Warts

Skin warts are local outgrowths or thickening of the skin that are caused by the human papilloma virus (HPV). There are about 100 types of HPV, and many of them can cause warts on different parts of the body. Some of these warts are round, and others are oval. Some are raised, and some are flat. Some occur alone while others appear in clusters.

Warts are contagious skin lesions that can be spread by direct contact. The HPV virus usually infects damaged skin, but can infect an intact, healthy skin as well.

Types of warts

There are different types of warts depending on their location and appearance:

• Common warts - Common warts, as the name implies, are the typical type of warts that grow on the fingers, toes, or anywhere in the body. These are usually round and elevated outgrowths of the skin. that are
• Molluscum contagiosum - Molluscum contagiosum, most commonly seen in children, is also a viral skin lesion that presents with round outgrowths of the skin. However, skin lesions of molluscum contagiosum are smooth and pearly whereas common warts are rough and fleshy.
• Plantar warts - Plantar warts are warts that grow on the sole. These warts appear as flesh bumps on the sole that are speckled with rough black dots. These warts can cause significant discomfort when walking.
• Periungual warts - Periungual warts are warts that grow around or underneath the nails. This type of wart can cause pain and can sometimes affect the growth of the nails.
• Flat warts - Flat warts are smooth, flat outgrowths that usually occur in clusters on the face, neck and extremities of younger individuals. These are usually small and sometimes difficult to spot.
• Filiform warts - Filiform warts are warts that look like tiny finger-like projections. These are like small skin tags that usually grow on the neck and face.
• Genital warts - Warts can also grow around the genital area. They can appear like small, pinkish, cauliflower-like lesions on the genitalia. This type of wart is a sexually transmitted disease and is particularly important because of its risk of being associated with cancer.

Home remedies

• Warts are generally benign conditions that resolve spontaneously even without treatment. Two-thirds of warts will spontaneously resolve without treatment within two years. However, because their appearance can be distressing or because they are located in bothersome locations, some people choose to treat them. Here are some home remedies that may be effective in removing warts:
• Salicylic acid - This keratolytic medication that promotes the sloughing off of skin. This medication is applied on a daily basis for several weeks before results are seen. To make it work faster, it is advised to soak the skin for 15-20 minutes in warm water before applying the medication. In between treatment, the wart should be filed gently using an emery board, a nail file or a pumice stone.
• Duct tape - A duct tape can be used to cover the wart for several days, and then it is soaked in warm water for 15-20 minutes. After that, the wart is filed to remove the dead skin and is covered again with duct tape. The process is repeated several times until the wart disappears.
• Freezing - Over-the-counter liquid nitrogen sprays are available. It can freeze the top layer of the skin and allow the wart to be scraped.

When to seek a doctor

A consult to the doctor is advised in the following situations:

• If you are not sure if your lesion is just wart
• If you are not sure about using home remedies
• If you have tried home remedies but your warts are still there
• If your wart is on your face (Do not attempt to remove facial warts at home.)
• If your wart is on the genital area
• If you are diabetic (Do not attempt home remedies if you are diabetic.)

Treatment

Your doctor can offer you other treatment modalities that work faster and are more effective in removing wart. These include:

• Liquid nitrogen - Unlike the spray, liquid nitrogen is colder and can freeze a bigger part of the wart. However, this can be a bit painful. Most people heal within a week but multiple treatments may be required.
• Cantharidin — The clinician applies this liquid medication which initially is usually pain-free but some can develop blisters, pain, and swelling in the first 24 hours after treatment. Most people heal within a week. Follow-up treatment at home with salicylic acid is usually recommended for 7 days after the skin heals to minimize the chances recurrence.
• 5-Fluorouracil — This medication is a cream that requires prescription and is used to treat flat warts. The cream is applied twice a day for up to five weeks.  Avoid the sun, which can cause irritation.
• Imiquimod — This medication is a cream that requires prescription that works by provoking the immune system to fight the wart. The cream is applied at night multiple times per week.  Skin irritation side effects are not uncommon during treatment.
• Immunotherapy — This procedure involves a substance injection into the wart to provoke the body’s immune system to respond to the infection. This procedure is repeated every three weeks (maximum five doses) until the wart disappears.
• Shave excision or surgery— Your doctor can remove the wart by burning it with electrocautery or by excising it using a knife. The doctor performs the procedure, usually after injecting local anesthesia to numb the skin.

Prevention

Wart is a contagious skin disease. To prevent getting it or spreading it, the following are recommended:

• Wash your hands frequently with soap and water.
• Avoid manipulating your warts.
• Cover your warts with a plaster.
• Practice safe sex.