Warts and Genital Warts, and help on how to diagnose your wart!

Many people grow warts at some point in their life. Warts are most often found in a child or teenager.

Warts are unsightly and warts can be painful. There is quite a social stigma attached to having warts, especially if the warts are on prominent parts of the body like the hands, face or neck, or on the genital area. Warts make you feel unclean, and people see you as a source of contagion.

This article on warts is about having a short look at some of the different kinds of warts, and to help you diagnose the warts you may have.

What causes warts?

Warts are caused by the Human Papilloma Virus (HPV).

The HPV virus infects the epidermal cells of the skin. Like most viruses, HPV changes the way that the cell behaves, mostly by hijacking its internal DNA to make more copies of the virus, but also to help the virus to spread on to other hosts.

In the case of the warts virus family, this is done by making the skin cells grow much faster than usual, causing a roughly cylindrical, fat tough growth of skin, at the end of which the new wart viruses are released into the outside world. This growth is the wart (or papilloma).

As the wart growth stands out from the surrounding skin, the wart is prone to getting knocked and damaged; the wart also can be painful if pressed on, due to the added pressure it causes to local skin as you press the wart in.

There are many different subtypes of the wart virus, but they all behave in more or less the same way, causing this disfiguring growth of the skin.

Over 90 different wart strains are known to exist, and it is likely that the warts virus will develop new wart strains over time, as any virus can.

The warts virus is extremely contagious, and you pick it up through direct contact through broken skin such as a graze or burn, either with a wart or through contact with a surface that has been in contact with a wart recently. This is especially likely to happen on damp surfaces, and swimming pools are an example of a prime place to pick up warts.

The warts virus doesn’t always cause warts, so it is possible to be a carrier without exhibiting symptoms.

Warts are more likely to break out if the immune system is compromised, either with stress, exhaustion or fighting other infections. Some people, however, seem to be able to carry the virus without ever getting the symptoms, and exactly why this should be isn’t well understood.

The different kinds of warts

Warts are essentially distinguished by where they occur on the body, but they also can have slightly different appearances.

Common warts

Common warts are described in medical terms as being a ‘papular lesion’, which means the warts are raised from the surface of the skin (this is as opposed to a macular lesion, which lies flush with the skin surrounding it).

Common warts have a rough, lumpy surface, which is sometimes described as looking like a cauliflower, and will often contain tiny black dots, which are caused by bleeding from the tiny blood vessels that supply the wart.

Common warts come in all sizes but don’t usually get much bigger than a large pea.

As the common warts get larger, they may appear grayish in color, or even slightly translucent.

Common warts are most often found on the hands and feet but can appear on other skin surfaces, such as the elbows or knees.

Common warts usually occur singly or in small groups.

Common warts may be tender if they grow in an area that restricts their growth, like next to a toenail, but common warts aren’t usually especially painful by themselves.

Common warts are fairly fast growing, developing over a month or so.

Plantar warts aka thorn warts Warts that occur on the soles of the feet are called plantar warts, although most people know them as a verruca (plural verrucae). Such warts are also commonly called thorn warts. Plantar warts may appear flat, or even as though they are growing into the skin, but this is mostly because they get squashed when you walk on them. Plantar warts can be difficult to diagnose, as they may grow under calluses on the feet; plantar warts are also often confused with corns. Plantar warts actually have almost exactly the same structure and appearance as a common wart, even with the same tiny black dots, but they are more likely to be painful on account of the pressure plantar warts are under. This picture of plantar warts is following their treatment, but you can see that where the pressure is, the warts have flattened.

Periungual warts

Warts growing round or under a nail are called periungual warts.

Periungual warts can be quite sore, and are harder to treat than common warts purely because of where they are.

Seed warts

It is possible to get a sort of rash or carpet of many small warts - these are referred to as seed warts, but are just another manifestation of the same virus.

Filiform warts

The skin on the hands and feet is relatively thick and tough. Warts occurring elsewhere on the body, on areas where the skin is thinner, may have a different appearance - they are referred to as filiform warts, which is Latin for ‘spindle shaped’.

Filiform warts are longer and thinner, and possibly more protruding (like a short fleshy stalk) than warts elsewhere, and may have a thicker, horny cap.

