Warts are a common pediatric skin issue, affecting approximately one in five children. These small, noncancerous growths are highly transmissible in school-aged populations. While generally harmless and self-limiting, warts can be persistent and may cause discomfort or embarrassment.
Understanding Warts: The Viral Origin and Common Forms
Warts are caused by an infection with a specific type of virus belonging to the Human Papillomavirus (HPV) family. This virus invades the outer layer of the skin, triggering an accelerated rate of cell growth that results in the characteristic bumpy, raised texture of a wart. The infection is localized to the skin and does not cause a systemic illness throughout the body.
Different strains of HPV cause various types of warts, distinguished mainly by their appearance and location on the body. Common warts often have a rough, raised surface and are typically found on the hands, fingers, and knees. Plantar warts develop on the soles of the feet, where the pressure from walking forces them inward, often making them painful and sometimes appearing with small black dots from clotted blood vessels. Flat warts are smoother and smaller than common warts, frequently appearing in clusters on the face or legs of children and teenagers.
Transmission Routes and Risk Factors for Children
The virus that causes warts is spread through direct and indirect contact, making transmission common where children congregate. Direct contact involves touching an existing wart on another person or on a different part of the child’s own body. Self-inoculation, the spread of the virus from one site to another, often occurs through scratching or picking at a wart.
Indirect transmission involves contact with contaminated objects, known as fomites, that have been touched by an infected person. Shared items such as towels, gym equipment, socks, or bath mats can harbor the virus and transfer it to another child. The virus thrives in warm, moist environments, increasing the risk of infection in communal areas like public swimming pools, locker rooms, and shared showers.
A primary risk factor for acquiring warts is having breaks or compromised skin, such as small cuts, scrapes, or abrasions. These openings provide an easier entry point for the HPV virus. Children who bite their nails or pick at hangnails are also at higher risk for developing warts around the fingers and nail beds. Those with a weakened immune system are more susceptible to viral infections, including warts.
Managing and Treating Warts at Home and with a Doctor
Many warts will spontaneously disappear as the child’s immune system recognizes and fights the virus, although this process can take months or even a few years. For those that persist, over-the-counter (OTC) treatments are often the first line of defense, with salicylic acid being the most common option. This acid works by slowly peeling away the layers of the infected skin, and its effectiveness is improved by consistent application over several weeks or months.
Another home treatment involves using OTC freezing kits, which apply a cold spray to the wart to destroy the affected tissue. For both topical acid and freezing methods, covering the treated area with a bandage or duct tape can help maximize the effect and prevent the virus from spreading. Complete resolution often requires patience and consistent effort over an extended period.
A doctor’s visit becomes necessary if the wart is painful, especially plantar warts that interfere with walking, or if the wart bleeds, shows signs of infection like pus, or is rapidly spreading. Professional medical treatment can include stronger prescription-strength topical treatments, such as higher concentrations of salicylic acid or other compounds. The doctor may also use in-office procedures like cryotherapy, which involves applying liquid nitrogen to freeze and blister the wart. For stubborn or large warts, other methods like minor surgical removal or laser treatment may be considered.