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Warts: description, treatment, contagion

by Josephine Andrews
Published: Last Updated on 224 views

Warts (verrucae) are benign growths on the skin that are caused by viruses. Children, in particular, often have warts on their fingers or in other places on their hands—often in multiples. Warts on the face and feet are also common. Here you can read everything you need to know about the topic: How do wars develop? are they contagious How to prevent wars?

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

B07

quick overview

  • Types of warts: common warts, brush warts, plantar warts , flat warts , “fake” warts ( mollusc warts, senile warts , stalk warts )
  • Causes: Real warts are usually caused by the human papilloma virus (HPV). Molluscum contagiosum virus is responsible for warts. The exact cause of senile and skin tag warts is unknown.
  • Risk factors: including skin wounds, weakened immune system, circulatory disorders, tendency to allergies (atopy) or existing atopic disease (such as neurodermatitis), emotional conflicts and stress
  • Treatment options: including freezing ( cryotherapy ), acid treatment (eg as an active plaster or ointment), “burning” with electricity (electrocoagulation), laser treatment, removal with a medical instrument (curette, sharp curette, scalpel, etc.)
  • Prognosis: Warts are usually harmless and often disappear on their own (but often only after months or years). However, the recurrence rate is high, whether with or without treatment.

types of wars

Warts (verrucae) are small, sharply demarcated growths (tumors) on the epidermis . They are triggered by viruses , in most cases by human papilloma viruses (HPV). Warts are particularly common in children and adolescents. In principle, however, you can get verrucae at any age.

This is how most wars develop
Human papillomaviruses infect cells in the upper layer of the skin and multiply in their cell nuclei. The dead cells become horny.

There are different types of HPV. Depending on which type of virus is responsible for the infection and where it settles, morphologically different types of warts develop. There are also some skin lesions that look like warts but are of a different origin. Below you will find a description of the most important real and fake warts as well as treatment options (read more about general wart treatment below):

Common Warts (Verrucae vulgares)

Common or common warts are the most common form of viral warts. Other names are vulgar wart, skin wart or prickly wart. These skin nodes can form anywhere on the body . Such wars are most commonly found on the hand or foot . A wart on the finger is often located near the edge of the nail (periungual).

Common warts are usually the size of a pinhead to a pea . Its initially smooth surface becomes fissured and horny as it grows. In addition, the initially skin-colored skin growths gradually turn a dirty yellow color . They sometimes appear singly (solitaire). However, they are often observed in larger numbers .

As a rule, verrucae vulgares do not cause pressure pain or itching . If you don’t want to wait for the skin nodules to heal on their own, you can try a variety of wart treatment options. These include, above all, icing (with liquid nitrogen) and an acid treatment (eg with salicylic acid). Occasionally, other methods are used, such as laser therapy .

Brush warts (Verrucae filiformes)

It is a special form of common warts with a long, thread-like stalk . They form on the face (on the eyelids, lips, nose ) or on the neck, especially in older people . Occasionally they itch . In addition, you can irritate or injure brush warts when washing, drying or shaving. Above all, however, the thread-like or prickly-looking warts on the face are often perceived as cosmetically unsightly. Therefore, many sufferers have them removed by the doctor, for example by freezing (cryotherapy), acid treatment or laser treatment .

Plantar Warts (Verrucae plantares)

Unlike common warts, plantar warts are not raised, hemispherical skin growths. Instead, plantar warts are pushed inward . This is because they usually form on the soles of the feet: the weight of the body on them pushes the warts inward into the subcutaneous tissue. Plantar warts are also usually quite painful , unlike common warts . Every step can be uncomfortable for those affected.

You can get plantar warts if you become infected with the causative virus (HPV) while walking barefoot in a swimming pool, gym or communal shower. To get rid of them, you can put on a plaster containing salicylic acid . It softens the horny layer so that it can be easily sanded off in a warm foot bath. Another treatment option is to freeze the plantar warts (cryotherapy). They can also be “burned” with electricity (electrocoagulation) or removed with a special medical instrument (” sharp spoon “).

