Wart, Common (Verruca Vulgaris, HPV)

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Overview

Warts are common growths on the skin that are present on 5–10% of all children. They are caused by a virus called the human papillomavirus (HPV). Warts appear as circular raised flesh-colored growths that have a roughened, irregular surface. Common warts (verruca vulgaris) occur most frequently on the fingers, backs of the hands, face, knees, and elbows. They are usually not painful and are harmless. Warts will usually resolve on their own and do not require any treatment.

Who's at risk?

All populations of people can have warts, but they are rare in children under the age of 2 years. Infants who are affected were usually infected during the birthing process. If mothers have genital warts, they can be passed to their infants during vaginal birth. It is unclear how common warts are spread in young children; it is thought they are spread through direct contact if there is a break in the skin. However, they do not appear to be highly contagious.

Signs and Symptoms

Warts may occur singly or in multiples and often have multiple small black "dots" at the surface from tiny blood vessels.

  • Common warts are rough, thick, and either skin-colored, pink, or white bumps from 1 mm to over 10 mm in size.
  • Filiform warts are long and narrow, like tufts of thread, and usually small at the base (1–3 mm).
Infection can be described as:
  • Mild – Just one or few painless lesions
  • Moderate – 10-20 lesions, which are painless
  • Severe – Over 20 lesions, pain that limits normal life activities, or bleeding

Self-Care Guidelines

Before trying any self-care measures, your child's doctor should see him or her.

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.

Family members should avoid sharing personal items such as towels.

When to Seek Medical Care

Any infant with warts should be checked by the doctor.

Treatments Your Physician May Prescribe

If an infant has warts, the doctor will check the baby to make sure there are no warts in the breathing passages.

If treatment is needed, it might include:

  • 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 induce 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.