Warts

A wart is typically a small, rough or smooth raised bump on the skin.¹ They can appear on any part of the body but are more likely to show up on the hands, fingers, fingernails, elbows, knees and the bottom of the feet.^2a,3a,4a Often disappearing on their own over time, warts are not normally painful unless you have one on the underside of your foot.⁵

Warts are caused by the human papillomavirus (HPV) infecting the top level of your skin. Each person’s immune system responds differently to viruses, so some people who come into contact with HPV will get a wart, others will not. Also, there are 100 different strains of the HPV virus.^6a for example, the strain that causes common warts is not the same as the one that causes genital warts.^6b

Warts are contagious and can spread by skin-to-skin contact to other parts of your body and to other people. ^7a If you constantly touch or pick at your wart and touch another part of your body or someone else’s skin, or if you have an open wound (cut or scrape) that touches someone else’s wart, they may spread.^{7b, 8}

Warts can also spread indirectly through fomites, which are objects, materials or surfaces likely to carry infection, for example moist places such as swimming pools or bathrooms.^9a Genital warts, however, are spread through sexual contact.

Different types of warts are identified by where they grow on the body and what they look like.^3b

Common warts, also called verrucas, most commonly develop on the fingers, around the nails, the hands, and the knees, elbows and face. They can also occur elsewhere, in areas where there is broken skin from biting fingernails or from open wounds.^3c Common warts are fleshy, dome-shaped, skin-coloured and often rough-textured.^7c

Plantar warts are found on the soles of the feet but also under the toes. They are often flat or grow inward caused by pressure from walking. Described as feeling like you have small stones in your shoe they are uncomfortable and often painful.^3d When occurring in clusters they are called mosaic warts. Deep plantar warts are called myrmercia.¹¹

Flat warts, also called plane warts, are smaller and smoother than other warts, can occur anywhere and tend to appear in clusters – 20 to 100 at a time.^3e

Filiform warts have long, narrow spike-like projections and tend to grow on the face, around the eyes, nose and mouth.¹²

Developing around the fingernail or toenail, periungual warts appear as thickened skin around the nail.^13a They may disturb nail growth and can cause nail loss.^13b People who bite their nails are more likely to get periungual warts.

Appearing on or around the genital or anal area and in the genital tract, genital warts are one of the most common sexually transmitted diseases. They are spread by intimate skin-to-skin contact including oral and penetrative sex.^6c Up to 70% of sexually active women will become infected with HPV during their lifetime

Non-genital warts occur in 7-10% of the general population, occurring equally in males and females mainly in children and teenagers.^9b People with a weakened immune system are at greater risk.^2b It makes sense then, that children and teenagers are more likely to have warts because they have less developed immune systems.

Warts of the genital tract carry a much more serious threat particularly for women:^9c

• HPV infection can cause cervical cancer
• HPV DNA is present in almost all cervical cancer cases worldwide ^9d

There is no proven way to prevent warts from occurring and no cure for the HPV virus.^3f However, you can reduce risk of getting them by boosting your immune system and not making direct contact with someone else’s wart.¹⁴ If you already have a wart you can prevent it from spreading by leaving it alone (not picking at it or touching it) and then touching others, and practising good hygiene habits by washing your hands and skin often.^4b

Warts are among the 3 most common skin conditions treated.^9e A dermatologist (skin doctor) can usually tell if you have a wart by looking at it. While warts often go away without treatment, and can be self-treated if they persist, treatment requires an individualised approach. Always consult your doctor or dermatologist if:

• A young child or infant has a growth anywhere on the body
• The wart is on the face, genitals or anal area
• There are many warts
• The wart becomes painful, red, itches, is swollen, bleeding or oozing pus ^{3g, 4c}