You can read more about the appearance and treatment of painful plantar warts in the article plantar warts .

Flat warts (verrucae planae juveniles)

Slightly raised warts on the face or hands are probably so-called flat warts or planar warts. Occasionally, this type of wart also forms on other parts of the body. Flat warts are most commonly observed in children and adolescents. They are therefore also called juvenile warts .

Like other real warts, this type of wart is triggered by the human papilloma virus. A weakened immune system can promote infection with these viruses. Children in particular often scratch their flat warts. Then new flat warts can form along the scratch mark because the viruses are spread with the nails.

Flat warts are harmless and often go away on their own. If you don’t want to wait or if you are very severe and suffer from flat wars, you should talk to your doctor about treatment options. For example, flat warts can be dissolved with vitamin A acid or salicylic acid (possibly in combination with UV radiation). They can also be frozen (cryotherapy) or“burned” with electricity (electrocoagulation). Sometimes they are also removed with a special surgical instrument ( curette ) or removed using laser therapy .

You can read more about this in the article flat warts .

Mollusca contagiosa

Mollusc warts are not real warts – despite their name and similar appearance. They are not caused by the human papilloma virus. Instead, the molluscum contagiosum virus is what triggers these wart-like, harmless skin lumps.

Mollusc warts usually appear in groups on one or two skin areas. In some people, however, they are also found loosely distributed over the body. The genital region is most commonly affected by mollusc warts in adults. In children, on the other hand, other parts of the body are often affected, such as the face, neck or armpits .

Mollusc warts contain an infectious secretion inside . If you come into contact with it, you can get infected quite easily ( smear infection ). This is especially true if your own skin is soft (eg when you go to the swimming pool or sauna). Then the triggering viruses can penetrate the skin more easily. Wounds, fungal infections of the skin and neurodermatitis also promote infection with the mollusc pathogens.

Molluscs usually go away on their own. But they can also last for years. Similar to flat warts, they can be removed with salicylic acid or vitamin A acid . But they can also be removed with a surgical instrument . There is also the possibility of irritation treatment : by applying an irritating liquid, the skin in the area of ​​​​the molluscs becomes inflamed. This should help them heal faster.

You can read more about this topic in the article warts .

Age Warts (Seborrheic Keratosis)

Age warts (senile warts) are also not real warts , even if they resemble them. Its cause is unknown. However, it is known that they are not caused by viruses – neither by HPV nor by other types of viruses. Age wars are therefore not contagious .

The name of these wart-like skin nodules comes from the fact that they mainly appear in old age. They tend to form on the face, chest and back, on the backs of the hands and on the fronts of the arms and legs. Their appearance is very variable. Doctors therefore distinguish between different forms of age warts , for example stalked age warts and stucco keratoses.

Because age warts are harmless and usually do not cause any symptoms, they usually do not necessarily have to be removed. If you still want to get rid of them, you should consult a doctor (as with other warts): You can remove senile warts with a surgical instrument (curette, sharp curette, scalpel) or with a laser . Pedunculated warts can be removed with an electric snare .

You can read everything you need to know about these widespread, harmless skin growths in the article Age warts .

Skin warts (fibromas)

Skin warts are not real warts either . Rather, they are soft, benign growths of certain skin cells. Their medically correct name is soft fibroids .

Pretty much everyone gets the small, stalked, skin-colored skin tags sooner or later . One does not know why this is so. Since skin tag warts occur more frequently in some families, experts suspect a genetic predisposition.

Like senile warts, skin tag warts are harmless and non-contagious . However, they can be cosmetically unattractive. Sometimes they are also mechanically disruptive. So it can happen with skin warts in the neck area that thin necklaces or fine silk scarves get caught on them. In such cases, those affected can have their skin tag removed by a doctor – using a laser , electrical current (electrocoagulation) or surgical scissors .

You can learn more about these stalked skin appendages in the Stem warts post .

