Skin Cancer & Disorders

Dermatologist Wart Removal

Whether you notice one on your hand, foot or face, when you have a wart, you want it to go away as soon as possible. While warts can clear up on their own, seeing a dermatologist for treatment is often the best option. Your provider can diagnose the wart by examining it, then recommend the treatment they believe will work the fastest.

What Are Warts?

Warts are non-cancerous growth in the epidermis, the upper layer of skin. They form when infection with the human papillomavirus (HPV) accelerates skin cell growth. About 10 of the 150 known strains of HPV can cause skin warts. Other HPV strains can cause genital warts. While some HPV strains can cause cancer, such as cervical cancer, the strains connected to skin warts have no known connections to cancer.

HPV is a widespread virus, and people face regular exposure to it. However, not everyone who comes into contact with a wart-causing strain of HPV will develop warts. Children and people with weakened immune systems are more likely to have warts than others.

Warts can be contagious, but they don’t spread between people easily. If you have a wart on one part of your body, however, you can spread it to other areas.

Types of Warts

Four main types of warts exist:

Common warts: Common warts — verruca vulgaris — usually form on the hands, fingers and knees or in areas where the skin has broken. When a common wart is under a fingernail, it can be challenging to treat.
Plantar warts: Plantar warts — verruca plantaris — form on the bottom of the feet. They are typically flat and may form a cluster or line of warts called mosaic warts.
Flat warts: Flat warts — verruca plana — are smooth and small. They typically form in clusters and often appear on the face or legs. Flat warts can also appear on the hands.
Genital warts: Genital warts are sexually transmitted and appear on the genitals.

Generally, warts produce no serious illness and may disappear in time without scarring. However, bothersome or painful warts should be treated.

What Do Warts Look Like?

Warts differ in their appearance based on the type:

Common warts appear as firm, flesh-colored, bumpy, cauliflower-like growths anywhere from 1 to 10 mm, which disrupt the normal line of fingerprints on the fingers or hand. Some may have red or brown dots caused by small blood vessels.
Plantar warts appear as small, shiny, well-bordered bumps that may grow into rough plaques on the feet and may also have red or brown spots. They may occur in clusters and are often pushed back into the skin from the pressure of walking and are, therefore, not usually raised.
Flat warts appear as flesh-colored or brown, well-bordered, “flat”-surfaced, thick bumps on the face, beard area, shins and back of hands. Sometimes these grow in linear patterns caused by re-infection from scratching or shaving abrasions.

Who Gets Warts?

Warts are very common and occur frequently in all races, and equally among males and females. Common warts occur in up to 20 percent of all school children; plantar warts are more common in older children and young adults; and flat warts occur in children and adults. Flat warts may occur more commonly in butchers, meat packers, and fish handlers. Warts may be more aggressive or multiply faster among individuals with compromised immune systems.

What Causes Warts?

Warts are caused by many different strains of a DNA virus called the Human Papillomavirus (HPV) that invades and colonizes cells of the skin and mucous membranes. The virus is transmitted by skin contact and by sexual contact among healthy individuals. However, the risk of catching hand, foot or flat warts from another individual is relatively small.

What Triggers Warts?

Warts may be triggered or may “seed” in areas where the skin frequently breaks or abrasion frequently occurs. This explains why warts grow more commonly among children who bite their nails or pick at hangnails and why warts occur near other warts in frequently shaved areas. In addition, continued scratching, picking or shaving over warts can trigger the spread of the virus and cause new warts to form nearby. Certain individuals are more prone to having warts than others, just as some individuals are more prone to catching the common cold. Most transmission occurs among small groups such as households or school gym classes. A greater risk of acquiring warts is observed among immune-compromised individuals such as HIV patients or organ transplant patients.

How to Treat Warts

A number of treatments may be used to eradicate warts. Sometimes, no treatment is needed, and the warts clear up on their own. If warts are bothering you, you may prefer to seek treatment rather than wait for them to clear.

Treatment options include:

Freezing: Liquid nitrogen may be applied to freeze off the infected tissue. After freezing, a blister may form over the wound, which may burst and crust while healing. In between repeated freezing treatments (typically two to three weeks apart), the application of small bandages that contain salicylic acid or even small pieces of duct tape will help in speeding the destruction of the wart.
Cantharidin: A dermatologist can coat the wart with cantharidin, which causes a blister to form beneath it, which destroys the wart. After about a week, you return to the practice for the provider to remove the damaged wart. Topical destruction with cantharidin followed by gentle paring of the dead skin is also a very effective treatment that may be successful after one to two treatments.
Electrosurgery: Warts may also be removed by electrosurgery using a small curette, with little discomfort or pain. The V-Beam Pulse Dye Laser (PDL) has been shown to be very effective in eradicating warts and is especially good for recalcitrant warts on the bottom of the foot.
Bleomycin: Bleomycin is an anti-cancer treatment that can help remove warts. Bleomycin injections and topically-applied DNCB immune therapy have a very high success rate and can be used for the most stubborn cases. For more information on treatments for warts or to schedule a skin check, please call and speak with a representative at Berman Skin Institute.