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Viral warts: Treatment, symptoms, advice and help

About viral warts

Warts are tumours or growths of the skin caused by infection with Human Papillomavirus (HPV).

Signs and symptoms of viral warts: Diagnosis

Common warts appear initially as smooth, skin-coloured papules. As they enlarge, their surface becomes irregular and hyperkeratotic, producing the typical warty appearance. They are most common on the hands but may also be seen on the face, genitalia and sun-exposed surfaces of the arm and leg.

Causes and prevention of viral warts

Viral warts are extremely common and are result of infection with the DNA human papillomavirus (HPV). Transmission is by direct contact with the virus, in either living skin or fragments of shed skin, and is encouraged by trauma and moisture (e.g. in swimming pools, fishmongers etc) Genital warts usually due to specific HPV subtype, are spread by sexual activity.

Viral warts: Complications

Some types of HPV have been found to cause cancer of the cervix and vulva.

Viral warts: Treatment

Viral warts will, in the vast majority of normal individuals resolve spontaneously. However, this may take several years. Most practitioners try to avoid treating warts that are not causing distress.

Initial treatment should be with salicylic acid or salicylic and lactic acid combinations, together with frequent and regular paring of the hyperkeratotic skin. Such treatment needs to continue for at least several months before convincing effects will be appear. If it fails, or as an alternative, warts can be treated by cryotherapy using liquid nitrogen. Such therapy needs to be repeated at intervals of 2 – 4 weeks.

Viral warts can be a particular problem in inviduals who are immunosuppressed following organ transplantation. Other treatments systemic retinoids, intralesional injection of bleomycin or interferon, and the application of contact sensitizers such as diphencyprone or dinitrochlorobenzene to the warts. The immunomodulator, imiquimod, is useful in treating stubborn anogenital warts.