Warts are common during pregnancy, often prompting questions about their safety and removal. While generally benign, consulting a healthcare provider is important for accurate diagnosis and to discuss appropriate management options.
Warts and Pregnancy Considerations
Warts are skin growths caused by the human papillomavirus (HPV). Different HPV types cause various kinds of warts. Common warts typically appear on hands and elbows, plantar warts develop on the soles of the feet, and flat warts often affect the face or legs. Genital warts, caused by specific low-risk HPV types, appear in the genital area.
Pregnancy can influence wart growth and development due to hormonal shifts and changes in the immune system. The body’s immune response is naturally suppressed during pregnancy to protect the developing baby, which can allow latent HPV to become active or cause existing warts to grow larger or multiply. Increased blood flow and vaginal discharge during pregnancy can also contribute to a more favorable environment for wart growth, particularly for genital warts.
Safe Removal Methods
Several wart removal methods are considered safe for pregnant individuals, typically involving localized treatment to minimize systemic absorption. Cryotherapy, which involves freezing the wart with liquid nitrogen, is a widely used and effective method. This procedure causes the wart tissue to freeze and eventually fall off, and it is considered safe throughout pregnancy. Electrocautery, a method that burns and destroys warts using an electric current, is another safe option. Radiofrequency treatment, which uses electrical energy to target and destroy warts, is also generally safe and effective during pregnancy.
Surgical excision, where the wart is cut off, can be preferred for larger warts or those that have formed a mass, with careful selection of pregnancy-safe anesthesia. Certain laser treatments, such as fractional CO2 laser and pulsed dye laser, are also considered safe during pregnancy as they target the wart directly with minimal systemic effects. These physical removal methods are often favored because they act locally without significant absorption into the bloodstream, thereby reducing potential risks to the developing fetus.
Some topical treatments, however, require caution or should be avoided during pregnancy due to concerns about systemic absorption and potential effects on the fetus. Salicylic acid, commonly found in over-the-counter wart removers, generally should be avoided in high concentrations or when applied to large areas during pregnancy. While low concentrations might be used cautiously for small areas, higher concentrations used for wart removal are not recommended. Imiquimod and podophyllin (also known as podophyllum resin) are generally not recommended during pregnancy due to limited safety data or concerns about potential systemic absorption and teratogenic effects. Podofilox, a derivative of podophyllin, is also typically not recommended for use during pregnancy. While some studies suggest local podophyllotoxin exposure may not be associated with adverse fetal outcomes, it remains generally contraindicated due to its antimitotic properties.
Deciding on Wart Removal During Pregnancy
The decision to remove warts during pregnancy involves assessing various factors, including the wart’s type, size, location, and whether it causes discomfort or potential complications. Small, asymptomatic warts may often be monitored and deferred for treatment until after delivery, as some warts can regress spontaneously when pregnancy hormones normalize. However, removal might be recommended if warts are large, causing discomfort, bleeding, or if they are genital warts that could obstruct the birth canal.
Genital warts, in particular, warrant careful consideration due to the rare but serious risk of transmission to the baby during vaginal birth. This can lead to juvenile-onset recurrent respiratory papillomatosis (RRP), a condition where warts grow in the baby’s airway, primarily caused by HPV types 6 and 11. Although the likelihood of a child developing RRP from an infected mother is low, typically between 1 in 231 to 1 in 400, the potential severity of the condition makes it a significant concern. While a cesarean section may be considered to reduce the risk of transmission if warts are extensive or obstructive, it does not entirely eliminate the possibility of HPV transmission.
Ultimately, any decision regarding wart removal during pregnancy must be made in close consultation with an obstetrician or dermatologist. Healthcare providers can evaluate the individual situation, weigh the benefits and risks of treatment, and determine the safest and most appropriate course of action for both the pregnant individual and the baby.