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OVERVIEW

What are warts?

Warts are small growths on the skin that normally don’t cause pain. Some warts itch and may hurt, especially if they’re on your feet. There are five kinds of warts:

• Common warts usually appear on the hands
• Flat warts usually appear on the face and forehead
• Genital warts (condyloma) appear on the genitals, in the pubic area and between the thighs
• Plantar warts are found on the bottoms of the feet
• Subungual and periungual warts are found under or around the fingernails and toenails

CAUSES & RISK FACTORS

What causes warts?

Warts are a type of infection caused by viruses in the human papillomavirus (HPV) family. There are more than 100 types of HPV. Warts can grow on all parts of your body. They can grow on your skin, on the inside of your mouth, on your genitals and on your rectal area. Common types of HPV tend to cause warts on the skin (such as the hands and fingers), while other HPV types tend to cause warts on the genitals and rectal area. Some people are more naturally resistant to the HPV viruses and don’t seem to get warts as easily as other people.

Can warts be passed from one person to another person?

Yes, warts on the skin may be passed to another person when that person touches the warts. It is also possible to get warts from using towels or other objects that were used by a person who has warts.

Warts on the genitals are very contagious and can be passed to another person during oral, vaginal or anal sex. It is important not to have unprotected sex if you or your partner has warts on the genital area. In women, warts can grow on the cervix (inside the vagina), and a woman may not even know they have them. They may pass the infection to her sexual partner without knowing it.

TREATMENT

Will warts go away on their own?

Often warts disappear on their own, although it may take many months or even years for the warts to go away. But some warts won’t go away on their own. Healthcare providers are not sure why some warts disappear and others do not.

Do warts on the skin need to be treated?

Generally, yes. Common warts are often bothersome. They can bleed and cause pain when they’re bumped. They can also be embarrassing, for example, if they grow on your face. Treatment may decrease the chance that the warts will be spread to other areas of your body or to other people.

How are warts on the skin removed?

First of all, it’s important to know that warts on the skin (such as on the fingers, feet and knees) and warts on the genitals are removed in different ways. Don’t try any home remedies or over-the-counter drugs to remove warts on the genital area. You could hurt your genital area by putting certain chemicals on it. You also shouldn’t treat warts on your face without talking to your healthcare provider first. The following are some ways to remove common warts from the skin:

• Applying salicylic acid. You can treat warts on places such as the hands, feet or knees by putting salicylic acid (one brand name: Compound W) on the warts. To get good results, you must apply the acid every day for many weeks. After you take a bath or shower, pat your skin dry lightly with a towel. Then put salicylic acid on your warts. The acid sinks in deeper and works better when it is applied to damp skin. Before you take a shower or a bath the next day, use an emery board or pumice stone to file away the dead surface of the warts.
• Applying cantharidin. Your healthcare provider may use cantharidin on your warts. With this treatment, the healthcare provider “paints” the chemical onto the wart. Most people don’t feel any pain when the chemical is applied to the wart. You’ll experience some pain and blistering of the wart in about 3 to 8 hours. After treatment with cantharidin, a bandage is put over the wart. The bandage can be removed after 24 hours. When mixtures of cantharidin and other chemicals are used, the bandage is removed after 2 hours. When you see your healthcare provider again, they will remove the dead skin of the wart. If the wart isn’t gone after one treatment, your healthcare provider may suggest another treatment.
• Applying liquid nitrogen. Your healthcare provider may use liquid nitrogen to freeze the wart. This treatment is called cryotherapy or cryosurgery. Applying liquid nitrogen to the wart causes a little discomfort. To completely remove a wart, liquid nitrogen treatments may be needed every 1 to 3 weeks for a total of 2 to 4 times. If no improvement is noted, your healthcare provider may recommend another type of treatment.
• Other treatments for warts on the skin. Your healthcare provider can also remove warts on the skin by burning the wart, cutting out the wart or removing the wart with a laser. These treatments are effective, but they may leave a scar. They are normally reserved for warts that have not cleared up with other treatments.

Talk to your healthcare provider about which treatment is right for you.

How does cryosurgery work?

Cryosurgery is a 2-step process that removes the wart without hurting the skin around it.

The first step is getting your wart ready to be removed. You can help with this step. The second step is freezing the wart, which will be done by your healthcare provider in their office. You may need to have several freezing treatments before the wart is completely removed.

What do I need to do to prepare the wart for cryosurgery?

You must do some things on your own at home to get the wart ready for removal. Doing these things before you come to your healthcare provider’s office can reduce the number of freezing treatments you need. You should do the following:

• Every night for 2 weeks, clean the wart with soap and water and put salicylic acid gel on it.
• After putting on the gel, cover the wart with a piece of 40% salicylic acid pad (one brand name: Mediplast). Cut the pad so that it is a little bit bigger than the wart. The pad has a sticky backing that will help it stay on the wart.
• Leave the pad on the wart for 24 hours. If the area becomes very sore or red, stop using the gel and pad and contact your healthcare provider’s office.
• After you take the pad off, clean the area with soap and water, put more gel on the wart and put on another pad. If you are very active during the day and the pad moves off the wart, you can leave the area uncovered during the day and only wear the pad at night.

What happens next?

After 2 weeks of this treatment, your wart will have turned white and will look fluffy. Your healthcare provider will then be able to remove the white skin layer covering the wart and use cryosurgery to freeze the base (root) of the wart. If your skin reacts strongly to cold, tell your healthcare provider before cryosurgery.

Cryosurgery can be uncomfortable, but it usually isn’t too painful. The freezing is somewhat numbing. When your healthcare provider places the instrument on your skin to freeze the wart, it will feel like an ice cube is stuck to your skin. Afterward, you may feel a burning sensation as your skin thaws out.

Healing after cryosurgery usually doesn’t take long. You will probably be able to enjoy all your usual activities while you heal, including bathing or showering. Cryosurgery leaves little or no scar. After the area has healed, the treated skin may be a bit lighter in color than the skin around it.

How are warts in the genital area treated?

Genital warts must be treated by your healthcare provider. Warts in the genital area can be removed, but there’s no cure for the viral infection that causes the warts. This means that the warts may come back even after they have been removed.

Do common warts ever come back?

Most of the time, treatment of warts on the skin is successful and the warts are gone for good. Your body’s immune system can usually get rid of any tiny bits of wart that may be left after a wart has been treated. Genital warts are more likely to come back because there’s no cure for the virus that causes them and because warts are more difficult to control in a moist environment. If warts come back, contact your healthcare provider to talk about other ways to treat them.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• Do I have a wart?
• How did I get a wart?
• What is the best way to avoid spreading warts to other parts of my body?
• How can I avoid giving warts to my family?
• What treatment is best for me?
• Do over-the-counter treatments work for warts?
• Will I need cryosurgery?
• How long will the cryosurgery treatment take?
• Are there other ways to get rid of my wart?
• Will I get more warts?