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Warts are a common viral infection of the skin. They affect 10% of the world’s population. 10-20% of school-aged children are affected. Warts are more common among patients with compromised immune systems. They can occur at any age and increase in children aged 12-16.

What are warts?

A wart is a small benign growth caused by the Human Papilloma Virus (HPV). A wart can be found anywhere on the body but most commonly appears on the hands, feet, arms, elbows, knees, legs, and around the fingernails and toenails.

There are more than one hundred different strains of HPV. Generally, common warts are benign, but some strains of the HPV virus can induce cancerous changes in the skin. These high-risk strains increase the risk of several types of cancers, including anal and penile cancer in men and cervical and vulvar cancer in women.

Warts are contagious and easily spread. Warts around the nails and on the feet are notoriously difficult to treat.

Types of warts

  • Common warts (Verruca vulgaris) frequently appear on the hands and feet of children and adults. A common wart is easily recognized by its appearance. It is flesh-colored, firm, rough, domed, lobed, and may contain blood vessels that appear as black dots. Common warts are slow growing and easily spread through contact.
  • Flat warts are similar to common warts but are small, flat-topped, round and smooth, and may be flesh-colored, brownish or yellowish. They tend to grow in groups near a break in the skin on the face, hands, and legs. Men get them on their faces from shaving, and women tend to get them on the legs where they shave.
  • Plantar warts appear as tiny black dots and develop on the soles of the feet. Walking can be painful with plantar warts. 

How does the virus infect the skin to cause a wart?

The virus enters the body through a break in the skin including a cut, scrape or hangnail as well as anywhere the skin is shaved. The virus can be spread through direct physical contact or indirect contact with a used towel or on hard surface shared by person who has a wart.  Common areas of spread are showers, gyms, and pool decks.

What are the symptoms of a wart?

Most warts cause no symptoms. Depending on the location, particularly the feet, they can be painful.

How are warts diagnosed?

Diagnosis is typically made based on a clinical examination and physical findings. If Dr. Michael Sotiriou’s examination indicates a potentially serious problem, he may take a biopsy of the lesion.

What are the treatments?

Once the diagnosis is made, the treatment options depend on symptoms and patient preferences. More invasive treatments are often reserved for recurrent warts.

At the point they come into the office, many patients have tried an initial treatment of topical salicylic acid available over the counter. Cryotherapy (freezing), retinoic acid, podophyllin, topical 5 FU, interferon and imiquimod are in office or prescription treatments. Injecting the wart using immunotherapy and cancer drugs have been successful in many cases. Surgical removal with laser, electrodessication, and excision are available, but not typically recommended.

Contact Salt Lake Dermatology & Aesthetics in Salt Lake City Utah to schedule a consultation.

At a Glance

Dr. Michael Sotiriou

  • Board-certified, Residency-Trained Medical and Cosmetic Dermatologist
  • Sub-Specialty Board Certification in Mohs Micrographic Dermatologic Surgery from the American Board of Dermatology
  • Fellow of the American Academy of Dermatology
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