Symptoms
Common warts are benign skin growths that occur mainly on the hands and feet. They have a fissured and rough surface, a hemispherical structure and occur singly or in groups. The black dots in the wart are thrombosed blood vessels. Warts on the sole of the foot are called plantar warts or plantar warts. They can cause pain when standing or walking and grow towards the inside. Warts are most common in children, adolescents, and people with immunosuppression. They are most common in teenagers. Adults are less commonly affected. Warts are primarily a cosmetic and psychosocial problem. Benign warts virtually never develop into skin cancer in immunocompetent individuals. This article refers to common warts on hands and feet. There are other types as well. For detailed information, see the corresponding articles (selection):
- Plane warts (Flat warts).
- Condylomata acuminata (Genital warts)
- Molluscum contagiosum (dell warts)
- Filiform warts (brush warts)
- Age warts
Causes
The cause of the disease is an infection of the epidermis of the skin with human papillomaviruses (HPV). These are DNA viruses, of which many different types exist. The infection leads to hyperplasia (cell proliferation), thickening and hyperkeratosis of the epithelium. The viruses are transmitted during direct contact with an infected person or through surfaces and objects. They enter the skin through a small injury. For example, nail biting is a risk factor for the development of warts near the fingernails.
Diagnosis
Diagnosis is made in medical treatment on the basis of the clinical picture and, less frequently, additionally with the examination of a tissue sample (biopsy). Other skin diseases such as skin cancer and corns must be excluded.
Nonpharmacologic treatment
A first option is to wait and see. Warts often disappear on their own within months to years. However, they can continue to spread, persist, and they are contagious. Warts are destroyed by physical methods. One common method is icing (cryotherapy). In this process, an applicator is saturated with liquid nitrogen, resulting in very low temperatures. The applicator is held briefly on the wart. After one to two weeks, the wart can be removed. Warts can also be ablated or cut out with a minor procedure. Methods used include curettage, laser treatment, cauterization, and photodynamic therapy. Warts can be covered with a patch or other methods so they are not visible or contagious.
Drug treatment
Corrosives and keratolytics with corrosive and peeling effects, such as salicylic acid, lactic acid, urea, chloroacetic acid, trichloroacetic acid, formic acid, and silver nitrate, are often used for drug treatment. Some such wart remedies are also available without a doctor’s prescription. Salicylic acid is considered to be well effective and is recommended in the literature as a first-line agent. Cytostatic agents such as fluorouracil have direct antiviral and cytotoxic properties. Immunomodulators such as imiquimod elicit an immune response. However, imiquimod is not approved for common warts. Other options (some off-label):
- Potassium hydroxide
- Bleomycin (intralesional)
- Formaldehyde
- Glutaraldehyde
- Diphenylcyclopropenone (DPCP)
- Cimetidine (oral)
- Zinc (local or peroral)
- Retinoids
- Podophyllotoxin
Alternative medicine remedies include:
Note: Treatment of planar warts is usually done with a retinoid, such as isotretinoin gel, rather than a caustic. The application depends on the preparation. As a general rule, wart medications should not get on healthy skin or in the eyes. As a complication, scars can occur with most treatment methods.
Prevention
- Avoid skin contact with warts carriers and do not touch your own warts.
- Stick over warts in the pool with a waterproof plaster.
- Wear bathing shoes in the swimming pool.
- Do not scratch or manipulate warts.
- Give up nail biting.
- Do not share towels, shoes and gloves.