Warts: causes and risk factors

In most cases, real warts are caused by human papilloma viruses (HPV): The pathogens penetrate skin cells through small injuries and cracks and trigger uncontrolled cell proliferation there. The invaders force the human host cells to produce more viruses.

The pathogens are different types of HPV. For example, common (vulgar) warts are usually caused by HPV types 1, 2, 4 and 7. HPV types 1, 2 and 4 can also be detected in plantar warts. In contrast, flat warts (verrucae planae juveniles) are generally caused by HPV type 3.

By the way: Certain types of human papilloma viruses are involved in the development of several types of cancer (such as cervical cancer and penile cancer). However, these are not the virus types that are responsible for conventional verrucae. Caution is only required with the so-called genital or genital warts (condylomata).

Fake warts are not caused by HPV: Molluscum contagiosum viruses are responsible for mollusc warts. The cause of senile warts is unknown The same applies to skin wars .

Risk factors for wars

Various factors can favor the formation of verrucae—particularly the most common form, verrucae vulgares. These risk factors include increased sweating (hyperhidrosis), impaired blood flow in fingers and toes (acrocyanosis), and a weakened immune system . People with a tendency to allergies (atopy) or an existing atopic disease (such as neurodermatitis) are particularly susceptible.

Mental conflicts and stress also seem to increase the risk of illness. Affected adults are also often smokers .

Are you contagious?

Viral warts are contagious (infectious): The viruses are transmitted directly from person to person, sometimes indirectly via towels or razors. Four weeks to eight months can elapse between infection and the appearance of the first verrucae (incubation period).

It is particularly easy to get infected with wart viruses if the skin is injured . Moist or softened skin also has a beneficial effect . This is why it is particularly easy to get infected in swimming pools, saunas and communal showers, for example. People who have frequent contact with the triggering viruses or affected people (such as children) are also at risk.

Someone who already has the small skin growths can further infect themselves ( autoinoculation ). This is how the verrucae can spread on the body: the viruses are transmitted to neighboring or more distant parts of the body, for example by scratching the skin nodules, where they can also settle.

“Fake” warts that are not caused by viruses (senile warts and skin tags) are not contagious.

Warts: investigations and diagnosis

Verrucae are usually harmless. A doctor’s visit is only necessary if the small skin tumors are cosmetically disturbing and need to be removed, or if they occur in the intimate area. You should definitely go to the doctor if

  • a war is bleeding or inflamed
  • Warts arise on other skin diseases (such as neurodermatitis) or
  • Molluscs spread quickly.

Age warts may be confused with skin cancer. So if you are not sure that wart-like skin nodules are actually harmless age warts, you should also see a doctor.

Diagnosis usually easy

Diagnosing verrucae is generally not difficult for a doctor. He can usually recognize the small, benign skin tumors by their appearance. In addition, the shape, structure and location of the growths in most cases also provide information about the type of wart it is.

However, if the doctor is not quite sure, he can take a tissue sample from the skin nodules and have it examined histologically in the laboratory. In individual cases, an attempt is also made to detect the pathogen (human papilloma virus) in the sample.

Wait: treatment

Most warts do not cause any symptoms and will disappear on their own sooner or later. There is then no medical reason why the warts should be removed.

However, if you find the small skin growths cosmetically unsightly, you should discuss with a doctor how your warts can be removed. The same goes for warts that cause discomfort, such as plantar warts on the soles of the feet that make walking very painful.

How to remove wars

“What helps against wars?” Many sufferers turn to their pharmacist or doctor with this question. The answer is: There are different methods and remedies for warts. Which strategy makes the most sense in individual cases depends, for example, on the type and number of warts and their location.

dissolution of the horny layer

Various acids can remove warts by dissolving their stratum corneum. Salicylic acid is most often used for this , sometimes another acid such as lactic acid . If you want to remove flat warts on your face, vitamin A acid is usually used. The acids are available in pharmacies as a solution, cream or plaster – usually without a prescription.

Read the package leaflet before using for the first time. It says exactly how to use the product in question. Generally, a solution or cream needs to be applied to the warts several times a day for several weeks. A patch is worn for a few days (possibly with repetition).

