Common Warts

Overview

Common warts are small, grainy skin growths that occur most often on the fingers or hands. They are caused by the human papillomavirus (HPV) and are transmitted through casual skin contact or shared objects. Common warts are usually harmless, but can be painful or bothersome. They may feature a pattern of tiny black dots, which are clotted blood vessels. In some cases, they may require medical attention if they become painful, change in appearance, recur, or interfere with daily activities.

Understanding the disease

Symptoms

The symptoms of common warts are small, fleshy, grainy bumps that usually occur on the fingers or hands. They are rough to the touch and often sprinkled with black pinpoints, which are small, clotted blood vessels. If the common warts are painful, change in appearance or color, or persist despite treatment, it is advisable to consult a healthcare professional.

Risk Factors

Risk factors for developing common warts include people at higher risk, such as children and young adults, who may not have built up immunity to the virus. Additionally, people with weakened immune systems, like those with HIV/AIDS or those who have had organ transplants, are more susceptible to common warts. Other risk factors include direct contact with warts, picking at warts, and using the same tools on warts as on healthy skin and nails.

Development

Common warts, including those on the fingers or hands, typically develop due to exposure to the human papillomavirus (HPV). This common virus is transmitted through direct skin contact, and it can take two to six months for a wart to develop after the skin has been exposed to the virus. Common warts are usually harmless and may eventually disappear on their own, but many people choose to remove them for cosmetic reasons or because they find them bothersome. If the warts become painful, change in appearance or color, or persist despite treatment, it's best to consult a doctor.

Assessment and Diagnosis

Triage

You should see a doctor if common warts are painful, change in appearance or color, persist despite treatment, interfere with daily activities, or if you are unsure whether the growths are warts. Additionally, if you are an adult with numerous warts appearing, it may indicate a malfunctioning immune system.

Diagnosis

To diagnose common warts, your doctor can typically examine the wart and may also perform a scraping to check for dark, pinpoint dots, which are common in warts. In some cases, a shave biopsy may be done to rule out other types of skin growths.

Management and Treatment

Prevention

Although it's difficult to prevent HPV infections that cause common warts, you can take certain precautions to reduce the risk of spreading the infection and forming new warts. These precautions include not picking at a wart and not biting your nails. By avoiding direct contact with warts, washing your hands carefully after touching a wart, and using a disposable emery board or pumice stone, you can help prevent the spread of the virus.

Home Remedies

There are various home remedies suggested for common warts, including:

1. Duct tape: Covering the wart with duct tape can help gradually remove it. Apply a piece of duct tape to the wart, leave it on for about a week, and then remove it. Repeat this process until the wart falls off.
2. Apple cider vinegar: Soak a cotton ball in undiluted apple cider vinegar and apply it to the wart. Cover the area with a bandage and leave it on overnight. Repeat daily until the wart disappears.
3. Salicylic acid: Over-the-counter products containing salicylic acid can help remove warts. Apply the product according to the instructions on the packaging.
4. Castor oil: Apply castor oil to the wart and cover it with a bandage. Reapply the castor oil daily until the wart falls off.
5. Garlic: Apply a fresh garlic clove to the wart with a bandage. Change the garlic clove daily and continue until the wart disappears. Please note that home remedies may not work for all warts, and some may even cause skin irritation. Consult a doctor if your warts persist, spread, or become painful.

Treatment

There are several treatments for common warts:

1. Over-the-counter treatments: Salicylic acid is an effective ingredient for treating common warts. It can be found in wart removal products available at pharmacies and drugstores. Apply the product according to the instructions, usually covering the wart with the medication and then covering it with a bandage for 48 hours. Repeat the process for several days or weeks until the wart disappears.
2. Cryotherapy: This involves freezing the wart with liquid nitrogen. Your doctor can perform this procedure in their office. Cryotherapy can cause blistering, so it's essential to protect the surrounding healthy skin during treatment.
3. Electrocautery: This method uses an electrical current to remove the wart. It's typically performed in a doctor's office and can be uncomfortable but is generally effective.
4. Excision: Your doctor can cut out the wart using surgical scissors or a scalpel. This method is effective but may leave a scar.
5. Cantharidin: A chemical mixture of cantharidin can be applied to the wart, causing it to blister and eventually fall off. This treatment is usually done in a doctor's office.
6. Immunotherapy: Imiquimod and cidofovir are immune response modifiers that can be prescribed by your doctor. These medications can help your body's immune system fight off the wart. It's important to note that warts may disappear on their own without treatment, but this can take a long time. Consult a healthcare professional if self-treatment doesn't work or if you're unsure about the best course of action.

Preparing for medical consultation

To prepare for an appointment for common warts, bring a list of all medications you take regularly, including over-the-counter medications and dietary supplements, and the daily dosage of each. You may also want to list questions for your health care provider, such as:

1. When did you first notice the wart?
2. Has it changed in size, color, or shape?
3. Is your condition painful?
4. Have you had warts before?
5. Do you have any condition or take any medication that has weakened your ability to fight disease (immune response)? Additionally, be aware of any pre-appointment restrictions, write down your symptoms and medical history, and make a list of all your medicines, vitamins, or supplements. Consider bringing a relative or friend along to help remember information discussed during the appointment. Prepare a list of questions to ask your health care team, such as the most likely cause of your symptoms, types of tests needed, available treatments and their side effects, and prognosis.