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Warts

Wart Basics

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Created: July 22, 2006

Warts are a common, frustrating, and confusing problem for parents and children. In fact, some people still think that you get warts from frogs, that warts have 'seeds,' and have no idea that warts are a simple viral infection.

Although warts are caused by a virus and they are contagious, it is not clear why some people get them very easily, but other people in the same family, including household contacts, and their close friends and other contacts, don't get them.

Wart Symptoms

Common warts are flesh colored and have rough and irregular surfaces, have a dome shape, and can occur almost anywhere on a child's body.

Types of Warts

There are many different types of warts, most of which look different either because they are growing in different parts of the body or because they are caused by different viruses.
  • Classic or Common Warts
  • Plantar Warts - typically on the soles of a child's feet and can be painful. The little black dots in a plantar wart are broken blood vessels. Unlike a corn or callus, they do not retain the normal fingerprint marks around them.
  • Periungal Warts - warts around a fingernail or toenail
  • Flat Warts - smooth warts with flat tops and are often found on a child's face
  • Molluscum Contagiosum is not really a wart, but many doctors call them 'little warts.'
Except for molluscum contagiosum, which is caused by a poxvirus, warts are caused by the human papillomavirus (HPV), which also causes genital warts.

Wart Treatments

Your Pediatrician is likely to get frustrated when it comes to treating warts, as no wart treatment work consistently well and some are painful. Although most warts do typically go away on their own and may not require treatment, some do become painful, bothersome, rapidly spread, or don't go away, even after several years, and do need to be treated.

The most common treatments that your Pediatrician will likely try include freezing the warts with liquid nitrogen, which is called cryotherapy, or applying cantharidin to the warts. Both treatments should cause some blistering of the wart, causing it to come off, although multiple treatments are often necessary. The cantharidin treatments have the benefit of usually being painless, although it can trigger a large, painful blister later that day.

Although uncommon, a side effect of any treatment that induces a blister, including cryosurgery and using cantharidin, can be that the wart spreads to the edge of the blister, so that you end up with a much bigger wart after treatment. Another complication can be scarring.

Home Wart Treatments

Many parents try to treat their children's warts at home, which has become much easier now that home wart freezing kits are now available, such as Compound W Freeze Off, Dr. Scholl's Freeze Away Wart Remover, or Wartner Wart Removal System. In addition to home cryotherapy, another home remedy that many parents use involves applying salicylic acid to the warts, using OTC products such as Compound W Liquid Wart Remover or Dr. Scholl's Clear Away One Step Salicylic Acid Wart Remover.

An increasingly popular home wart remedy involves applying duct tape to warts. Using this duct tape treatment, you cover the wart with duct tape for six days. Next, remove the duct tape, soak the wart, and use an emery board or pumice stone to remove skin on top of the wart if possible. Reapply the duct tape after twenty-four hours and repeat the steps for one or two months, after which time over 80% of people often find that their warts are gone.

What You Need To Know

  • About 10% of kids get warts, typically when they are teens, although kids at almost any age can get warts.

  • Warts are contagious and typically spread from one to person to another by direct contact with warts, or by touching a contaminated towel, etc. Children can also spread them to other parts of their own body by touching or scratching their warts.

  • To help avoid warts, keep bites, scrapes, and rashes clean and covered, and wear shoes or sandals in all public places.

  • A Pediatric Dermatologist might be helpful to treat multiple warts or warts that simply aren't going away. Treatments that your Pediatrician might not have access to for difficult to treat warts include using higher strength salicylic acid, a pulsed dye laser, bleomycin, or intralesional immunotherapy.

  • Warts are actually benign tumors that occur when the wart virus infects keratinocytes, a type of skin cell.

  • Aldara (Imiquimod) is an immunomodulatory drug that is sometimes used to treat warts that won't go away.

  • Genital warts must be evaluated and treated by your child's doctor.



References:
1Pediatric viral skin infections. Purdon M - Clin Fam Pract - 2003 Sep; 5(3): 589
2Habif: Clinical Dermatology, 4th ed., Copyright © 2004 Mosby, Inc.
3Cutaneous warts: an evidence-based approach to therapy. Bacelieri R - Am Fam Physician - 15-AUG-2005; 72(4): 647-52

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