Wart & Molluscum
* we provide wart and molluscum treatment at Village Pediatrics for most types of lesions
Many of us have had a wart somewhere on our bodies at some time. Other than being a nuisance, most warts are harmless and go away on their own.
More common in kids than in adults, warts are skin infections caused by viruses of the human papillomavirus (HPV) or pox virus families. They can affect any area of the body, but tend to invade warm, moist places, like small cuts or scratches on the fingers, hands, and feet. Warts are usually painless unless they're on the soles of the feet or another part of the body that gets bumped or touched all the time.
Kids can pick up HPV and pox viruses through direct contact, or from touching anything someone with a wart has used, like towels and surfaces. Kids who bite their fingernails or pick at hangnails tend to get warts more often than kids who don't because they can expose less-protected skin and create open areas for a virus to enter and cause the wart.
Types of warts include:
- common warts. Usually found on fingers, hands, knees, and elbows, a common wart is a small, hard bump that's dome-shaped and usually grayish-brown. It has a rough surface that may look like the head of a cauliflower, with black dots inside.
- flat warts. These are about the size of a pinhead, are smoother than other kinds of warts, and have flat tops. Flat warts may be pink, light brown, or yellow. Most kids who get flat warts have them on their faces, but they can also grow on arms, knees, or hands and can appear in clusters.
- plantar warts. Found on the bottom of the foot, plantar warts can be very uncomfortable — like walking on a small stone.
- filiform warts. These have a finger-like shape, are usually flesh-colored, and often grow on or around the mouth, eyes, or nose.
- molluscum contagiosum. Caused by a pox virus, these are clusters of pearly, flesh-colored warts with a central small umbilication. These tend to spread when scratched or irritated, and are commonly found in children with eczema. Visit this link for more information on molluscum.
Sometimes warts are sexually transmitted and appear in the genital area, but most warts appear on the fingers, hands, and feet.
Warts are caused by viruses that hide in the uppermost layers of the skin, avoiding detection by the body’s immune system. Treatment typically involves irritating the wart to allow the body to respond to it, as well as shedding the layers of skin containing the virus. In thicker areas such as the palms and soles repeated treatments may be necessary.
Warts don't generally cause any problems, so it's not always necessary to have them removed. Without treatment, it can take anywhere from 6 months to 2 years for a wart to go away. A doctor might decide to remove a wart if it's painful or interferes with activities because of the discomfort.
Doctors have different ways of removing warts, including:
- using over-the-counter medications on the wart (typically an irritant such as salicylic acid)- these need to be applied regularly for several weeks to work.
- A prescription irritant such as phenol or a blistering agent such as canthridin- these are well tolerated and not painful, and what we use at Village Pediatrics for treatment.
- burning the wart off using a light electrical current.
- freezing the wart with liquid nitrogen (called cryosurgery.)
- using laser treatment (with recalcitrant warts.)
Within a few days after the doctor's treatment, the wart may fall off, but several treatments might be necessary. Doctors don't usually cut off a wart because it can cause scarring and the wart may return.
If an older child has a simple wart on the finger, ask the doctor about using an over-the-counter wart remedy that can help remove the wart. This treatment can take several weeks or months before you see results, but eventually the wart should crumble away from the healthy skin. Wart medicines contain strong chemicals and should be used with care because they can also damage the areas of healthy skin. Talk with your doctor before using any over-the-counter wart medicine on the face or genitals.
Also make sure that your child:
- soaks the wart in warm water and removes dead skin on the surface of the wart with an emery board (that's never going to be used for nails) before applying the medicine. Be careful not to file into it.
- keeps the area of the wart covered while the medicine works
- knows not to rub, scratch, or pick at it to avoid spreading the virus to another part of the body or causing the wart to become infected
You might also have heard that you can use duct tape to “suffocate” a wart. There is no proof that this is an effective treatment, and may take some time to work, though will not harm your child.
Are Warts Contagious?
Simply touching a wart on someone doesn't guarantee that you'll get one, too. But the viruses that cause warts are passed from person to person by close physical contact or from a surface that a person with a wart touches, like a bathmat or a shower floor. (You can't, however, get a wart from holding a frog or toad, as your child might have wondered!)
A tiny cut or scratch can make any area of skin more vulnerable to warts. Also, picking at a wart can spread warts to other parts of the body.
The length of time between when someone is exposed to the virus that causes warts and when a wart appears varies. Warts can grow very slowly and may take weeks or longer to develop.
Although there's no way to prevent warts, it's always a good idea to encourage kids to wash their hands and skin regularly and well. If your child has a cut or scratch, use soap and water to clean the area because open wounds are more susceptible to warts and other infections.
It's also wise to have kids wear waterproof sandals or flip-flops in public showers, locker rooms, and around public pools (this can help protect against plantar warts and other infections, like athlete's foot).
When to Call the Doctor
Before you try to remove a wart with a store-bought remedy, call your doctor if:
- you have a young child or infant with a wart anywhere on the body
- your child (of any age) has a wart on the face, genitals, or rectum
Also call the doctor if a wart or surrounding skin is painful, red, bleeding, swollen or oozing.