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Warts

A wart is a non-cancerous skin growth that is the result of a viral infection in the top layer of the skin. The HUMAN PAPILLOMA VIRUS (HPV) is the virus that causes warts. Warts are generally skin-coloured and have a rough texture, although they can also be smooth, flat, and dark. The location of a wart impacts its appearance.

TYPES OF WARTS
  • Common warts – can normally be found around the nails, on the fingers, and on the backs of the hands. They are the most common where skin has been damaged, for example where fingernails are bitten, or hangnails that have been picked at.
  • Flat warts - are smaller and smoother than other warts. They tend to grow in large numbers. They can occur anywhere, but in children they are most common on the face. In adults they are often found in the beard area in men and on the legs in women. Irritation from shaving probably accounts for this.
  • Foot warts - are typically found on the soles (plantar area) of the feet and are called plantar warts. When these warts are growing in groups they are called as mosaic warts. The majority of plantar warts do not protrude above the surface of the skin like common warts due to the pressure of walking flatting them and pushes them back into the skin. As with common warts, these warts may have black dots.
WHO GETS WARTS
Warts are transmitted from person to person, although on occasion the transition is indirect. The time from the first contact with the virus to the time the warts have grown large enough to be visible can be several months. The risk of catching hand, foot, or flat warts from another person is minimal.

WHY DO SOME PEOPLE GET WARTS AND OTHERS DON'T?
Some people get warts depending on how frequently they are exposed to the virus. The wart viruses tend to occur more frequently in skin has been damaged in some way, which explains the high frequency of warts in children who bite their nails. Some people are just more likely to catch the wart virus than are others, just as some people catch colds very easily. Patients with a weakened immune system also are more prone to a wart virus infection.

DO WARTS NEED TO BE TREATED?
In children, warts can disappear without treatment over a period of several months to years. However, warts that are rapidly multiplying, painful, or bothersome should be treated. In adults warts do not disappear quickly or easily.

TREATING WARTS
Dermatologists are trained to use a variety of treatments, the age of the patient and the type of wart will determine the treatment.

When Common warts are present in children the treatment can be done at home. The parents can apply plaster (Duofilm, Duoplant, Soluver), or a salicylic acid gel solution to the wart on a daily basis. There is generally minimal discomfort although it may take weeks of treatment to obtain results. Treatment should be stopped at least temporarily if soreness develops. Another treatment option is for your dermatologist to “paint” the wart with a cantharidin; this causes a blister to form under the wart.

For older children and adults cryotherapy (freezing) using liquid nitrogen is usually the preferred treatment. This treatment can be rather painful but rarely causes scarring. However, treatments should be repeated every 3-4 weeks. Laser treatment or Electrosurgery (burning) is used for more stubborn warts. Foot warts can be difficult to treat due to the fact the bulk of the wart is below the surface of the skin. Treatments options include liquid nitrogen, salicylic acid plasters, applying other chemicals to the wart (Cantharidin, Efudex, and DPCP), injecting bleomycin, or one of the surgical treatments including laser surgery, electrosurgery, or cutting.

Flat warts are often too numerous to treat with methods mentioned above. As a result, "peeling" methods using daily applications of glycolic acid, salicylic acid, or tretinoin are frequently recommended. For some adults, periodic office treatments for surgical treatments may be necessary.

THE VALIDITY OF “FOLK" REMEDIES OR HYPNOSIS
Many patients and doctors alike believe hypnosis and folk remedies can be effective. Since warts, especially in children, may disappear without treatment, it's hard to know whether it was a folk remedy or just the passage of time that led to the cure. Since warts are generally harmless, there may be times when these treatments are appropriate. Medical treatments can always be used if necessary.

RECURRING WARTS
In some cases it seems like new warts appear as fast as old ones disappear. This may happen because the old warts have shed virus to the surrounding skin prior to being treated. In reality new or "baby" warts are growing up around the original "mother" warts. The best way to limit this is to treat new warts as quickly as they develop so they have minimal time to shed virus to nearby skin. An examination by your dermatologist can determine if the wart was removed completely.

We put academic qualifications, many years of combined experience, and training in a variety of special interest areas to work for your healthy, radiant skin. Our providers – Drs. Schachter, Hanna, Curtis, Abdulla, Pollack, and Taradash – welcome new patients for treatment at the Dermatology on Bloor practice on Park Road in Toronto. Our team is here to serve your needs

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