Overview

HPV warts, also known simply as warts, are non-cancerous skin growths caused by certain strains of the human papillomavirus (HPV). These warts can appear on various parts of the body, including the hands, feet, face, and genitals. While HPV warts are generally harmless, they can be bothersome due to their appearance, location, or discomfort. Warts are highly contagious and can spread through direct skin-to-skin contact or indirectly via contaminated surfaces. Although many warts go away on their own, some may require treatment to prevent spread or alleviate symptoms.

Causes

HPV warts are caused by infection with the human papillomavirus (HPV). There are over 100 different strains of HPV, and specific strains are responsible for different types of warts:

• Common warts: Usually caused by HPV types 2 and 4, appearing on hands and fingers.
• Plantar warts: Caused by HPV type 1, found on the soles of the feet.
• Flat warts: Typically caused by HPV types 3 and 10, appearing on the face, neck, or legs.
• Genital warts: Caused by HPV types 6 and 11, affecting the genital and anal regions.

The virus enters the body through small cuts or abrasions in the skin. Contributing risk factors include weakened immune system, direct contact with warts, walking barefoot in communal areas, and skin trauma.

Symptoms

Symptoms of HPV warts vary depending on their type and location:

• Common warts: Rough, raised bumps with a grainy surface, usually on fingers, knuckles, or knees.
• Plantar warts: Hard, painful lumps on the soles of the feet, often with black pinpoint dots (clotted blood vessels).
• Flat warts: Small, smooth, flesh-colored lesions often clustered on the face or legs.
• Genital warts: Flesh-colored or grey growths in the genital area, which may be small or form cauliflower-like clusters.
• Itching or discomfort: Warts may cause mild pain or itching, especially in weight-bearing areas or sensitive regions.

Diagnosis

Diagnosis of HPV warts is usually straightforward and based on clinical appearance:

• Physical examination: A healthcare provider can typically identify warts through visual inspection.
• Dermatoscopy: In some cases, a magnifying tool helps examine skin lesions in detail.
• Biopsy: Rarely needed, but a skin biopsy may be performed if the diagnosis is uncertain or to rule out other skin conditions.
• Pap smear or HPV testing: For genital warts, cervical screening may be recommended in women to check for high-risk HPV strains.

Treatment

Many HPV warts resolve on their own within months or years, but treatment is often pursued for cosmetic reasons, discomfort, or to prevent spread:

• Topical treatments: Salicylic acid creams, gels, or patches to gradually peel away the wart tissue.
• Cryotherapy: Freezing the wart with liquid nitrogen to destroy the abnormal cells.
• Cantharidin: A blistering agent applied in a clinical setting to cause wart shedding.
• Electrosurgery or curettage: Burning or scraping off the wart under local anesthesia.
• Laser therapy: Used for stubborn warts, particularly genital or plantar warts.
• Immune therapy: Treatments like imiquimod stimulate the immune system to fight off the virus, especially for genital warts.
• Surgical removal: Minor surgery may be done for large or resistant warts.

Prognosis

The prognosis for HPV warts is generally favorable:

• Spontaneous resolution: Many warts disappear on their own without treatment within one to two years.
• Treatment success: Most treatment options effectively remove warts, though multiple sessions may be required.
• Risk of recurrence: Warts can recur after treatment, especially in individuals with weakened immune systems.
• Prevention: HPV vaccination can prevent certain types of genital warts and high-risk HPV strains linked to cancer.
• Contagious nature: Avoiding direct contact with warts and maintaining good hygiene can help prevent transmission.

With proper management and preventive care, most individuals can effectively control HPV warts and reduce their impact on daily life.