Warts – Causes, Symptoms, Treatment & Prevention

What are Warts?

Human papillomaviruses (HPV) are a large group of viruses, numbering over 200, some of which cause different types of warts and other skin lesions. HPV infects the superficial layers of the skin as it enters through small injuries or by skin contact with people who already have warts. As a result, an enhanced division of the upper layers of the skin appear and this leads to the formation of warts. Some warts may disappear by themselves after months or years.

Warts can appear anywhere on the body and are divided into several types. For example, common warts are found mostly on the hands, especially on the fingers and the palms. Flat warts are more typical for the face. Plantar warts affect human feet etc.

Warts are spread easily by direct contact with human papillomavirus. Everyone can be affected right after scratching oneself after being in contact with an affected person. You can also get infected if you share towels, razors or other personal items. After initial contact with HPV, it may take several months before you notice the wart.

In general, not any contact with HPV leads to the development of warts. Some people are more prone to the infection than others. Even people from the same family have different susceptibility to the virus.

Warts can vary in size and color. They can have rough and uneven surfaces, as well as flat and smooth ones. At the center of warts, there are small blood vessels growing (their purpose is to supply warts with blood). Usually, common warts are painless. Exceptions are those located in places under pressure and friction, such as plantar warts.

Although warts are not considered a serious health threat, it is important to know how to treat them because of their tendency to spread, and the risk of infecting other people.

What are the different types of warts?

The types of warts can be determined by their locations (the area which is affected) and their appearance.

Common warts

The most familiar type of wart has a domed shape and occurs most often on the outside of the fingers or toes. They are more likely to affect the skin which was broken. Common warts can have black dots and can be associated with rough bumps.

There are warts, which are located only in the lower leg (also known as plantar warts). Such warts often grow in clusters (mosaic warts). Plantar warts are often flat or grow inward as a result of the pressure they are exposed to while walking or running. Sometimes, plantar warts cause minor discomfort, but when a very sensitive area if affected, plantar warts can cause significant pain.

Plantar Warts
Figure 2: Six weeks later following biopsy, the wart had completely disappeared (inset: close-up view).
Credits: openi.nlm.nih.gov

Flat Warts

The flat (“plane”) warts affect the facial area, feet and other body parts. They often occur in large quantities (20 to 100 at a time). This type of warts is smaller and smoother than any other type. They are usually skin-colored spots which are absolutely painless but it can take very long to resolve (up to two years).

Periungual warts

Warts around or under the finger/toenails (Periungual warts)

When they first appear, they have the size of a pinhead, therefore it is almost impossible to notice them. Couple of weeks later, they grow bigger and turn into rough, irregular bumps. Sometimes, as they grow, they can affect the nail plates, in more severe cases, permanently deform the nails and, sometimes, even cause a fungal infection.

Periungual warts
Source: www.https://zh.wikipedia.org/

Filiform warts

Warts having the form of a pillar, most often appear on the face. They usually grow around the mouth, nose, and eyes and develop very quickly. Filiform warts are also painless but also have the tendency to spread to other parts of the body.

All these types of warts are caused by contacting people who have HPV (touching, sharing clothes, shoes or items for personal hygiene. The HPV can be found on different surfaces, including shower floors, saunas, pools so it is very important to protect your skin from such contact e.g. by wearing flip-flops when entering a place where the infection could be existing.

Filiform warts
Source: commons.wikimedia.org

What’s the treatment for common types of warts?

Information on warts’ treatment refers to the types of warts, not including the genital ones. There are various methods for common warts treatment, including home remedies, over the counter remedies and surgical removal of warts.

Treatment of common warts on the skin is usually based on the use of products containing salicylic acid. Newer treatments include warts freezing techniques.[4]

 Salicylic acid – based formulations

Such products are available as drops, gels, and plasters. They are designed for use on all types of warts, from smaller ones to the largest ones. Salicylic acid [5] has bacteriostatic, fungicidal and keratolytic properties, which leads to protein (keratin) dissolution that makes up warts and a thick layer of dead skin, which often covers them.

Wart freezing

Treatment with aerosol sprays, which freezes warts at a temperature of minus 57 ° C. There is a common treatment with liquid nitrogen used by dermatologists which, however, uses much colder temperature -196˚C.

