Everything You Need to Know About Warts

What are warts?

Warts are a protrusion of the skin, caused by a viral infection in the body called human papillomavirus (HPV), of which there are over 100 types! The HPV needs an entry point into the epidermal (skin) layer, usually a small cut or scratch.Once the virus has entered the skin barrier it begins to cause extra cell growth, hence the appearance of the wart. Warts are most likely to infect moist, soft or broken skin. Warts are most common in children between the ages of 12 and 16, but can affect any age. It is said that 1 in 3 children will get warts, but only 3 to 5 percent of adults experience them. Different strains of HPV can cause different types of warts. Usually the HPV is picked up in communal areas like swimming pools. Warts are highly contagious and can spread quickly if they are not managed properly. There are many different types of warts that can affect the human body, each of which can be treated by a healthcare professional.

What are the types of warts?

Types of warts differ all over the human body. The types include; common warts, plantar warts. Flat warts, filiform warts and periungual warts.
Common warts are usually found on fingers, knees, elbows and hands and are usually round and brown or grey in colour. It will have a cauliflower appearance.
Flat warts are small and flat on the top, appearing smooth to look at. Flat warts may be pink, light brown, or yellow. Usually flat warts are found on the face. 

Filiform warts have a finger-like appearance and are usually skin coloured. These are commonly found on the face.
The type of wart that affects the feet is called a plantar wart, they are usually found on the soles of the foot.

How will I know if I have a wart?

The symptoms experienced when a wart is contracted can vary from person to person and will depend on the size and location of the lesion. Some of the symptoms of plantar warts include; 

  • A small bump on the skin with a mosaic or cauliflower appearance
  • A rough surface with small black spots 
  • You may have one wart or many in one spot (cluster)
  • On the feet sometimes warts are painful and can be itchy
  • Plantar warts can present anywhere on the sole of the foot, as well as between the toes

What are the risk factors for contracting warts?

We know that warts are contagious and can be difficult to get rid of once acquired, but what puts you at risk of contracting these warts?

You are more likely to contract warts if;

  • You have an injury or break in the skin barrier
  • You go to a communal swimming pool, gym or locker area barefoot
  • Your feet sweat or are often wet
  • You have direct contact with another person’s wart
  • Your immune system is compromised or you experience high levels of stress
  • You scratch or cut your wart

When should I see my Podiatrist?

If you suspect that you have a wart it is best to consult with your Podiatrist immediately to avoid the spread of infection. If you have compromised or poor health, it is recommended that you visit your podiatrist as soon as possible, as your warts are more likely to spread than someone with a healthy immune system. Your Podiatrist will be able to diagnose your wart with a simple squeeze test, as well as an examination of its clinical presentation. Your treatment path will be decided by you and your podiatrist, and will be specific to you and your needs. 

How can my Podiatrist treat warts?

Your Podiatrist will be able to give you a few different options for wart treatment in the clinic. Firstly your podiatrist will debride the wart with a scalpel blade, this is usually pain free, but can occasionally be slightly uncomfortable. Once the wart has been debrided there will be small blood vessels exposed, so you may experience some bleeding – this is expected and it is a good result!

The exposed blood vessels are important when eradicating the viral infection, it allows the treatment to get to the virus. Your podiatrist will use one of two treatment options; salicylic acid or liquid nitrogen.
Salicylic acid is a paste and is pain free when applied, but can sometimes cause blistering post treatment – This is important in the treatment of the wart because it is drawing the virus away from the body.
Liquid nitrogen treatment or cryotherapy is a treatment often used by Podiatrists. It is known for  often being uncomfortable when applied, but tends to be less painful post treatment. Liquid nitrogen treatment can also cause minor blistering.

Both treatment options are effective, but usually require about 5 or 6 treatments to completely rid the wart. The length of the treatment will depend entirely on the size and severity of the wart(s).
After your treatment your podiatrist will dress the wart with a padding which assists in taking pressure away from the affected area. Usually your podiatrist will review your wart in 2 weeks time and will likely treat the wart again at this appointment. What can you do to treat the wart between treatments in the clinic?

Can I treat warts at home?

Your Podiatrist will likely recommend you purchase Wart Off or Duofilm from your local chemist. These products are approximately 15% salicylic acid and can be used daily on the wart at home. You may be advised to gently file the wart before you treat it, this helps the treatment get closer to the viral tissue. It is recommended that you do not use the same file anywhere else on your feet/nails as this may cause the virus to spread.
If your warts are stubborn and taking a long time to heal, your podiatrist may recommend some other treatment methods, such as duct tape. Duct tape over the wart can starve it of oxygen and therefore has been known to be quite successful in treating warts. We recommend that you always consult with your podiatrist before trialing any treatment, as it may not be suitable for you.

What can parents do to stop the spread of warts at home?

As we know, warts are very contagious. Here are some tips to ensure the warts don’t spread within the household;

  • Do not share towels or other household items
  • Be sure to change and wash your childs socks regularly
  • Ensure children do not touch their warts
  • Clean the shower and bath with a bleach solution to stop the spread of the virus
  • Keep warts covered with a bandaid
  • Encourage children to wash their hands regularly and practice good hygiene

Can I have surgery for warts?

Yes, in some cases warts can be surgically removed in a process called curettage or electrocautery. 

Curettage is a process which involves a local anesthetic to numb the affected area, followed by incision into the epidermal and dermal layers of the skin to remove the plantar wart. It is done with an instrument called a curette (a small scoop-like device). Following the procedure, a chemical called phenol is used to kill off any of the remaining viruses in the skin.

Electrocautery is a procedure which also involves a local anesthetic to the affected area, followed by a needle placed directly into the plantar wart, conducting electricity into the viral tissue. The procedure takes approximately 20 minutes with the end result being that the heat kills off the viral tissue. 
Surgery is usually a last resort as it imposes many risks and often causes scarring to the affected area. 

Can warts be prevented?

Yes, there are many things that can be done to minimize your risks of contracting warts. These include; 

  • Do not touch another person’s wart
  • Do not share personal items, such as socks, shoes or towels
  • Be sure to wear thongs when in communal areas like pools and gyms
  • If you have warts, do not pick, scratch or cut them

Warts on the feet can be difficult to treat, but with help from your Podiatrist you will begin to see progress quickly. Your Podiatrist can give you tips on how to manage your wart(s) and stop the spread of infection. If you think you have a plantar wart and would like assistance, call Foot Centre Group on 03 9553 0044 or visit www.footcentregroup.com.au to book your appointment. 

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