Closeup view of a wart on a patients finger prior to removal by a dermatologist at Phoenix's Saguaro Dermatology

Warts

Warts are rough, noncancerous growths of skin that appear as thick pads or bumps, most commonly on fingers, hands or feet. While generally harmless, warts can cause discomfort, irritation, and pain. Moreover, they frequently reoccur, and they may be hard to completely eliminate.

What are Warts?

Common in both adults and children, warts are caused by an infection from the human papilloma virus (HPV), of which there are over 100 types. The virus likely infects the skin through cuts, scrapes, or other minimal injuries (1). When the HPV virus infects the skin, it causes the skin cells to multiply. This cell proliferation results in a thickening of the outer layer of the skin, which builds up into a rough, bumpy wart. The development of the wart takes time, however. Once the virus invades your skin, it is often not detectable by your body’s natural defenses. It may take up to 12 months for the wart to appear (2).

Certain environments contribute to the risk of being infected by the HPV virus and, thus, of developing warts. For example, warts on the feet can be acquired from walking barefoot in areas where other people walk barefoot. Moreover, because the HPV virus can exist on the surfaces of things, places such as showers and swimming pools with non-slip, abrasive floors can both harbor the virus and cause a scratch or other abrasion whereby it can enter the body (2). Indeed, one study of 146 adolescents found that 27% of those who used a communal shower room developed warts on their feet (1).

Although it is a common belief shared by many people, it’s a myth that handling a toad or frog can give you warts. As explained above, warts are caused by the HPV virus, which only humans carry. So while the appearance of these creatures may suggest warts, there is no connection. Neither can rubbing a toad on a wart help get rid of it, as an old folk tale describes. (2)

What are the Types of Warts?

The type of wart varies by where it is located on the body and what it looks like. There are five basic types of warts.

  • COMMON WARTS are small, flesh-colored bumps that are dome shaped, rough, irregular, or thick and callous like. They commonly develop on the backs of the hands, fingers, and feet but may also appear on lips and genitals (2).
  • FLAT WARTS are most often seen on the backs of the hands and on the legs (1), although they can also appear on the face. As indicated by the name, these warts are only slightly elevated, smoother, and usually skin-colored or light brown. However, they tend to appear in multiples—up to a hundred or more—and thus affect more of the skin surface. Flat warts are commonly seen in children, young women, and immunocompromised patients (2).
  • PLANTAR WARTS are thick, sometimes painful, callous-like growths that appear on the soles of the feet. They are seen as single growths or in clusters and can embed themselves in the skin from pressure caused by walking and standing (2).
  • FILIFORM WARTS are long, narrow tags of skin that most commonly appear on the face, for example, around the mouth, on the eyelids, or on the nose. In men they commonly occur in the beard regions. Spiky in appearance, they can cause more discomfort than common warts or flat warts.
  • GENITAL WARTS appear on the genitals as scattered pinkish or skin-colored bumps, or clusters of bumps similar to clumped grains of rice. These warts are most often passed through sexual contact with a partner who has them.
Warts and moles are similar in that, like warts, moles are overgrowths of cells that appear on many parts of the body. Moles are often congenital or caused by repeated and prolonged exposure to the sun, not by a virus, and they appear in a range of colors from pink or tan to brown, red, or black. Moles are generally less crusty or rough than warts. And while warts are harmless, some moles have a higher risk of developing into skin cancer.
Many (non-genital) warts resolve on their own but it may take months or years. Whether or not they go away without treatment depends on many factors, including the immune system of the person affected, age, the type of HPV responsible for the wart, and the site of the wart. One study of 1000 children found that two thirds of warts went away without treatment within a 2-year period (1).

What Treatments Are Used to Get Rid of Warts?

While many treatment options are available for warts, the therapy will be based on the type of wart being treated, the location of the wart, and other factors, such as cost, minimization of pain and scarring, and effects of treatment that may impact the patient’s lifestyle or occupation (2). Currently, there is no single therapy that provides painless wart elimination in one visit, and a combination of treatments may be recommended to achieve the best outcome. In any case, while all current treatments are effective to some extent, warts frequently return and require repeated treatment (3).

Common treatments for warts include the following:

  • Topical therapeutic agents: Applied directly to the wart, the most common of these is a peeling agent called salicylic acid.  The acid gradually dissolves the wart, but it takes repeated application over several weeks. For genital wart removal, topical therapies include imiquimod and sinecatechin ointment. For stubborn plantar warts, topical retinoids used to treat acne have been prescribed, as has topical 5-fluorouracil, commonly used to treat actinic keratosis(2). Your doctor will be able to advise you on the best topical treatment for your particular type of wart.
  • Physical removal of warts:
    • Cryotherapy, or freezing, involves the application of liquid nitrogen directly to the wart.
    • Electrocautery is a procedure whereby the doctor burns away the wart using an electrical current sent through a needle.
    • Lasers are used to remove warts by heating up the blood and blood vessels in the wart, causing the growth to die and fall off.
  • Photodynamic therapy is a treatment that uses special drugs, sometimes called photosensitizing agents, along with light to destroy the wart.