Duct Tape application

It is claimed that warts can be “stifled” by covering them with duct tape or other adhesive. This type of treatment [1] requires patience because the duct tape should be applied on the affected area until the complete disappearance of the wart. A clinical trial analyzing The Efficacy of Duct Tape vs Cryotherapy in the Treatment of Verruca Vulgaris (the Common Wart) concluded that duct tape occlusion therapy was significantly more effective than cryotherapy for treatment of the common wart.[3]

some practical approaches for the treatment of warts:

If you can ignore the existence of your warts in the process of treatment, this would be the best you can do. Eventually, they will disappear (although this can take long time – months or even years).

If your problem is not very dramatic e.g. you have a single wart, you can consult a doctor for quick freezing or electric elimination. These methods are simple, almost painless and leave no scars on the skin.

 If you have large and solid warts, you can start self-treatment:

Plantar warts – while they are still within the surface layer of the skin, the affected area can be treated with salicylic acid drops and various ointments in order to remove the thick surfaces and reduce their sizes.

Warts under the fingernails: They are extremely resistant to treatment. Various studies concluded that the best treatment for periungual and subungual viral warts is the carbon dioxide laser treatment. [2]

Herbal treatment of warts

Essential Tea Tree Oil

Apply undiluted essential tea tree oil [5] with a cotton swab directly on the wart 4 times a day. This treatment requires at least 2 weeks.

Echinacea

Prepare echinacea [6] tea in order to strengthen the immune system: 1-2 tsp of Echinacea herb, which is boiled in 500 ml water for 15 minutes. Drink 1 tea cup 4 times a day after meals.

Vinegar

Soak lemon slices in apple cider vinegar [7] with some salt. Leave the so-prepared mixture for two weeks. After that, rub the lemon slices onto the wart.

Garlic

Garlic [8] has powerful anti-viral properties. Chop some raw  garlic. Apply some essential oil on your skin and add vitamin E. Place the garlic directly on the wart. Cover with a bandage and leave it there for 24 hours. The wart should disappear within one week.

Calendula

Calendula [9] has anti-viral properties. Long ago, the Romans used the plant to treat warts, indeed the old latin name for the plant was verrucaria, the wart curing plant. A strong tea of the herb is prepared by soaking the 2 tablespoons of calendula herb for 20 minutes in a cup of boiling water. You can drink it or apply it as a compress on warts. Another herb that you can use the same way is St. John’s Wort [10].

onion and honey

The mixture of onion and honey, the ratio between products is 1:2. Instead of onions, you can also use garlic, which is grated or chopped into small pieces. Next step is to apply the mixture onto the wart and leave it for about 15 minutes.

Potatoes

Using the potato peel to treat the wart infection is a very common technique. You should just cut peel the skin off of a potato and cover your wart with it. Apply the potato peel (smooth cut side down) on the wart. Apply a band-aid to secure the potato peel in place. The wart will completely disappear within 3 weeks.

Castor oil

Apply hot castor oil [11] on the wart. Repeat is procedure 3 times a day until warts disappear completely. You should not apply the castor oil for more than a week.

Over the counter treatments for warts

Nonprescription treatments for warts are also great if you would like to get rid of the infection as fast as possible. They are usually sold in liquid, gel, pad, or ointment form. The list below shows the products with most positive customer reviews and highest rankings:

Compound W

Wart Remover, Maximum Strength, Fast-Acting Gel, 0.25-Ounce

This is a formula for both common and plantar warts removal. The active ingredient is salicylic acid (17%); the product should be applied directly to the affected area (each wart should be covered) once or twice daily as needed. Most customers inform that the product removed their warts after a couple weeks. One of the reviews suggests to ‘put some tape over the affected area to suffocate the wart some more, and the warts go away faster‘. However, there are customers considering it difficult to use. Bad comments warn that the product dries the skin and did not work as expected.

Dr. Scholl’s Freeze Away Wart Remover, 7 Treatments, Box 

Wart Remover, 7 Treatments, Box 

Another product which is very popular for warts treatment is Dr. Scholl’s Freeze Away Wart Remover. It is important to strictly follow the application requirements in order to accomplish the desired results. There are comments telling that the product works depending on the type of warts you have – it is less effective on bigger warts:

„The wart was somewhat large, so I would expect it to have least gotten a little smaller.”

