Warts

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Introduction

Warts (wawts) are generally harmless growths on the skin, they are also known as verucca (vuh-roo-kuh). They are caused by the HPV virus. There are hundreds of different strains of HPV virus and each strain affects different parts of the body. Warts can come up anywhere on the skin or mucous membranes (mouth or gential areas), but they mostly occur on hands, feet, fingers, toes and face.

Plantar wart on a child's foot

Who gets it?

Warts are very common and affect one in five children. Warts are most common in the following groups:

School-aged children and young adults, though they may occur at any age
Children with eczema
Children on medications or with conditions that affect their immune system

What causes it?

Warts are caused by a family of viruses called the human papilloma virus (HPV). Warts can be spread to other people by skin-to-skin contact. Picking or scratching may lead to spreading of warts on the same child. The virus is more likely to infect skin that is injured or softened by water, but it can affect healthy normal skin as well. Warts can also be spread indirectly through swimming pools or public showers in children that walk barefoot. After getting exposed to the virus, it can take 6 months or longer for the wart to appear. The wart can then grow slowly over a period of months to years.

Genital warts are caused by a different type of HPV. They are sexually transmitted and can sometimes turn into types of genital cancers. Usual skin warts do not cause cancer.

What does it look and feel like?

Looks like…

Round or oval shaped bumps on the skin, usually less than 1 cm in size.
Often seen on the palms, soles, back of hands and knees, but they can occur anywhere.

Feels like…

They are often painless but can occasionally be painful, especially if they are on the bottom of your child's foot or under their nail.

What tests might be needed?

Warts can usually be diagnosed based on how they look. Sometimes a doctor may use a dermatoscope (a handheld device that magnifies the skin) to confirm the diagnosis. In very rare situations a biopsy may be needed.

What treatments are available?

Most children do not need treatment for warts especially if they are not causing any symptoms. Treatment of warts can depend on where the wart is and how much it bothers your child. Most warts go away on their own within two years. Sometimes the wart can get bigger or spread or become painful, so in these cases treatment may be necessary.

There is no single treatment for warts that works every time on every child and often multiple different treatment options are trialled before the wart resolves.

What can I do?

Cover the wart with a waterproof tape for 24 hours of the day - a masking tape usually does the trick.
Apply salicylic acid (a mild acid) on the wart once a day - these are avalible in various preparations over the counter at your local pharmacy. You should always follow the directions on the label. Usually before you put on the salicylic acid you should soak the wart in a bath or bowl of warm water to soften it and then rub the wart with a pumice stone or emery board to remove the dead skin over the top of the wart.

Medical therapies

Your GP or dermatologist may provide the following treatments:

Cryotherapy: this is a common treatment that usually requires 3-6 treatments to be effective. It can be quite painful and children may not tolerate this well. Sometimes scarring may result.
Cantharidin: blistering cream that is applied by the dermatologsit in the clinic to lift the wart off the skin. Usually 2 treatments or more may be required.
DCP: special sensitising cream is applied to create a dermatitis around the wart on purpose to help your child's immune response against the virus.
Prescription creams: the doctor will ask you to apply this at home for your child until the warts resolve.
Injections: the wart is injected with a medicine to clear the wart.
Tablets: very rarely the dermatologist may prescribe tablets for your child.

What happens after treatment?

Often, you might need to repeat treatments many times or combine different treatments to completely clear your child's wart. Patience is essential! Even without treatment, half of all warts disappear within six months. In two years, nine out of ten children have completely cleared their warts.