The term warts (also called verrucae) refers to a dermatological condition caused by the human papillomavirus (HPV). Although warts come from the HPV virus, they are essentially one of its most harmless forms, since strains of HPV are also responsible — among other things — for genital warts and the development of cervical cancer.

Warts are characterised as benign bumps or flat reddish skin rashes, and although they are not considered dangerous, they can cause great discomfort to the patient due to their unsightly appearance. Therefore, seeking treatment from a specialised dermatologist is essential for the effective management of the condition.

What are warts?

Warts are bumps that appear on various parts of the skin and are caused by the HPV virus. However, in contrast to the strains of HPV that cause genital warts — one of the most common sexually transmitted infections — the strains that cause skin warts are harmless and do not cause cellular dysplasia or malignancies.

The strains of HPV responsible for warts are: HPV-1, HPV-2, HPV-3, HPV-4, HPV-7, and HPV-10. Warts can appear anywhere on the body, including the hands, feet, and face. Warts are usually painless, but their appearance is unpleasant.

Seeking medical help is imperative because, in addition to the cosmetic problems they create, warts are highly contagious and can quickly spread from one area of the body to another, as well as be transmitted through contact from one person to another.

Why is it important for the patient to consult a dermatologist promptly?

Although warts are not considered dangerous to a patient’s health, seeking medical help is essential for several reasons:

Accurate diagnosis: Dermatologists are specialists in diagnosing skin conditions. A dermatologist can confirm that the bumps are indeed warts and not some other, more dangerous condition.

Personalised treatment plan: A dermatologist can assess the type, size, and location of the warts to recommend the most appropriate treatment.

Limiting the spread: Warts are highly contagious and can spread to other parts of the body or to other people. Dermatologists can help prevent this spread.

Prevention of complications: Complications such as infections or scarring, while rare, may arise if warts are not treated in time.

What causes warts?

Warts are caused by the human papillomavirus (HPV), which exists in various forms. The strains of HPV responsible for warts are usually harmless, but they can cause these growths when they infect the skin.

Several factors can increase the risk of developing warts:

  • Direct contact: Direct skin contact with an infected person can transmit the virus.
  • Skin damage: Warts are more likely to develop on injured skin.
  • Weakened immune system: Individuals with a weakened immune system are more susceptible to HPV and may experience more persistent or severe symptoms.
  • Public spaces: Walking barefoot in public places, such as locker rooms or pools, can transmit the virus.

How are warts transmitted?

HPV is highly contagious and can spread in various ways:

Direct contact: If someone comes into direct contact with infected skin, they can catch the virus or cause the virus to spread to other areas of the body.

Indirect contact: Sharing personal items such as towels or razors with an infected person can transmit HPV. Contact with contaminated surfaces in gyms and swimming pools is also a likely cause of spread.

What are the symptoms of warts?

Warts can present in various ways, depending on their location and type.

Morphological symptoms

Warts are morphologically classified into three types: common warts, plantar warts, and flat warts.

Common warts most often appear on the fingers, hands, and knees. They may also appear on the elbows or face. They are mainly small, rounded bumps (papules) and have a skin-coloured tone.

Plantar warts appear on the soles of the feet. They tend to grow inward and are quite painful when pressure is applied while walking. Their appearance can resemble a horny plug, and small black dots are also observed due to thrombosed blood vessels.

Flat warts are small in size and have a flat, smooth shape. They appear most often on the face, neck, or hands and have the colour of the skin.

Other symptoms:

Warts can be particularly bothersome as they may cause:

Pain or sensitivity, especially when pressure is applied.

Discomfort during activities involving gripping or touching objects.

Annoyance due to their appearance.

While warts are generally harmless, complications can arise if left untreated:

  • Spread: Warts can multiply and spread to neighbouring areas of skin or to other people through direct contact.
  • Infection: Bacterial infections may occur, leading to redness, pain, and swelling.
  • Scarring: Aggressive removal methods or excessive scratching can lead to scars, which may become permanent.

What does wart treatment include?

Various treatment options are available for warts, ranging from conservative, non-invasive treatments to surgical approaches. The choice of ideal treatment depends on the type, location, and size of the skin lesions, as well as on patient preference.

Salicylic acid: This over-the-counter treatment is available in various forms, such as gels, patches, and solutions. Salicylic acid softens warts and helps remove them over time. It is an effective option for common warts.

Laser treatment: Laser treatment of warts is an effective and absolutely safe method. During the session, either vaporisation of the lesions or necrosis of the vessels supplying the wart is performed, depending on the type of wart — that is, whether it is a hyperkeratotic wart or a flat wart, respectively. The treatment is painless, simple, and quick, leaves no marks, and requires no recovery period. Return to daily activities is immediate.

Cryotherapy: During this treatment, extreme cold is used to destroy warts.

Surgical removal of warts: For cases where conservative treatment or laser treatment is not suitable, surgical removal may be recommended by the dermatologist. This method is applied to large lesions. If the surgical removal plan is followed, the following are required:

  • Local anaesthesia: The area around the wart is numbed to minimise discomfort during the procedure.
  • Removal: The dermatologist carefully removes the warts.
  • Sutures: Depending on the size and depth of the skin lesion, sutures may be required to close the wound.
  • Follow-up care: Proper wound care and follow-up appointments are essential to ensure healing and prevent infection.

Conclusions

Warts are caused by the HPV virus. Although they are a source of great discomfort to the patient, they are largely harmless. However, they should not be ignored, as they are highly contagious and can lead to various complications if left untreated. Seeking the specialised help of a dermatologist is essential for accurate diagnosis and effective treatment.

Whether through topical treatments such as salicylic acid or via laser treatment, cryotherapy, or surgical removal, dermatologists have a range of options to help patients get rid of warts and restore healthy skin. If you suspect you have warts, do not hesitate to consult a dermatologist for guidance and personalised care.