Brief overview
- Treatment: icing (cryotherapy), acid treatment, “burning” with electricity (electrocoagulation), laser treatment, surgical ablation (with curette, sharp spoon, scalpel).
- Symptoms: Different types of warts depending on location and cause – common warts, brush warts, plantar warts, flat warts, “fake” warts (dell warts, age warts, stalk warts).
- Diagnosis: Visual diagnosis, possibly tissue sample, rarely pathogen detection.
- Prognosis: Mostly harmless, often disappear on their own (sometimes after months or years); recurrence rate is high – with and without treatment.
- Prevention: Do not walk barefoot in swimming pools and the like, do not share towels or razors, tape off warts, do not scratch, protected sexual intercourse
What are warts?
There are different types of HPV. Depending on which type of virus is responsible for the infection and where it settles, morphologically different types of warts develop. There are also some skin lesions that look like warts, but are of a different origin.
A distinction is made between common warts, brush warts, plantar warts and flat warts, genital warts and “non-genuine” warts (dell warts, age warts, stalk warts).
How can warts be removed?
If you find the small skin growths cosmetically disturbing, discuss with a doctor how your warts can be removed. The same applies to warts that cause discomfort, such as plantar warts on the sole of the foot that make walking very painful.
What helps against warts?
Dissolving the horny layer
Various acids remove warts by dissolving their horny layer. Salicylic acid is usually used for this purpose, but sometimes another acid such as lactic acid is used. If flat warts on the face are to be removed, vitamin A acid is usually used. The acids are available as a solution, cream or patch in pharmacies – usually without a prescription.
Dissolving the horny layer
Various acids remove warts by dissolving their horny layer. Salicylic acid is usually used for this purpose, but sometimes another acid such as lactic acid is used. If flat warts on the face are to be removed, vitamin A acid is usually used. The acids are available as a solution, cream or patch in pharmacies – usually without a prescription.
The application of the liquid nitrogen sometimes triggers a short, stinging cold pain. As a result, the skin usually reddens and swells somewhat. A skin blister forms in some cases. It takes several days for the warts to heal with crust formation. If cryotherapy is performed with care, no scar remains.
It is not absolutely necessary to go to the doctor to remove warts with the help of cold. Meanwhile, pharmacies offer over-the-counter icing pens for self-treatment at home. However, these are less cold than the liquid nitrogen applied by the doctor. Study results showing the effectiveness of such icing pens are largely lacking to date.
Other methods
Special ointments and solutions with active substances that inhibit cell growth (5-fluorouracil) or viruses (aciclovir) are sometimes used to remove warts. Sometimes the doctor administers various drugs as an injection directly into the warts, for example 5-fluorouracil or substances that influence the immune system (interferons).
Some people have their warts lasered, that is, strongly heated and destroyed with a laser.
Photodynamic therapy involves applying a special gel to the wart. It is left to work for about three hours and then the wart is irradiated with light. Certain ingredients in the gel are activated and destroy the wart. The method actually originates from the treatment of skin tumors.
Home remedies against warts
Various medicinal plants are said to be helpful against warts. For example, the milk juice of celandine is said to eliminate the small skin tumors if you dab them with it several times a day. In the same way, warts can be treated with the milk juice of the dandelion or a solution of the tarsal root. This should also eliminate the small skin nodules.
Another home remedy is adhesive tape, which you stick on the wart. However, the effect is controversial.
Traditional is the method of “wart talking”, which is based on a form of suggestion. In the field of alternative medicine, this is often still offered – without any scientific evidence of its effectiveness.
Where can warts appear? What are the types?
Below you will find a description of the main true and false warts:
Common warts (Verrucae vulgares).
In most cases, common warts are the size of a pinhead to a pea. Their initially smooth surface becomes fissured and callused as they grow. In addition, the initially skin-colored skin growths gradually take on a dirty yellow color. They sometimes appear singly (solitary). However, they are more often observed in larger numbers.
Brush warts (Verrucae filiformes).
These are a special form of common warts with a long, filiform stalk. They form especially in older people on the face (eyelids, lips, nose) or neck. Occasionally they itch. It is also possible to irritate or injure brush warts when washing, drying or shaving.
Plantar warts (Verrucae plantares)
Unlike common warts, plantar warts are not raised, hemispherical skin growths. Instead, plantar warts are pressed inward. This is because they usually form on the sole of the foot: The body weight bearing down on them pushes the warts inward into the subcutis. In addition, plantar warts are usually quite painful, unlike ordinary warts. Every step is sometimes unpleasant for those affected.
Read more about the appearance and treatment of painful plantar warts in the article Plantar warts.
