Viral warts

Verruca Vulgaris

What are viral warts?

Viral warts are harmless growths on the skin and mucous membranes caused by infection with papilloma viruses. Moderately contagious, warts may occur anywhere on the body, but the most common locations are the hands and feet.

Warts infect only the topmost layer of skin, and do not have roots, seeds, or branches. They may appear singly or together in a cluster.

How is it diagnosed?

Signs and symptoms of Viral warts

A small, raised bump on the skin with the following characteristics:

  • Warts begin very small (1mm to 3mm) and grow larger.
  • Warts have a rough surface and clearly defined borders.
  • They are usually the same color as the skin, but sometimes darker.
  • Warts often appear in clusters around a "mother wart."
  • If you cut into the wart surface, it contains small black dots or bleeding points.
  • Warts are painless and don't itch.
  • Plantar warts appear on the soles of the feet.

Physical exam: All warts are basically the same, but their appearance may be modified according to their location on the body. Common warts (verrucae vulgaris) are sharply defined, round or irregular, firm, flesh-colored growths of up to about one quarter inch (six millimeters) in diameter. They usually have a rough surface, and may appear on hands, face, knees, and scalp. Flat warts, flat-topped and flesh-colored, occur mainly on the wrists, backs of the hands, and the face. Digitate warts are dark-colored growths with fingerlike projections. Filiform warts are the long, slender growths that often occur on the eyelids, armpits, or neck of overweight, middle-aged people.

Tests: No diagnostic tests are indicated except biopsy when skin cancer is suspected.

How is it treated?

Many warts disappear spontaneously (without treatment) in six to twelve months. Warts are commonly treated by using liquid nitrogen to freeze them off (cryosurgery).

Other means of removing a wart include applying a keratolytic plaster (corrosive substance that destroys wart), burning it off (electrocautery), surgical removal (curettage), or laser removal.

Additional Information

Medications

  • Topical drugs, such as mild salicylic acid may be prescribed to destroy warts. If so, follow package instructions.
  • Tretinoin (retinoic acid) or benzoyl peroxide may be prescribed to help in treating warts.
isotretinoin

What might complicate it?

Individuals with depressed immunity (AIDS undergoing chemotherapy) can have extensive lesions.

Predicted outcome

Complete recovery is expected, although recurrences are frequent.

Alternatives

Similar conditions include hyperkeratosis, moles and skin cancer.

Appropriate specialists

Dermatologist and podiatrist.

Notify your physician if

You or your child has warts and you want them removed.

  • After removal by cryosurgery or electrocautery, signs of infection appear at the treatment site.
  • After treatment, fever develops.
  • Warts don't disappear completely after treatment.
  • Other warts appear after treatment.