remove a wart from the face or genital area. (21)
Genital Wart
Those affected may treat it with cream or medicine. It greatly depends on texture and location. (22)
Unlike other types, a genital wart must be treated immediately to prevent spreading and complications.
FAQ
What is a wart? A wart is a contagious growth which may appear anywhere on the skin.
What are the signs of a wart? Symptoms can include itchiness, discomfort, pain and tightness. Each type of wart has a set of features which differ in texture and location. (23)
How do you develop a wart? A wart develops after incurring HPV. Following a minor injury or cut in the skin, contact with the virus may infect the sore. It generally results from person-to-person contact, but it can also be acquired through contact with infected objects.
How is a wart diagnosed? Many times when a wart is recognized by the affected person, a medical diagnosis is not required. However, if the wart has alarming appearance doctors might request a skin biopsy to rule out cancer. (24)
What is the best treatment for a wart? The two most prevalent treatments include topical medication and cryotherapy. Some prefer to let the wart run its course with no medical intervention. For genital warts medical advice should be sought. (25)
What are the long term complications of a wart? Women have an increased risk of cervical cancer from a genital wart. Otherwise, a persistent wart may cause emotional stress and low self-esteem. (26)
Is a wart considered a disability? No, a wart is not regarded as a disability.
Can a wart be cured? Yes, it can be removed with treatment or it may simply resolve on its own.
Is a wart life threatening? A wart in itself is generally not ruled as a life threatening ordeal. However, it can be a cause of cancer which might be fatal.
Summary
A wart is an ancient infliction which can be traced back to biblical times. It can be defined by a growth on the skin. (27)
It’s very contagious and can present in various types; these may range in shapes, color, sizes and can affect any part of the body.
It is not always a cause for concern unless the affected has a preexisting condition which compromises the immune system. Under most circumstances, it will resolve on its own over time, even without treatment.
However, it’s a good idea to take preventative measures. Wearing shoes around public pools and changing rooms, avoid sharing towels and wear protection during sexual intercourse can all reduce risk.