Warts & Wart Care

McKenzie Pediatrics 2007

What Are Warts?

Warts (verrucae) are harmless skin tumors caused by the human papilloma virus (HPV), of which there are over 100 known types. They are very common in children, and are unrelated to hygiene. All varieties are mildly contagious, especially to family members or school gym classmates. They are not spread by animals.

All warts have limited life spans, usually disappearing within 1 to 2 years, or less. Some warts can be painful, such as plantar warts (on the soles of the feet), but most warts cause no symptoms besides being cosmetically displeasing.

Where Do Warts Occur?

Warts can infect any skin, but the most likely sites include areas prone to trauma, such as the hands, the feet, the forearms, and the shins.

Certain HPV varieties are more common in the genital and anal areas; while a mother can pass HPV to her newborn baby, thereby causing warts to develop in these areas anytime in the first two to three years of life, any warts in the genital areas of young children must also be considered suspicious for abuse.

How Are Warts Treated?

There are no specific anti-viral treatments for warts. Most warts, especially those non-painful or not cosmetically displeasing, are best left alone, for they will eventually disappear.

However, warts on the fingers or on the soles of the feet are often painful, and are more likely to spread. Therefore, treatment is usually necessary. Several over-the-counter treatments are available, none of which should be used on the face. Over-the-counter remedies (liquids, occlusives, or freeze treatments) are most successful when started when the warts are very small. When the warts are larger, or have more of an overlying callous (thickened skin), such medications are not likely to work.

One unusual home treatment that often works, especially for finger or plantar warts, is known as the �triple whammy�. Apply a drop of a liquid over-the-counter wart remedy to the wart, then apply an occlusive wart remedy, and finally apply a piece of duct tape. Leave these on for six days, and on the seventh day remove them and let the skin air out for a day before repeating it all again. It may take three to five weeks to treat the wart.

If home treatment fails to resolve the wart, call your doctor�s office or a dermatologist for an appointment. In our office, we commonly use Cantheridin to treat warts. This is a blistering agent that is painless to apply, but might cause a blister within several days that may burn or irritate. Ibuprofen works well to relieve the discomfort. Repeat treatment is usually necessary every 3-4 weeks for 2-4 treatments.

Children with very large or multiple warts might instead be given a prescription for 5-Fluorouracil in Pyruvic Acid, which is applied nightly to the wart (and then covered with a bandage) until the wart resolves, usually 2-4 weeks.