Warts are common skin growths caused by the human papillomavirus (HPV). Finding them during pregnancy often raises concerns about fetal safety. Warts can sometimes grow larger or multiply rapidly due to the hormonal and immunological changes of gestation. Any risk to the baby depends entirely on the type and location of the wart. Understanding the distinction between common skin warts and genital warts is necessary to assess potential complications.
Understanding the Different Types of Warts in Pregnancy
Warts fall into two main categories, and their cause dictates the level of concern during pregnancy. Common warts (verruca vulgaris) are typically found on the hands, fingers, or soles of the feet (plantar warts). They are caused by low-risk, non-sexually transmitted HPV strains. These lesions are generally a cosmetic or discomfort issue for the mother and pose no known risk to the fetus or newborn.
In contrast, genital warts (Condyloma Acuminata) appear in the anal or genital area. They are caused by specific, sexually transmitted strains of HPV, primarily types 6 and 11. Pregnancy involves natural immune suppression and hormonal changes, which can accelerate the growth and proliferation of existing genital warts. Lesions may become larger, multiply, or appear for the first time during gestation.
The HPV strains causing genital warts are different from those causing common warts. The low-risk HPV strains responsible for genital warts are distinct from the high-risk strains associated with cervical cancer. This distinction between the location and the HPV type determines the specific management and risk assessment during the prenatal period.
Assessing Fetal and Neonatal Risks
Concern for the baby is almost exclusively related to the presence of genital warts, as common skin warts carry no known fetal risk. The risk of transmission of genital warts to the baby is very low, but not zero. The primary risk occurs during delivery as the baby passes through the birth canal and contacts the lesions.
In extremely rare instances, this vertical transmission of the HPV virus can result in a serious condition known as Recurrent Respiratory Papillomatosis (RRP). This involves the growth of warts in the baby’s mouth, throat, or larynx, which can obstruct the airway and require frequent surgical intervention. Despite this potential complication, most babies born to mothers with genital warts do not experience HPV-related issues, and their bodies often clear the virus on their own.
An active genital wart outbreak typically does not affect the baby’s health during pregnancy. No link has been established between HPV and complications like miscarriage or premature delivery. However, the physical presence of large or extensive genital warts can directly influence the delivery plan. If warts are very large, they can obstruct the birth canal or increase the risk of maternal bleeding during a vaginal delivery. In these circumstances, a Cesarean section may be recommended to avoid maternal trauma and minimize the slight risk of viral transmission.
Safe Treatment and Management Strategies During Gestation
When treating warts during pregnancy, the primary goal is often conservative management. Many warts spontaneously regress after delivery when the immune system returns to its non-pregnant state. Treatment may be necessary if the warts cause significant pain, bleeding, or are located in the genital area and may affect delivery. Any treatment decision must be made in consultation with an obstetrician and dermatologist to ensure fetal safety.
Several physical methods are considered safe for wart removal during pregnancy, particularly after the first trimester. These include cryotherapy (freezing the wart with liquid nitrogen) and surgical excision to remove the lesion entirely. Laser ablation can also be used for larger lesions. Trichloroacetic acid (TCA) is another provider-applied chemical treatment often considered safe for use.
Conversely, many common wart treatments are avoided or strictly contraindicated during pregnancy due to concerns about systemic absorption and potential effects on the fetus. Topical medications such as Podophyllin, Podofilox, Imiquimod, and 5-Fluorouracil should not be used. High-concentration salicylic acid products, often found in over-the-counter removers, are usually avoided because of absorption risk. It is imperative to consult a healthcare provider before using any self-treatment.