All about warts: the good, the bad & the ugly

Warts may look ugly and be a little embarrassing but the good news is they’re mostly harmless and treatment can be simple and effective. 

Although mostly small and harmless, warts can prompt a big reaction. But things usually aren’t as bad as they seem when it comes to this very common skin complaint.

Warts come in different shapes and sizes, and certain types tend to grow on different parts of the body. The good news is, treatment for warts is usually simple and effective. Here are the different types of warts and how to get rid of them.

How do you get warts?

Warts are caused by a virus known as the human papillomavirus (HPV) and are spread through skin-to-skin contact with another person who has HPV. You can also be infected through contact with a surface that has the virus on it.

Regular or common warts look like small skin growths or bumps, and may be a bit rough on the surface. The virus causes an excess amount of keratin, a hard protein found in skin, hair and nails, to develop in the top skin layer (epidermis). This is what produces the rough, hard texture of a wart.

The good news is that most warts are harmless, says GP Dr Ronda Gurney. “The biggest concerns people have about warts are usually cosmetic – they just don’t like the look of them.”

Different types of warts

In addition to the common wart, here are some other types of warts:

• Plane warts – flat, often yellow and can spread and cluster together, usually on the hands and face
• Plantar warts – appear on the toe or soles of the foot and may be white with tiny black dots
• Filiform warts ­– long, thin and usually grow on your eyelids, armpits or neck
• Mosaic warts – can grow in clusters and mostly appear on your hands and feet
• Genital warts – can grow on the penis, anus, vulva, vagina and cervix.

When it comes to warts, genital warts are those that should be taken the most seriously. Not only can they cause pain, discomfort and itching, but they can also be warning signs for strains of HPV that can lead to cancer of the cervix and anus. Always consult your doctor if you suspect that you have, or are concerned about existing warts.

The good news is, prevention of HPV is possible through vaccination, which we will talk about more below.

How to get rid of warts

Not all warts need to be treated. About 65% will clear up by themselves within two years. In children, 50% of cases disappear within six months.

“But warts can be stubborn,” Dr Gurney says. “Our treatments may hurry them along a little bit, but most of the time the wart will decide when it wants to go away.”

If a wart is painful or you find it unsightly, here are some common wart removal methods:

• Topical ointments or creams – these usually contain salicylic acid, which softens the hard keratin protein that causes the wart, and may need to be applied for at least three months
• Freezing (cryotherapy) – a health professional uses liquid nitrogen to freeze off warts but it can be painful and may need multiple rounds of treatment
• Burning and laser – performed under a local anaesthetic and may scar your skin
• Scraping and cutting – also performed under a local anaesthetic, the wart is cut out (curettage) and the base cauterised (burning the skin with a heated instrument to stop bleeding and prevent infection).

What are genital warts?

There are more than 100 of types of viruses that make up HPV. Some of these viruses cause genital warts, which are a sexually transmitted infection (STI). Genital warts appear on the penis, vulva, vagina, cervix and anus, and are also transmitted through skin-to-skin contact.

Dr Gurney explains that certain types of HPV can be transmitted during sexual intercourse and infect a woman’s cervix. This can lead to pre-cancerous or cancerous changes in these cells in later life. Regular cervical screening for women will help pick up any changes in cervix cells before they develop into cervical cancer.

Similarly, exposure to HPV during anal intercourse has been linked with anal cancers.

When it comes to genital warts, prevention is the best course of action. If you are a young man or woman, you should consult your doctor about getting vaccinated against HPV. The ideal age for vaccination is around 12-13 years, though you can still get vaccinated past that age. However, it’s important that vaccination occurs before the first exposure to HPV, so it’s recommended before a young person becomes sexually active.

If vaccinated properly and at the right time, before exposure to HPV, the risk of cervical and anal cancers can be almost completely eliminated.

Genital warts can be treated with ointments, freezing, laser or by using a special cream that improves your immune system’s response to the virus. In some cases surgery may be required.

Like common warts, genital warts might not be painful and may go just away. But removing them will reduce the risk of them spreading to someone else. Using condoms will also reduce the spread but won’t eliminate transmission altogether because condoms don’t completely cover the skin in your genital area.

If you’re experiencing genital warts, it is important to consult your GP.

Wart prevention

It’s hard to pinpoint where you may have got a wart from because they can take up to a year to appear from the time the HPV infects the skin. But there are some things you can do to lower your risk of getting a wart or spreading yours to someone else:

• Don’t go barefoot in public places.
• Don’t share towels or shoes with others.
• If you have a plantar wart, clean your shower base and change your socks daily.
• Wash your hands if you have direct contact with your wart.
• Don’t pick or scratch your wart.
• If you’re a young person, talk to your parents and GP about HPV vaccination.
• Consult your GP if you have any sores or lesions in the genital region.

Words by Laura McGeoch
First published July 2021