Flat warts (Verrucae planae juveniles)
Warts that are not very raised on the face or hands are probably so-called flat warts or planar warts. Occasionally, this type of wart is also found on other parts of the body. Flat warts are most frequently observed in children and adolescents. They are therefore also called juvenile warts.
Flat warts are harmless and often disappear on their own. Those who do not want to wait for this or suffer very severely from flat warts, talk to the doctor about treatment options.
You can read more about this in the article Flat warts.
Dell warts (Mollusca contagiosa).
Dell warts are not true warts – despite their name and similar appearance. This is because they are not caused by human papilloma viruses. Instead, the Molluscum contagiosum virus is the trigger of these wart-like, harmless skin nodules.
Inside them, dell warts contain an infectious secretion. If you come into contact with it, you become infected quite easily (smear infection). This is especially true if your own skin is softened (for example, when visiting a swimming pool or sauna). Then the viruses that cause the infection penetrate the skin more easily. Wounds, fungal infections of the skin and neurodermatitis also favor infection with the genital warts pathogens.
Read more about the topic in the article Dellwarzen.
Senile warts (seborrheic keratosis)
Senile warts are also not true warts, even though they resemble them. Their cause is unknown. However, it is known that they are not caused by viruses – neither by HPV nor by other types of viruses. Senile warts are therefore also not contagious.
Because age warts are harmless and usually do not cause any discomfort, they usually do not have to be removed. However, if you still want to get rid of them, you should consult a doctor (as with other warts): he or she will remove age warts with a surgical instrument (curette, sharp spoon, scalpel) or by laser. Pedunculated warts can be removed with an electric snare.
Peduncle warts (fibromas)
Stalk warts are also not true warts. Rather, they are soft, benign growths of certain skin cells. Their medically correct name is soft fibromas.
Pretty much everyone gets these small, pedunculated, skin-colored skin tags sooner or later. Why this happens is not known. However, since pedunculated warts occur more frequently in some families, experts suspect a genetic predisposition.
You can learn more about these stalked skin appendages in the article Stalked warts.
Genital warts (Condylomata acuminata)
You can read more about genital warts in the article Genital warts.
Causes and risk factors
In most cases, true warts are caused by human papilloma viruses (HPV): The pathogens penetrate skin cells via small injuries and cracks and trigger uncontrolled cell reproduction there. In the process, the invaders force the human host cells to produce further viruses.
Certain types of human papilloma viruses are involved in the development of several cancers (such as cervical cancer and penile cancer). However, these are not the virus types responsible for conventional verrucae. Caution is advised only in the case of the so-called genital or genital warts (condylomata).
Read more about human papilloma viruses (HPV) in our article HPV.
Non-genuine warts are not caused by HPV: Molluscum contagiosum viruses are responsible for dell warts. For age warts, the cause is unknown. The same is true for pedunculate warts.
Risk factors
Mental conflicts and stress also seem to increase the risk of disease. Affected adults are also often smokers.
Are warts contagious?
Viral warts are contagious (infectious): The viruses are transmitted directly from person to person, and sometimes indirectly through towels or razors. Between infection and the appearance of the first verrucae (incubation period) usually four weeks to eight months pass.
Someone who already has the small skin growths sometimes continues to infect themselves (autoinoculation). This is how the verrucae spread on the body: The viruses are transmitted, for example by scratching the skin nodules, to neighboring or more distant parts of the body, where they also settle.
Not contagious are “fake” warts, which are not caused by viruses (age warts and stalk warts).
Examinations and diagnosis
- a wart is bleeding or inflamed,
- warts develop on other skin diseases (like neurodermatitis) or
- dell warts spread quickly.
In the case of age warts, there may be a risk of confusion with skin cancer. Who is not sure therefore that wart-like skin nodules are actually harmless age warts, is well advised to go likewise to the physician.
Diagnosis usually simple
If the doctor is not quite sure, a tissue sample can be taken from the skin nodules and examined in the laboratory for fine tissue (histological). In individual cases, an attempt is made to detect the pathogens (human papilloma viruses) in the sample.
Course and prognosis
How quickly the small skin growths disappear in individual cases depends on various factors. For example, the type of virus and wart, as well as the state of the immune system, play a role. Verrucae, for example, are often very stubborn in people with weakened body defenses.
Once warts have healed – with or without treatment – you are not immune to them in the future: the recurrence rate is high.
Prevention
- Do not share towels, shoes, and socks with other people.
- Do not walk barefoot in swimming pools, community showers, gyms and locker rooms.
- Cover existing warts with a waterproof band-aid before swimming.
- Do not touch verrucae.
Also, ideally avoid scratching warts. Otherwise, you may transfer the viruses they contain to other parts of your body or to other people.
