Warts Explained
Warts (verruca) are benign skin growths caused by the human papillomavirus (HPV). These growths can appear anywhere on the body and are common in children and adults. While generally harmless, warts are infectious, unsightly, and possibly uncomfortable, depending on their location. Understanding their causes, treatment options, and prevention strategies can help manage and reduce the occurrence of warts.
Warts are small, bumpy skin growths that occur when the HPV infects the top layer of skin. There are several types of warts, each with distinct characteristics:
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Common Warts: Usually found on fingers and hands, these warts have a rough, grainy appearance and can be grayish-brown.
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Plantar Warts: Located on the soles of the feet, these warts can be painful due to their position and the pressure from walking.
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Flat Warts: Smaller and smoother, these warts often appear in large numbers on the face, neck, hands, and wrists.
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Filiform Warts: These are spiny and typically grow around the mouth, eyes, and nose.
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Periungual Warts: These are found under and around the toenails and fingernails. They can be painful and affect nail growth.
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Condyloma (genital warts): These warts occur in the genital and anal areas, appearing as small, flesh-colored, or gray growths that can cluster together, resembling a cauliflower-like shape. They are one of the most common sexually transmitted infections.
The hallmark symptom of psoriasis is the development of plaques—thick, red/pink, and with silver scales. These plaques commonly appear on the knees, elbows, lower back, and scalp and can be itchy or uncomfortable.
Warts are caused by the human papillomavirus (HPV), which has more than 100 different strains. Not all HPV strains cause warts, but those that can be transmitted through direct contact with a wart or something that touched a wart, such as towels or surfaces.
Individuals with weakened immune systems, such as those with HIV/AIDS or who have had organ transplants, are more susceptible to developing warts. Additionally, minor skin injuries, wet or damaged skin, and frequent contact with rough surfaces can increase the risk of wart formation.
Genital warts are transmitted through sexual contact with an infected person. This includes vaginal, anal, and oral sex. It is important to note that HPV can be spread even when the infected person shows no signs or symptoms.
A lesser-known but significant aspect of psoriasis is psoriatic arthritis, which causes joint inflammation and pain. Most individuals develop skin symptoms before experiencing arthritis, but psoriatic arthritis can sometimes appear before skin plaques. Symptoms of psoriatic arthritis include swollen or tender joints, joint pain, and stiffness that gets worse in the morning but typically eases as the day progresses.
Psoriasis-related inflammation affects more than just the skin and joints. It can increase the risk of cardiovascular diseases, including heart attack and stroke, which should be considered when managing psoriasis.
Most warts eventually disappear on their own, but many people choose to treat them due to their infectious nature, discomfort, pain, or cosmetic reasons. Warts are stubborn growths that often take many months and regular visits to the dermatologist to resolve. Treatment options include:
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Topical treatments: Over-the-counter treatments containing salicylic acid can help remove warts. Prescription-strength topical treatments may also be used.
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Cryotherapy: This involves freezing the wart with liquid nitrogen, causing it to blister and eventually fall off.
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Cantharidin: This chemical is applied to the wart, causing it to blister and eventually fall off.
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Surgical removal: In some cases, minor surgery may be necessary to remove the wart.
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Immunotherapy: This treatment stimulates the immune system to fight the wart-causing virus.
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Antiviral medications: Antiviral medications can help reduce symptoms and prevent recurrence.
Preventing warts involves reducing exposure to the HPV virus and maintaining good skin care practices. Here are some tips:
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Avoid direct contact: Do not touch warts on yourself or others. If you have warts, keep them covered with a bandage.
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Do not share personal items: Avoid sharing towels, razors, socks, or shoes with others, especially in public places.
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Keep skin clean and dry: Moist environments can promote wart growth, so keep your skin dry and clean.
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Wear protective footwear: To avoid contact with contaminated surfaces, wear flip-flops or waterproof sandals in public showers, pools, and locker rooms.
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Avoid biting nails or cuticles: This can create openings in the skin where the virus can enter.
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Boost your immune system: To support your immune system, maintain a healthy lifestyle with a balanced diet, regular exercise, and adequate sleep.