Wart Stick

Max Strength Wart Remover, 0.2 Ounce

Active ingredient in the product is salicylic acid 40 percent. Inactive ingredients castor oil, chlorobutanol in a waxy base. Customer reviews inform that this wart remover is very easy to use and is very effective on common and plantar warts. It seems that this product works faster than freezing kits, according to a comment.

Negative reviews claiming that this wart remover is not effective also include that the product „Made the skin around the wart turn red and get dry and scaly.”

Bazuka

Extra Strength 6G

The gel is developed to remove verrucas, warts, corns and calluses. The product is one of the highest rated available online and according to more than 80% of the comments –very effective as well. It has no negative reviews which is also impressive. Some customers inform that their warts have completely disappeared after a few days, for others it took longer:

„Not as fast acting as stated other reviews, but definitely working. I’m glad that I bought 2 tubes.”

Duofilm

Liquid Salicylic Acid Wart Remover – 1/3 Oz

This wart remover is created for both common and plantar warts treatment. It has nice reviews on the Internet claiming that it is very effective for warts removal, but negative ones inform that:

„it turns your skin white, builds up to a hard shell and really doesnt do much”

Prevention

The only way to prevent warts infection is to avoid any contact with HPV. Below are some useful tips on how to prevent potential infections:

Protect your skin from scratching.Do not damage the skin around the wart, otherwise other healthy areas can also get infected.

Dry your feet thoroughly after showering or swimming. Always wear suitable shoes that allow your feet to breathe.

When you walk by swimming pools and other public places always wear flip-flops – never walk barefoot!

Do not share your personal hygiene items (towels, razors etc.) especially if other people in the family are infected with the virus that causes warts.

When you are in good health and have a strong immune defence, it would be much easier for you to overcome the virus HPV if infected.

What happens when you cut off a wart yourself?

To be honest, most of the people who tried to remove their warts by themselves and shared their experience on the Web did not really succeed. They inform that even if they had successfully removed the entire wart, it would come back within a few weeks. The complications expected after cutting off warts by yourself are

  • You will have a small wound there.
  • It can get infected
  • It may come back or spread
  • It may hurt

On the other hand, there are people claiming that this is the only thing that really worked for them.

Whatever method for warts treatment you choose, you should be aware that warts can be stubborn, so you may need to use more than one type of treatment.

References

  1. http://jamanetwork.com/journals/jamapediatrics/fullarticle/203979
    The Efficacy of Duct Tape vs Cryotherapy in the Treatment of Verruca Vulgaris (the Common Wart)
  2. https://www.ncbi.nlm.nih.gov/pubmed/1294058
    Carbon dioxide laser treatment of periungual and subungual viral warts.
  3. http://jamanetwork.com/journals/jamadermatology/fullarticle/411864
    Duct Tape for the Treatment of Common Warts in AdultsA Double-blind Randomized Controlled Trial
  4. http://www.cmaj.ca/content/182/15/1624.short
    Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: randomized controlled trial
  5. https://www.ncbi.nlm.nih.gov/mesh/68020156
    Salicylic Acid Compound Information
  6. http://www.wrightsnutrients.com/ns/DisplayMonograph.asp?storeID=v3qdfkaq17s92nd700akhlbd3ucfbvqa&DocID=bottomline-echinacea
    Echinacea (Echinacea angustifolia, Echinacea pallida, Echinaceapurpurea) in warts treatment
  7. http://onlinelibrary.wiley.com/doi/10.1111/1750-3841.12434/full
    R: Concise Reviews in Food Science; Functional Properties of Vinegar
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211483/
    Garlic in dermatology
  9. https://www.ahcmedia.com/articles/53134-calendula-preparations-to-treat-cutaneous-infections
    Calendula Preparations to Treat Cutaneous Infections
  10. http://onlinelibrary.wiley.com/doi/10.1111/j.1610-0387.2010.07496.x/full
    Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and herpes simplex
  11. http://www.sciencedirect.com/science/article/pii/0378874182900381
    Various uses of the castor oil plant (Ricinus communis L.)

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