Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis
All warts, no matter where they grow on the body or what they look like, are caused by the same family of viruses called the human papillomavirus (HPV) group. Although in the same family, different types of these viruses tend to infect different areas of the body. Warts are classified by their characteristic appearance as well as where they appear on the body.

• Common warts: warts that frequently occur on the hands, arms, and legs. The warts often look like little rough cauliflowers.
• Periungual warts: warts around the fingernails.
• Flat warts: warts are flat, slightly elevated, and flesh colored, and occur on the face, knees, and elbows of children and young women.
• Genital warts: warts on the genital and rectal area, often transmitted sexually.
• Plantar warts: warts on the bottom of the feet, often transmitted by bare feet.
• Filiform warts: warts that are small with hairlike projections. Warts may look different and occur in different places on the body, but they are all caused by the HPV family.

Warts are extremely common, especially in individuals 10–20 years of age. The majority of these warts (up to 65%) will disappear on their own without treatment within 2 years. Unfortunately warts often come back even when treated. Because warts are an infection, you can catch warts from another individual and you can give warts to someone. You can also infect other parts of your body by scratching and picking warts. Skin that is moist from prolonged soaking, or skin that has been open by cuts or scratches is more likely to become infected by virus and form warts. Treatment of warts is usually but not always successful. The treatment itself can often cause problems such as pain, infection, and scarring. With the high number of warts that go away on their own (65% in 2 years), not all warts need treatment. However, depending on where the wart is, how big it is, how many there are, and your degree of concern about it (physical and emotional), as well as to prevent spread of the wart, treatment may be needed. Your doctor should be consulted if you have any questions.

Living With Your Diagnosis
Most warts are little more than unsightly tumors on the skin. At times they are in places where they can catch and bleed, such as on the face and head. The long-term effects of most warts are usually not serious or dangerous, but warts are not pretty and can spread. If you decide to get rid of your warts, you must treat carefully. The treatment often takes several weeks, and in some cases can cause pain, blistering, and infection. Self- treatment for some warts can be done by yourself using over-thecounter medications. Other warts, especially genital warts that may lead to cancer, need to be treated by your doctor.

Treatment depends to some extent on where the warts are located. Warts of the common variety on the arms, hands, and legs can initially be treated by salicylic acid and lactic acid in solution (Duofilm, Dalactic Film, Viranol Solution, Wart Solution). You should apply the solution each night directly on the wart. Peel off any dead skin from the previous night’s treatment. If redness or pain occurs, the treatment needs to be stopped for a few days. Usual treatment is from 2 to 3 weeks. If satisfactory results are not obtained, stronger medication may be needed from your doctor. Plantar warts can be treated with application of 40% salicylic acid plasters. Cut the plaster to the size of the wart and place on the wart; remove weekly, cleaning all dead skin. The wart should begin to go away in 2–3 weeks; if not, you may need to see your doctor to obtain stronger medication. Flat warts are often treated with skin peeling using acne medications. This will require seeing your doctor. Genital warts almost always require the evaluation of your doctor to ensure the warts have not spread. Treatment is usually with a blistering agent that will require your doctor’s application and follow-up. Your sexual partner will need to be examined also. Other treatments include freezing the warts, injecting them with drugs that stimulate the immune system, surgically cutting the warts, and burning the warts with a laser or electricity. Your doctor will know which method is best for your particular warts.
The DOs
• Do treat warts early to improve response to treatment.
• Do wash hands after touching your warts if you must touch them at all.
• Do use salicylic acid solution on common warts as directed.
• Do use salicylic acid plasters on plantar warts.

The DON’Ts
• Don’t bite fingernails, pick cuticles, or soak hands for long periods.
• Don’t pick at, dig at, or pull warts.
• Don’t cut or scrape warts.
• Don’t let your skin come in contact with warts.
• Don’t shave or cut hair over warts.

When to Call Your Doctor
• If you have warts that cannot be treated by overthe-counter preparations of salicylic acid.
• If after several weeks of treatment your warts are no better.