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Practice safe sex: Use condoms during sexual activity to reduce the risk of contracting genital warts. Regular screenings and HPV vaccinations are also recommended.
Condyloma
Condyloma, commonly known as genital wart, is a very common viral skin condition caused by certain strains of the human papillomavirus (HPV). Although the diagnosis can understandably feel stressful or embarrassing, condyloma is a benign and treatable condition.
Condyloma are flesh-colored, pink, or light brown bumps that can appear on the genital or anal skin. They are caused by HPV infection, most commonly HPV-6 and HPV-11, which are considered low-risk and not the strains associated with cervical cancer or high-grade dysplasia.
These lesions can be:
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Smooth or cauliflower-like
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Flat or raised
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Singular or clustered
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Symptomatic (itching, irritation) or asymptomatic
HPV is extremely common. There is a high likelihood that sexually active adults will encounter it at some point, but many infections clear on their own. When the immune system does not fully eliminate the virus, condyloma may develop.
Condyloma spreads primarily through skin-to-skin contact, usually during vaginal, anal, or oral sexual activity. HPV transmission does not require intercourse and can occur even with condom use (though condoms reduce the risk).
Key points:
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Having condyloma does not imply infidelity or poor hygiene
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The incubation period, the time it takes from exposure to the virus to developing a genital wart yourself, can be weeks to many months, so pinpointing when HPV exposure occurred is challenging
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Many people carry HPV without ever developing visible warts
Diagnosis is typically made by a dermatologist through visual examination. In certain cases, especially when lesions are atypical, grow rapidly, or do not respond to treatment, a skin biopsy may be recommended to confirm the diagnosis and rule out other conditions.
There is no single “best” treatment. Therapy is tailored to the number of lesions, their location, patient preference, and likelihood of recurrence. The treatment of condyloma often requires several regularly spaced visits until there is confidence that all lesions have been treated and no new ones are developing. In most cases, more than one treatment is used simultaneously, as combined therapy is more effective than a single treatment approach.
In-Office Treatment Options
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Cryotherapy (Liquid Nitrogen Freezing) – first-line therapy that causes targeted destruction of the infected tissue.
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Often an important part of the treatment regimen, including for those who prefer not to use topical prescriptions
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Shave removal – reserved for isolated or larger warts
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Provides tissue for pathology
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Typically a one-time procedure
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At-Home Treatments
Various prescription medications are available, which are often used in conjunction with in-office cryotherapy for better clearance. These exert their effect through different mechanism of action:
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Imiquimod – an immune response modifier used several times weekly
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Podofilox – a caustic topical cream that causes destruction of infected warty tissue
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Cidofovir – an antiviral medication that can be compounded to apply topically
At TeeHealth Dermatology, you can expect:
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Private, non-judgmental care with a board-certified dermatologist
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Comprehensive treatment plans tailored to your individual circumstance
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Education around prevention, vaccine eligibility, and reducing recurrence
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A calm, respectful environment supporting your overall well-being
You should schedule an appointment if you notice new or changing bumps in the genital or anal region. While condyloma is often asymptomatic, lesions may become itchy, irritated, or grow in clusters over time. Early evaluation can help lead to more effective treatment and faster clearance.
References
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Centers for Disease Control and Prevention (CDC). Human Papillomavirus (HPV) – Genital Warts.
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Workowski KA, et al. CDC Sexually Transmitted Infections Treatment Guidelines (2021).
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Garland SM et al. Natural history of HPV infection. Vaccine. 2012.
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ACOG Practice Bulletin. Management of Condyloma Acuminata.
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Dr. Michael Tee
Clinical Director & Founder
Dr. Michael Tee focuses on helping patients manage a comprehensive range of skin conditions that can significantly impact daily comfort and confidence. He works extensively with patients experiencing skin changes during pregnancy, helping them navigate the complex dermatological shifts that occur during this important time. His practice also centers on mole evaluation and management, including atypical moles that require careful monitoring and assessment. Dr. Tee regularly treats patients dealing with acne, seborrheic dermatitis, and various forms of eczema, conditions that can affect both appearance and quality of life.