Human papillomaviruses (HPV) are a common group of viruses that cause small, noncancerous skin growths known as warts. These warts are frequently observed in children, often appearing on various parts of the body. This article explains how children acquire warts, describes their common appearances, and outlines preventive strategies and when to seek medical advice.
Primary Transmission Routes
Warts in children primarily spread through non-sexual contact with the human papillomavirus. The virus typically enters the body through minor cuts, scrapes, or other skin abrasions. Children are more susceptible because their immune systems may not be fully developed to resist all strains, and they often engage in activities that result in skin breaks.
Direct skin-to-skin contact is a common way HPV spreads among children, such as during play or close physical interaction with an infected person or their wart. Transmission risk increases if the child’s skin has open wounds or is damaged, as cuts or scratches provide an entry point for the virus.
Indirect contact also contributes to HPV spread. The virus can survive on surfaces and objects touched by an infected person’s wart. Sharing items like towels, toys, or shoes, or walking barefoot in public areas such as swimming pools, locker rooms, or showers, can facilitate transmission. These communal spaces are potential sources of infection, as HPV thrives in warm, moist environments.
Perinatal transmission, though less common for typical skin warts, can occur when HPV is passed from a mother to her child during vaginal birth. While studies suggest HPV DNA can be detected in infants born to infected mothers, not all such transmissions lead to visible warts. The exact mechanisms of vertical transmission are still being investigated.
Children can also spread warts from one part of their body to another through a process called autoinoculation. This occurs when a child touches or scratches an existing wart and then touches another area of their skin, transferring the virus. Picking at warts can increase the risk of spreading them to new locations.
The HPV types responsible for common skin warts in children are generally distinct from those causing sexually transmitted genital warts. While genital warts can occur in children, non-sexual transmission routes are the primary concern for common skin warts in this age group.
Common Types of HPV Warts in Children
HPV can manifest as several distinct types of warts, each with characteristic appearances and preferred locations on a child’s body.
Common warts are typically rough, raised, and dome-shaped growths. They often appear grayish-yellow or brown and may have tiny black dots, which are clotted blood vessels. These warts are frequently found on the hands, fingers, elbows, and knees.
Plantar warts develop on the soles of the feet, especially on pressure points like the heels or toes. Due to pressure from walking, they tend to grow inward, making them flatter than common warts. They often have a grainy or bumpy texture and may feature small black pinpoints, sometimes referred to as “wart seeds”. Plantar warts can be painful, feeling like a small stone embedded in the foot.
Flat warts are smaller and smoother than other types of warts. They are only slightly raised, often appearing as flesh-colored, yellowish-brown, or pinkish bumps. These warts commonly occur on the face, arms, and legs, and can appear in clusters. They are sometimes called juvenile warts because of their prevalence in children.
Preventive Measures and When to Seek Medical Advice
Preventing the spread of HPV warts in children involves practicing good hygiene and being mindful of direct and indirect contact. Consistent handwashing with soap and water, especially after touching any wart, helps remove the virus from the skin and reduce transmission.
Avoiding the sharing of personal items is a key preventive measure. Towels, washcloths, razors, nail clippers, and socks should not be shared among family members, as these can harbor the virus. Wearing flip-flops or other protective footwear in public showers, locker rooms, and around swimming pools can help prevent plantar warts, as HPV thrives in moist environments.
Covering cuts, scrapes, or existing warts can help prevent the virus from entering the skin and limit its spread to other body parts or individuals. Children should be encouraged not to pick at or scratch their warts, as this can lead to autoinoculation and potential bacterial infections. Keeping skin moisturized and preventing dryness or cracking can reduce entry points for the virus.
The HPV vaccine is a significant preventive tool, though it primarily targets high-risk HPV types associated with genital warts and certain cancers, not all types that cause common skin warts. It is recommended for both boys and girls, typically starting between ages 9 and 11, to protect against specific HPV infections that can lead to serious health issues.
While many warts in children resolve on their own over several months to years, medical advice should be sought under certain circumstances. Parents should consult a doctor if warts are painful, bleeding, or causing discomfort that interferes with normal activities. Rapidly spreading warts, those located in sensitive areas like the face or genitals, or any wart that appears infected (red, swollen, oozing pus) warrant a medical evaluation. Consulting a healthcare provider is advised if there is uncertainty about whether a growth is a wart or if home treatments have not been effective.