Other at-home remedies may help as well, although their effectiveness in preventing the wart from coming back is unclear.

  • Applying duct tape to a wart is a popular home remedy. This procedure requires the duct tape to be replaced every few days and exposing the wart to air between applications of tape.  Upon removal, the duct tape will gradually peel away more and more layers of the wart.
  • Periodically soaking the wart in warm water may speed up the above process, or it can be done alone over a period of 2 or 3 weeks. When dry, layers of the wart can be peeled off or rubbed off with a pumice stone or emery board.

Of all these methods, one review concluded that topical salicylic acid increased the cure rate of warts compared with a placebo, with cryotherapy promising to be as effective as salicylic acid. However, there was not enough evidence from the studies under review to show whether duct tape occlusion, laser treatment, photodynamic therapy, or surgical methods increased cure rates compared to placebos (1).

In part because of their location, plantar warts and genital warts present a therapeutic challenge for both patients and clinicians. With plantar warts, debridement—scraping away of the affected tissue—is necessary to remove the hardened skin before treatment with a topical therapy (2). As for genital warts, treatment focuses on removal of the warty tissue, rather than eradication of the virus (3).

Warts are very contagious and can be passed to other parts of your body—or to another person—after touching them. In addition to increased risk through use of communal showers, warts can also be passed through shared use of a towel or personal item such as a razor.

Final Word on Warts

We recognize that even apparently minor conditions such as a wart can cause significant discomfort and interfere with daily activities. Our dedicated team of  medical professionals can provide quick removal of common warts as well as treatment for painful warts, warts that do not respond to over-the-counter remedies, and warts that appear on the face, genitals, and other tender areas of the body. For wart removal in Phoenix and Mesa, call us today.

Of all these methods, one review concluded that topical salicylic acid increased the cure rate of warts compared with a placebo, with cryotherapy promising to be as effective as salicylic acid. However, there was not enough evidence from the studies under review to show whether duct tape occlusion, laser treatment, photodynamic therapy, or surgical methods increased cure rates compared to placebos (1).

  1. Loo SK, Tang WY. Warts (non-genital). BMJ Clin Evid. 2014 Jun;2014:1710. Accessed August 6, 2021 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054795/
  2. Vlahovic TC, Khan MT. The human papilloma virus and its role in plantar warts. Clinics in Podiatric Medicine and Surgery 2016;33(3):337-353
  3. Yuan J, Ni G, Wang T, et al. Genital warts treatment: Beyond imiquimod. Hum Vaccines Immunother 201;14(7):115-119. Accessed August 6, 2021 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067868/pdf/khvi-14-07-1445947.pdf

Visual Guide to Warts https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-warts

Saguaro Dermatology Reviews

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Itaro Elaisa

“I totally recommend this place to anyone who’s looking for a dermatologist who’s professional, informative, respectful and very helpful. They are quick to solve your problems and get you home.”

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I had an awesome experience with Dr Hamann and staff. I was very comfortable and i was able to have all my questions answered without feeling rushed. The staff was courteous and welcoming.

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“Dr Dathan and the team were very helpful, kind and knowledgeable. Plus, there was no wait time so I was able to get back to work faster than expected. I would highly recommend.”

Robert P.

Staff was friendly, & on time. office is super clean!! Doctor was awesome, felt like a family member taking care of me.

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“Very friendly and professional. I had a great experience, Dr. Hamann was very good at answering my questions and concerns. I will certainly come back for another visit.”

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Great doctor and friendly, professional staff. The doctor spends time listening and answering questions, something rare to find anymore. The office is beautiful and very clean. I love all the artwork with saguaros.

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“The office was recently renovated–it is a beautiful, clean, and calm environment. I would highly recommend this practice for anyone who is looking for a general dermatologist.”

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Dr. Hamann is very knowledgeable, nice, and professional. You can tell that he truly cares about his patients by the way he operates. He took the time to listen to all of my concerns then address them with good, well-informed answers.

Saguaro Dermatology | Phoenix Dermatology

About Saguaro Dermatology

Our comprehensive dermatology clinic is dedicated to providing you with the highest quality of care, innovative practices, helpful resources and state-of-the-art technology to prevent and treat a multitude of skin disorders. Led by Medical Director, Dathan Hamann, MD, FAAD, our passionate team looks forward to serving you with respect and compassion.

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