A wart is a common, non-cancerous skin growth frequently appearing on children’s skin. These firm, raised bumps develop when cells in the outer skin layer grow faster than normal. Warts are extremely prevalent in the pediatric population, with incidence peaking during school-age and adolescence. They are caused by an infection and spread through contact, making them a common concern for parents and caregivers.
The Underlying Cause: Human Papillomavirus
Warts are specifically caused by an infection with the Human Papillomavirus (HPV). While HPV includes over 200 different types, only a small fraction causes the common skin warts seen in children. The most frequent types responsible for non-genital warts are HPV 1, 2, 4, 27, and 57.
The infection begins when the virus enters the skin through tiny cuts or cracks in the top layer. Once inside, HPV targets the basal layer of skin cells and triggers them to multiply rapidly. This accelerated cell production results in a localized thickening of the skin, which is the characteristic appearance of a wart.
The visible wart is essentially a benign tumor of the skin. Unlike viruses that cause systemic illness, HPV primarily remains localized within the skin cells. The time between initial infection and the appearance of a visible wart can range from a few weeks to several months.
How the Infection Spreads
The Human Papillomavirus spreads primarily through skin-to-skin contact. Direct contact with an existing wart is one of the most common ways the virus is transmitted to another person. The virus can also survive for a period on surfaces, leading to indirect transmission.
Contaminated surfaces play a large role in the spread of warts in children. These include shared items like towels, socks, and nail clippers, or the floors of public areas such as communal showers or swimming pool decks. The virus easily penetrates skin that is moist, soft, or has minor breaks, especially on the feet after swimming.
A child can also spread the virus to other areas of their own body through autoinoculation. This happens when a child scratches or picks a wart, transferring viral particles to an uninfected area of skin. Keeping existing warts covered helps prevent this internal spread and reduces the likelihood of infecting others.
Identifying Common Wart Types
Warts are classified based on their appearance and location on the body.
Common Warts
Common Warts are the most frequent type and typically appear on the fingers, hands, and around the nails. They are easily recognizable as rough, dome-shaped, and raised growths with a grainy texture.
Plantar Warts
Plantar Warts are found on the soles of the feet. Due to the pressure of walking, these warts are often pushed inward, making them flatter and sometimes painful, feeling like a stone in the shoe. They may also display tiny black dots, which are actually clotted blood vessels.
Flat Warts
Flat Warts present as smooth, small papules that are generally flatter than other types. They are often skin-colored or light brown and tend to grow in large clusters. They most commonly appear on the face, neck, or shins of children.
When to Consult a Pediatrician
While many warts in children are harmless and resolve on their own, specific circumstances warrant a medical evaluation. Parents should consult a pediatrician if the wart is causing persistent pain, bleeding regularly, or showing signs of a secondary infection. Signs of infection include increased redness, swelling, warmth, or draining pus.
Consultation is also necessary if warts are rapidly spreading or located on sensitive areas like the face or genital region. A doctor can accurately confirm the diagnosis, as some skin conditions mimic warts. Consulting a professional ensures the growth is benign and determines the most appropriate course of action.