Everything you need to know about warts

Below are a series of questions we get asked from patients that Dr Salyards has answered. Hopefully this information is helpful and if you have any questions or would like to schedule an appointment call 865-545-0900 or email info@refinederm.com.

Are there different types of warts? There are several different types of warts that exist. Some of the most common warts we see are common warts (hands/body), plantar warts (bottom of the foot), flat warts, and genital warts.

Do they have to be treated differently? Depending on the type, number, and location of the wart(s), there are many different treatment options available. We’ll provide you with different options based on these criteria. The most common treatments for warts include freezing them with liquid nitrogen (cryotherapy), shave removal, injecting candida (yeast antigen) into the warts, prescription topical treatments, and oral therapies.

What causes warts? Warts are caused by a human papillomavirus (HPV) that infects the skin typically by direct contact with the virus. There are over 150 known types of HPV and only some of them infect the skin and give rise to warts.

Why do warts come back? Warts often recur in the same location if they have not entirely been treated. Often, warts will appear as if they are gone, but there is still a little bit of the wart left and it grows back over time. It is important to make sure that all warts are completely treated to prevent recurrence and spreading.

If I had warts as a kid, am I likely to develop them as an adult? Anyone can develop warts if they are exposed to a virus that causes them. Children are more susceptible to developing warts due to their immature immune system. It is thought that there may be some immunity to specific HPV types, so it may be less likely for adults to develop warts; but it can still be quite common. Those who are immunosuppressed or on immunosuppressive medications are also more likely to develop warts.

Can warts spread? Warts are spread by direct skin-to-skin contact and can also spread through scratching or picking. It is important not to scratch warts to prevent spreading. If subungual warts (warts around the nails) are present, it is important avoid biting the nails as they can spread to the lips and tongue.

Should I treat warts with over-the-counter creams before going to a dermatologist? For some small warts, over the counter treatments may be effective. Most over-the-counter treatments include salicylic acid, which breaks up the thickened skin and tries to exfoliate the wart. Another over-the-counter treatment is liquid butane or a freezing spray which is used to try to destroy the wart by creating a blister. This freeze spray does not get as cold as the treatment used in a dermatology office.

Will warts eventually go away on their own? Most warts will disappear on their own, even without treatment. In children, a good rule of thumb is that about 50% of warts resolve within 6 months and 90% resolve in 2 years. With adults, it is less predictable, and can often take longer than in children. The biggest risk with leaving warts untreated is spreading and the formation of new and larger warts.

How quickly can a wart be treated and disappear? The speed of resolution will vary depending on which treatment modality is used. Sometimes, a single wart can be removed that day, but often warts will require more than 1 treatment in the office and sometimes can take several treatments. Typically, the larger the wart and the longer it has been present, the longer it takes to treat it.

Is removing warts painful? There are several different ways to treat warts. Most destructive modalities (cryosurgery, candida injections, shave removals) are uncomfortable for a short period of time, but we do our best to minimize the discomfort. There are also non-invasive topical therapies that we offer as well. We will work with you to develop a treatment plan that is effective and that you are comfortable with.