Under the influence of acid, dissolve the horny skin layers. You need to carefully remove them periodically, such as with a file or callous plane . Be careful not to injure surrounding areas of skin and that war viruses are not transmitted there. Otherwise, new warts will develop on these injuries.

Freeze Warts (Cryotherapy)

Doctors can freeze warts by gently applying liquid nitrogen . When it evaporates, it creates extreme cold, which destroys the top layer of skin. The freezing has to be repeated several times, this is the only way to finally remove the warts. At least one week must elapse between the individual sessions.

Applying the liquid nitrogen can cause a brief, stabbing cold pain. As a result, the skin usually reddens and swells a little. A skin blister may also form. It then usually takes several days for the warts with scabs to heal. If cryotherapy is performed with care, no scar will remain.

Wart removal by freezing is not allowed in all cases . The method is not suitable, for example, for people with a diabetic foot or with “window claudication” (peripheral arterial occlusive disease, PAD). The freezing of warts on their feet can further disrupt their already poor circulation, damage nerves and cause wounds that heal poorly. Cryotherapy is also unsuitable for removing a wart in Raynaud’s syndrome (illness-related reduced blood flow to fingers and toes).

You don’t have to go to the doctor to use cold to remove warts. Pharmacies now offer over-the- counter freezing sticks for self-treatment at home. However, these are less cold than the liquid nitrogen that the doctor can apply. In addition, the effectiveness of such icing sticks has not yet been scientifically proven.

Remove Warts: Other Methods

There are other remedies for wars. So far, however, there has been no clear evidence that they really help or work better than acids or ice.

Special ointments and solutions with active ingredients that inhibit cell growth (5-fluorouracil) or viruses (aciclovir, etc.) should also be able to remove warts. Sometimes various drugs are injected directly into the warts, for example 5-fluorouracil or substances that affect the immune system (interferons).

Curettage can also be used to remove warts: the skin nodules are scraped off with a special medical instrument (curette). They are often pretreated with acid beforehand.

Some people have their warts lasered, ie heated and destroyed with a laser.

In photodynamic therapy , a special gel is applied to the wart. You leave it on for about three hours and then irradiate the wart with light. This activates certain ingredients in the gel and destroys the skin tumor.

The old method of cutting out warts is very rarely used today. This can lead to infections and cosmetically disturbing scarring.  

Home remedies for warts

Various medicinal plants are said to be very helpful if you want to remove warts. For example, the milky sap of celandine is said to remove small skin tumors if you dab it on them several times a day. In the same way, warts can be treated with the milky juice of the dandelion or a solution of the root of the tarsus . This should also be able to eliminate the small skin nodules.

In many cases, naturopaths also rely on the anti-viral power of tea tree oil when treating warts. It is applied to the wart in a diluted form several times a day. Garlic could also be effective against wart viruses : warts can also be removed by taking a high-dose garlic preparation.

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

Warts: course and prognosis

Warts are generally harmless . As soon as the body manages to successfully fight the triggering viruses, they disappear again on their own. However, this may take weeks or months. Studies on affected school children and adolescents showed that around fifty percent were free of warts after one year and around seventy percent after two years. There are no comparable studies in adults.

How quickly the small skin growths disappear in individual cases depends on various factors. The virus and wart type and the state of the immune system, for example, play a role. Verrucae can be very stubborn in people with weakened body defenses.

If warts – with or without treatment – have healed at some point, you are not immune to it in the future. On the contrary: the recurrence rate (recurrence rate) is high. 

Prevention Tips

Some measures can possibly prevent you from being infected by affected people or in turn transmitting the virus to other people:

  • Do not share towels, shoes and socks with other people.
  • Do not walk barefoot in swimming pools, communal showers, gymnasiums and locker rooms.
  • Cover existing warts with a waterproof band-aid before swimming .
  • Do not touch the verrucae.

You should also avoid scratching wars. Otherwise you can transfer the contained viruses to other parts of your body or to other people. 

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