This image displays a large wart on the thumb.   This image displays the area of a healed wart. This child has two warts: one near the left nostril and another doughnut-shaped one above the upper lip. The scratch above the wart on the lip could be the entry point for the infection. The color of common warts can vary depending upon the skin tone of the person on which they occur. Warts often have a rough, multi-pointed surface, like this wart near the eye. This image displays the thick and rough surface typical of a wart.  This image displays the "black dots" typical of warts, which are clotted, fine blood vessels in the skin. In children whose immune systems have not yet recognized the wart infection, lesions may be numerous and even form around and under the nails. Multiple warts are seen at the left mouth angle as well as on the chin. This image displays a wart on a finger.
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Common Wart  A parent's guide to condition and treatment information

Picture of Common Wart: This image displays a large wart on the thumb.   Divider line
This image displays a large wart on the thumb.
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Overview
Warts are growths of the skin and mucous membranes (the mouth or genitals) that are caused by over 100 types of the human papillomavirus (HPV). Common warts are usually found on areas of the body prone to trauma, such as the elbows, knees, and hands. The virus causes thickening of the top skin layer. They are usually painless and go away on their own, sometimes taking a few months to resolve (but can take up to 2 years).

Warts are usually acquired from person-to-person contact. The virus is not highly contagious but can cause an infection by entering through a small break in the skin. In the same way, warts can be spread to other places on the body. The virus is rarely transferred by touching an object used by an infected person, but family members should refrain from sharing towels and other personal items.
Who's At Risk
Warts can affect people of any age, but they are most common in those aged 12–16 years. It is estimated that 20% of schoolchildren and about 10% of the general population have warts. Those with HIV or organ transplants or on chemotherapy have a higher incidence of warts due to their weakened immune system.
Signs and Symptoms
Warts may occur singly or in groups and often have multiple small black "dots" at the surface, from tiny blood vessels.
  • Common warts are rough thick skin-colored pink or white bumps, from 1 mm to over 10 mm in size, often on the hands, face, elbows, and knees.
  • Filiform warts are long and narrow, like tufts of thread, and they are usually small at the base (1–3 mm). They often affect the face, eyelids, or nose area.
Infection may be one of the following:

  • Mild – just one or few painless lesions .
  • Moderate – 10–20 painless lesions.
  • Severe – painful lesions that limit normal life activities, lesions that are bleeding, or over 20 lesions.
  • Self-Care Guidelines
    Because warts can resolve on their own, it is not necessary to treat all warts. Additionally, treatment of warts may not always destroy them, nor will it necessarily keep other warts from appearing. Treatment can be painful and cause scars and might need to be repeated, so it should only be done in cases where the warts are highly bothersome or interfere with daily life.
    • Over-the-counter wart removers have a high percentage of salicylic acid and work by dissolving away the layer of skin infected with the virus. This treatment needs to be used daily and can sometimes be irritating if it touches unaffected skin around the wart.
    • Duct tape applied daily to the affected area seems to work for unknown reasons. The tape should be very sticky and kept on for a few days. Some children may have a reaction to the adhesive on the tape.
    • Over-the-counter freezing medications are available but have not been found to be very effective.
    • Coupled with the above therapies, the wart should be soaked in warm water, and any loose skin should be removed every few days with a mild abrasive, like a pumice stone.
    • Family members should avoid sharing personal items such as towels.
    When to Seek Medical Care
    Call your child's doctor or a dermatologist if he or she has the following:
    • Painful or bleeding warts.
    • Warts on the face or warts interfering with daily life that do not improve with self-care.
    • Diabetes – warts of the feet should be treated by a physician.
    Treatments Your Physician May Prescribe
    • Destruction with freezing (cryosurgery), burning (electrocautery), laser, or cantharidin, podophyllin, tretinoin, or acid application.
    • Injection of chemotherapy drugs.
    • Application of imiquimod, an immunotherapy agent, or other chemicals that trigger an allergic reaction to destroy the wart.

    References

    Bolognia, Jean L., ed. Dermatology, pp.28, 1221-1222, 1229. New York: Mosby, 2003.

    Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed., pp.2122, 2124-2125, 2148. New York: McGraw-Hill, 2003.
    Last Updated: 22 Dec 2008