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The viruses that cause warts are members of the human papilloma virus (HPV) family. Warts can be transmitted from one person to another and they can travel from one part of the body to another.

Warts occur most commonly among children, young adults, and women. They are a problem for 7 to 10 percent of the population. Warts are caused by nearly sixty different kinds of HPV. Each type prefers a certain part of the body.

For example, some types of HPV produce warts on the skin, others cause warts inside the mouth, and still others produce warts on the genital and rectal areas.

Viruses enter the body through the skin or mucous membrane. They usually do not produce symptoms for one to eight months after entering the body. When warts appear, they are usually skin-colored and feel rough to the touch, but they can also be dark, flat, and smooth.

People differ in their sensitivity to HPV. Some individuals get warts over and over again. Others seldom or never get them. The virus is able to penetrate the body more easily if the skin has been damaged. For example, children who bite their nails may damage their skin in the process, which makes it easier for the virus to enter the body and cause warts. People with weakened immune systems are especially sensitive to HPV and wart infections.

The most common types of warts include:

Common hand warts
Foot warts
Flat warts
Genital warts
Hand Warts
Common hand warts grow around the nails, on the fingers, and on the backs of hands. They appear most often where the skin is broken.

Foot Warts
Foot warts are also called plantar warts. Plantar warts usually occur on the ball of the foot, the heel and the bottom of the toes. The skin in these areas is subject to weight, pressure, and irritation and has a tendency to crack or break open, providing an opening for the virus. Foot warts usually do not stick up above the skin.

People of all age groups can get plantar warts. But they are most common among adolescents between the ages of twelve and sixteen. The virus can be picked up in locker rooms, swimming pools, or by walking barefooted on dirty surfaces. People with diabetes mellitus (see diabetes mellitus entry) are very likely to develop plantar warts. The warts develop in areas where sores did not heal properly.

Flat Warts
Flat warts are smaller and smoother than other kinds of warts and tend to grow in large numbers. Although they can appear anywhere on the body, flat warts appear most often on the legs of women and the faces of children and young adult males.


Warts: Words to Know

Cryosurgery:
The use of liquid nitrogen for the purpose of removing diseased tissue.

Human papilloma virus (HPV):
A family of viruses that cause hand, foot, flat, and genital warts.



Genital Warts

Genital warts are a type of sexually transmitted disease (STD). A sexually transmitted disease (see sexually transmitted diseases entry) is a condition that is passed from one person to another during sexual activity. The forms of HPV that cause genital warts are very contagious. A person who has sexual contact with someone
infected with HPV is very likely to contract the disease. Experts estimate that two-thirds of these people will develop genital warts within three months of contact. As a result, about one million new cases of genital warts are diagnosed each year in the United States.


While it is very easy to recognize the presence of warts, depending on the area of the body that is infected, the symptoms may vary. For instance, if left untreated, plantar warts can grow to a size of one inch or more. They can spread out and form clusters of warts that can become painful at times. They cause the most discomfort when they occur on parts of the foot where pressure occurs, such as the heel or ball of the foot. Some people say they feel as if they have a stone in their shoe all the time.

Genital warts are usually small flat bumps. They may also be thin and tall. They are mostly soft, and not scaly, like other kinds of warts. In women, genital warts usually appear within the vagina, on the cervix, and around the anus or within the rectum. In men, the warts usually appear on the tip of the penis, on the scrotum, or around the anus. Genital warts can also develop in the mouth of a person who has had oral sexual contact with an infected person.



Many over-the-counter wart treatments are available that remove hand and foot warts. These products are usually in the form of lotions, ointments or plasters. They work by removing the skin affected by a wart virus. After treatment, the skin and wart simply drop off. These products must be used with care, however. The chemicals they contain are quite strong and can affect healthy skin as well as infected skin. People with diabetes or heart conditions should not use these products.

Non-prescription drugs are also available for the treatment of flat warts. These products cause the skin to become saturated with water. Over time, the skin layer peels off, taking the wart virus with it. Flat wart remedies can take as long as three months to work, depending on the size and depth of the wart.

Moist patches are often the easiest and most effective products to use. They are placed on a wart for forty-eight hours. Then they are replaced with a new patch. In some cases, the patch may irritate the skin. In that case, the person should switch to a milder medication or stop treatment for a while.

Professional Treatment
A doctor should be consulted if home remedies do not work within a month. Doctors have many methods available for removing warts. One method involves the use of chemicals stronger than those found in non-prescription drugs. The use of these chemicals is often effective, but they may produce some burning and discomfort for a few days.

A second method of wart removal is cryosurgery (pronounced KRY-oh-SUR-juh-ree). Cryosurgery is the process by which tissue is frozen with liquid nitrogen, which has a temperature of about 330° F (200° C). This process freezes the tissue very quickly and the frozen tissue can then simply be removed. Healing of the frozen area usually occurs quickly.

Another method of wart removal is electrocautery in which an electric needle is used to burn the wart. The tissue around the wart is killed and can be peeled off, taking the wart with it. Laser surgery works in a similar way. A laser beam is aimed at the wart and the heat of the laser kills the skin around the wart, and the skin and wart simply fall off.

Genital warts are very difficult to treat. Any of the described methods can be used. But the first round of treatment may not be very effective. Although it may be possible to remove the warts, the virus that causes the warts may continue to survive under the skin and can produce new warts at a later time.

Plantar warts are also very resistant to treatment. The use of chemicals can be successful if the warts are diagnosed early. However, the treatment may take many months. In the most serious cases, surgical removal of the warts may be necessary.

Alternative Treatment
A number of alternative approaches have been recommended for the treatment of warts. The scientific justification for some of these treatments is inconclusive. The suggestions listed should not be used for genital warts, which should be treated by a doctor.

For the treatment of common or plantar warts, alternative practitioners recommend the following remedies:

Apply a paste made of vitamin C powder to the wart for one to two weeks.
Place a crushed or sliced clove of garlic over the wart for seven consecutive nights while sleeping.
Soak the wart in water. Then make scratches in the wart with a sterile needle. Apply drops of thuja dissolved in alcohol to the wart. Repeat several times a day for one to two weeks.
Tape a piece of banana peel on the wart over night, with the inner side of the peel touching the skin. Repeat nightly for one to two weeks.
Strengthening one's immune system is an objective of some forms of alternative treatment. A stronger immune system may be able to fight off the viruses that cause warts. A well-balanced diet rich in vitamins A, C, and E may help strengthen the immune system. Avoiding stress is thought to be another way of strengthening the immune system.

PROGNOSIS


Even if warts are removed, the viruses that cause them may remain in the body and the warts may reappear at a later time. This problem is especially common in cases of genital warts. In addition, genital warts can cause other problems. The human papilloma virus can also cause infections of the cervix. Women who have had genital warts should see their doctor regularly and should have a pap smear every six months. A pap smear is a test for cervical cancer.

Plantar warts are difficult to treat because of the weight placed on feet. The goal of treatment is to destroy the plantar wart and the virus without damaging healthy skin but the treatment can often cause pain until the foot heals completely.

PREVENTION


Using condoms during sexual activity can prevent genital warts. Condoms do not offer protection against areas that are not covered, however, such as the upper thighs. Plantar warts may be prevented by practicing good foot care. Good foot care involves keeping feet clean and dry, changing socks daily, and taking note of growths on the skin or changes in skin appearance.







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