Warts, often known as verrucae, are benign (noncancerous) tumors of the outer skin layer, and can occur at any time in life. They are most prevalent, however, during early to middle adolescence, infecting approximately one in twenty teens. A break in the skin allows one of several human papillomaviruses (HPV) to invade the body. Months later, several tiny, firm bumps with well-defined borders start to grow nearby. The most common sites include the fingers, hands, forearms and feet. Warts often emerge in clusters, with several small verrucae encircling a larger growth. Other members of the HPV family cause genital warts, a sexually transmitted disease. Although common warts also can be spread via sexual contact, they are usually passed from one person to another through casual contact, like shaking hands or using towels or other items that were touched by someone who has warts.
Warts generally do not cause itching, nor are they painful, except when they grow on the soles of the feet. These are called plantar warts—“plantar” being the medical term for this part of the foot.
Symptoms That Suggest Warts May Include
Clusters of tiny raised growths the same color as the skin or darker.
How Warts Are Diagnosed
Physical examination and thorough medical history.
How Warts Are Treated
Two-thirds of all cases resolve on their own within two years, while approximately one in four youngsters see their warts disappear spontaneously within just six months. Rarely do the growths remain more than five years. One benefit of treatment, however, is that you eliminate the risk of the warts spreading to other areas of the body, as well as the risk of transmitting the virus to someone else. As with acne therapy, teenagers may need occasional reminding that the techniques for wart removal are carried out over a period of weeks or months.
Drug therapy: Common warts and flat warts (usually tan to yellow-pink in color) respond well to some of the same topical medications used to heal acne: salicylic acid, tretinoin and benzoyl peroxide. Other candidates include trichloroacetic acid, a keratolytic, and cantharidin. The latter is a vesicant: When brushed on warts and left there for several hours or more, the chemical causes the tiny tumors to blister. Then the physician removes the dead tissue at the next office visit. This may be repeated for several weeks.
Surgery: Of all the office procedures for removing warts, only curettage actually involves the use of a scalpel. In cryosurgery, the warts are swabbed with liquid nitrogen or another freezing agent, which destroys the tissue little by little. Or the doctor freezes the warts using a handheld cryogenic probe. After two to four appointments, the growths are often completely gone.
Warts can also be burned away with an electrical instrument (electrofulguration) or an electrically heated device (electrocautery), or eradicated with a laser wand. Because these techniques can leave scars, you and your child will want to discuss with the doctor—and with one another—the pros and cons of each approach before making your decision.
Plantar warts are among the most stubborn skin conditions to treat. In general, the smaller the lesion, the greater the chances for success. Often a physician will take a surgical knife and pare down the tissue, then apply salicylic acid, or other agents (such as liquid nitrogen) over the course of several weeks.
Helping Teenagers Help Themselves
The following tips can help prevent warts from cropping up elsewhere:
- Don’t scratch or pick at a wart. Doing so can spread the infection to small cuts and other breaks in the skin.
- Wash hands frequently and moisturize the skin liberally; dry skin cracks more easily, opening the door to infection.
- Don’t walk a mile—or even one foot—in someone else’s shoes.
- Always wear footwear in gym locker rooms and showers.