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Common Warts

DEFINITION

Warts are abnormal growths of the skin due to infection with the human papilloma virus (HPV). The skin is made up of several layers with the outermost being the epidermis. HPV infects the epidermis. There are over 100 different kinds (or strains) of HPV that cause both benign conditions like warts and more serious conditions like cervical cancer. However, the types that cause cancer are not the same types as those that cause common warts. Warts are usually flesh colored and appear as bumps on the skin generally on the hands and fingers. Common warts are different than moles and are never cancerous. Most of the time, warts will disappear on their own if given enough time, but treatment may be desired to get rid of them sooner and to help prevent spreading them to other places on the body and to other people. However, many warts will recur after treatment. Warts are passed to a person by touching people or objects infected with the virus. After exposure to the virus, warts can take two to six months to develop, so it is generally very difficult to know where you got infected. Some people exposed to the virus will not get warts. The HPV virus has an easier time infecting the skin at areas where there is a break in the skin like cuts or where a person has been chewing on his or her fingernails. Risk factors for getting common warts include being a child or young adult and having a poorly functioning immune system. Other types of warts caused by HPV virus include plantar warts (on the soles of the feet), genital warts (on the pubic areas or anal canal), and flat warts (on the face or legs).

SYMPTOMS
Flesh-colored bumps on the skin, white or pink bumps on the skin

DIAGNOSIS
Your doctor will talk to you about your symptoms and do a physical exam. Generally, the diagnosis of common warts is based on looking at the wart. In cases where it is not clear if the growth is a wart, your doctor or dermatologist may take a biopsy which involves numbing the area, then cutting off the growth to send to a pathologist to look at under a microscope.

TREATMENT
Common warts may disappear without treatment within about two years. However, new ones can come up at any time. Many medications to treat warts can be bought over the counter including salicylic acid (17% salicylic acid is best). Soaking warts in warm water and rubbing them with an emery board or pumice stone can help the warts look smaller and go away faster. Warts can take a long time to go away, so treatment needs to be pursued with come persistence. Your doctor or dermatologist may also recommend freezing off the wart (cryotherapy), cantharidin (a medication applied to the skin that causes skin to blister and the wart to fall off), minor surgery (cutting away the wart then using electric current to burn the wart bed), or laser surgery (zapping the wart with a laser to remove it). If your common wart does not respond to these treatments, your dermatologist may recommend immunotherapy (medicines placed on the skin which decrease the body’s immune response and decrease warts), bleomycin (a medicine normally used to treat cancer that is injected in a small amount into the wart), or retinoids (a medicine similar to vitamin A that does not let skin or warts grow normally). At home you can also try covering a wart with duct tape for six days then soaking it in water and rubbing it with an emery board or pumice stone. While it is unclear whether this method really works, it is certainly inexpensive enough to try. You should discuss your treatment options with your doctor or dermatologist.

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