Benign viral wart

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What is a viral wart?

These appear as small rough lumps on the skin caused by infection with the human papillomavirus (HPV). They can occur anywhere but most common on the hands and feet. Examples of different types of warts include common wart, verrucae, plane warts (flat), filiform warts (finger like) or mosaic warts (many joined together)

What causes viral warts?

Viral warts are generally transmitted from one person to another through intact skin due to personal contact or via communal surfaces such as swimming pool floors. Individuals who are immunosuppressed from medical drugs taken for organ transplantation have a much higher rate of viral warts and other infections.

Anyone can get viral warts. In studies of children it has been shown that 7% have verrucae viral warts on the feet.

How is a viral wart diagnosed?

Diagnosis of a viral wart is usually clinical. We would only arrange for a skin biopsy test if we were concerned about a diagnosis of skin cancer.

Treatments for viral warts

There is no need to treat viral warts if they are not causing any problems. There are many over-the-counter topical treatments for viral warts available from your pharmacist. These are highly effective but do need to be applied on a regular basis for 12-16 weeks. The majority of treatments work by stimulating the body’s own immune system to recognise the HPV that hides in skin cells.

All treatment options cause the immune system to react to exposed viral elements.

Conservative management
(no treatment)

Up to 65% will resolve within 2 years with no treatment. In children 50% are gone in six months and 90% in 2 years.

Salicylic acid paints and gels

Before applying the paint the feet must be soaked and the hard skin removed by using a pumice stone or emery board. Be careful to dispose of any skin filings hygienically and do not use the emery board or hard skin removal tools elsewhere as this could spread the infection. The paint works by removing the dead skin and triggering the immune system to clear the virus.

Cryotherapy

May be available privately in your area or by a podiatrist. The warts will need to be shaved down prior to freezing to allow the treatment to get to the base of the wart. Several treatments may be needed every 3-4 weeks. Success is 70% after 3-4 months.

Surgery

This is no more effective than topical treatments. Options include curettage and cautery or ablative laser treatment with a carbon dioxide laser. Surgical procedures are often associated with significant pain afterwards and we would not recommend these as first line treatment.

Duct tape

Apply for 6 days then removed by soaking in warm water, wart shaved down again and left open over night then repeat for 2 months.

Complimentary therapy

Hypnotherapy, homeopathy, acupuncture and herbal treatments.

Podiatry treatment

Podiatrists will often be able to offer treatment for viral warts on the feet. Whatever treatments are used, no treatment is guaranteed to be more than 85% effective.

Do HPV vaccines protect against viral warts?

We know that certain types of HPV virus are associated with cervical cancer and other types of cancers. Vaccines are now available in many countries to protect against these particular subtypes. Unfortunately, they do not protect against common hand warts or verrucae.

What can I do if I have verrucae?

Do not share your shoes or socks with anyone else. Use special pads to relieve pressure on plantar warts these can be bought in the chemist. Keep your feet clean and dry. Change your shoes and socks daily. Do not go barefoot in public places. Plantar warts should be covered with waterproof plasters or rubber ‘verruca socks’ if you go swimming.

To avoid spreading viral warts to other parts of the skin (autoinoculation) do not pick or scratch plantar warts or use same pumice stone, nail file and or nail clippers for your warts and your healthy skin and nails.