The Dermatology Practice.

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Skin warts are common, benign growths caused by the human papillomavirus (HPV). They can appear anywhere on the body, affecting people of all ages. This comprehensive article explores the types, causes, symptoms, treatment options, and preventive measures for skin warts.

Types of Skin Warts

  1. Common Warts (Verruca Vulgaris): Small, rough, and flesh-colored, often on hands and feet
  2. Plantar Warts (Verruca Plantaris): Painful, flat warts on the soles of the feet
  3. Flat Warts (Verruca Plana): Smooth, flat warts, often on face, hands, and arms
  4. Genital Warts (Condyloma Acuminatum): Often taking on a cauliflower-shaped appearance- these warts are found in genital areas
  5. Filiform Warts: Long, thin, and thread-like warts, often on face and neck
  6. Periungual Warts: These are warts occurring at nail margins. In view of the functional nature of our hands and feet, they may be somewhat rough, thick and/or abraded. Should the nail plate be involved, they may alter the shape of the involved nail. Periungal warts have a propensity for recurring, due to the nailplate forming a barrier which may encumber direct treatment of the wart


    7. (Left: Common wart, Right: Palmar wart)


    (Left: Verrucous wart, Right: Periungal wart)


    (Left: Facial wart in a child, Right: Plantar wart)

    Credit: American Family Physician (2003).

Causes and Risk Factors

The main etiological agent is a skin virus known as Human Papillomavirus (HPV). There are over 100 strains, with some causing skin warts.

  1. Skin-to-Skin Contact: Direct contact with infected person or contaminated surfaces
  2. Weakened Immune System: Chemotherapy, and immunosuppressive medications
  3. Age: Children and teenagers are more susceptible owing to a maturing immune system/ response
  4. Skin Damage: Cuts, scratches, or bites provide entry points for HPV. After initial infection, warts frequently are spread by autoinoculation from scratching or shaving

Symptoms

  1. Small, Rough Growths: Typically 1-10mm in diameter
  2. Flesh-Colored or Pigmented: May be pink, brown, or gray
  3. Pain or Discomfort: Especially plantar warts
  4. Itching or Bleeding: Rarely, but possible

Treatment Options

All treatments are hampered by wart persistence and recurrence. Sometimes, field treatment may b be offered (treating a larger area surrounding the wart).

Topical Medications

They are locally exfoliative and abrasive- helping to remove the wart burden from the top layers of skin.

  1. Salicylic Acid: Over-the-counter (OTC) products
  2. Cryotherapy: Liquid nitrogen to freeze warts. This is a clinic administered procedure requiring regular sessions
  3. Cantharidin: Blistering agent derived from beetles
  4. Imiquimod: Prescription cream stimulating immune response
  5. Podophyllin: Prescription solution for genital warts

Surgical Options

  1. Curettage: Scraping off warts with a curette.
  2. Electrocautery: Burning off warts with electrical current.
  3. Laser Therapy: Targeted heat to destroy warts.
  4. Surgical Excision: Removing warts surgically.

Vaccination
HPV vaccinations, whilst useful in the prevention management of cervical cancer, is also effective in preventing skin wart occurrence from certain HPV strains.

Home Prevention Strategies

  1. Keep Skin Healthy: Moisturize and protect
  2. Avoid Sharing Personal Items: Towels, razors, and clothing
  3. Avoid Skin-to-Skin Contact: Especially over active lesions

    4. Conclusion

    Skin warts are common and usually harmless, but can be unsightly and uncomfortable. Understanding the types, causes, symptoms, and treatment options can help manage and prevent skin warts. Consult a healthcare professional for proper diagnosis and a tailored treatment programme.

    References

    1. American Academy of Dermatology. (2023). Warts: Diagnosis and Treatment.
    2. American Family Physician. (2003). Molluscum Contagiosum and Warts
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