Filiform warts are mostly commonly seen on the face or neck, particularly round the nose and mouth.

Although filiform warts are the same as common warts, and caused by the same group of viruses, the different appearance of the filiform warts is caused by the different quality of the skin they are occurring in.

Plane warts

Plane warts are a rarer kind, caused by specific subtypes of HPV, and tend to be smaller than common warts and have flat tops.

Plane warts are smoother, and either the same color as the surrounding flesh or a little darker with extra pigment.

Plane warts don’t have the little black dots that common warts do.

Plane warts are most often found on the back of the hand or on the face, and usually occur in multiple groups.

Plane warts may also occur in a thin line where the virus has entered a scratch on the skin - this is called the Koebner phenomenon.

Anogenital warts

Anogenital warts are warts found around the genitals or anus.

Anogenital warts are caused by specific types of HPV (number 6 and number 11 are common offenders).

Anogenital warts are usually transmitted by sexual contact and are thus classified as a sexually transmitted disease (STD).

Anogenital warts are very much like common warts, their main distinction being from where they occur on the body, but may be harder or softer depending on what kind of skin they grow on.

Vulval warts, for example, will tend to be soft, whereas penile warts will have a tougher, harder appearance.

Anogenital warts are very common, with about 1 in 100 people having the virus, although many people will just carry it without actually developing warts.

Wart Treatment

For almost all kinds of warts, the chances are that if you leave the warts alone, the warts will eventually get better of their own accord. Although it may take the immune system a long time to notice the warts, when it does it will get rid of the warts surprisingly quickly, within a couple of days and without leaving a scar.

But it may take months or even years before the immune system sees the warts and gets rid of them, and you may not want to wait that long to see your warts gone.

Donald believes that these Essential oils for warts appear to have an established place in treating warts, and you can find out more about them by clicking on the link.

In fact, warts can be quite hard to treat, or at least the wart treatments can take a long time to be effective. But warts, other than looking unpleasant and occasionally being in painful areas, are for the most part benign and harmless.

Most warts can be removed by minor surgery, either through burning the warts off with heat or frozen nitrogen or by cutting the warts out. Be advised that these wart treatments can be painful, sometimes extremely so, and also have the risk of leaving a permanent scar.

To help reduce the size of a wart, possibly before minor surgical options if it is very large, there are many different wart creams and solutions that can be applied. Collectively, these are called keratolytic agents (from Greek - ‘kerato’ means skin, hence the keratin that is the protein that occurs extensively in skin, and ‘lysos’ meaning to break down). These soften the skin cells that form the wart and either dissolve the outer layers of the wart away or help it be scrubbed down by pumice stones or other similar methods. An example is a mild solution of salicylic acid.

Either way, you should try to keep your wart covered. Partly this is to stop it getting knocked or cut, which will be painful as well as risk causing the wart to spread locally, but it’s also to help stop spreading warts to other people.

Don’t share towels whilst you have warts, and try not to walk on uncovered plantar warts - remember that they are extremely contagious, and you will probably end up giving the plantar warts to someone else without a bit of care.

It is not uncommon for warts to come back even once successfully treated.

If your wart is persistent, painful, changes color or grows extremely large or quickly, get it examined by your doctor to make sure it is a wart and not something else.

Anogenital warts are slightly more of a concern - both you and your sexual partner(s) should be screened for the virus as well as other sexually transmitted diseases.

Anogenital warts can be treated the same way, although the topical agents, such as wart creams or oils, are usually different (milder and less irritating, as the skin in the anogenital regions is more sensitive).

Some of the warts viruses that cause anogenital warts are associated with an increased risk of developing carcinomas later in life (that’s a kind of skin cancer), so it is well worth getting them checked out by a doctor.

[Genital warts can also be treated with essential oils and if you click on the link you can find out more about that too.]

Don't forget, a doctors opinion is best sought, as regular pap smears for cancer detection and so on may be required, even if the genital warts clear up.

Summary of warts and genital warts

In summary, then, warts are a common annoyance, but not generally a serious one. Warts are easily treated by simple methods, but if you can be patient, time will certainly heal them for you.

Main write by Dr. James D. Hogg, (BSc Oxon, MBBS & BA Hons), medical doctor, and minor rewrite by D S Urquhart.