Warts are common, benign skin growths caused by the human papillomavirus (HPV). They form when the virus enters the skin through tiny cuts or breaks, triggering an overgrowth of skin cells. Many individuals with a wart will seek some form of treatment, but others may choose to wait, wondering what the natural course of the condition will be. Understanding the potential outcomes of non-treatment is key to making an informed decision about managing these lesions.
The Natural Course of Untreated Warts
The most notable feature of untreated warts is the possibility of spontaneous resolution, also known as regression. This happens because the body’s immune system eventually recognizes the viral presence and mounts a defense to clear the infection. The immune response targets the HPV-infected cells, leading to the wart’s gradual disappearance.
This self-healing process is highly unpredictable and varies significantly among individuals. For children, the prognosis is often better, with approximately 50% of warts resolving within one year and 70% within two years without intervention. Adults tend to experience longer persistence, sometimes for several years, depending largely on the strength of the individual’s immune status and age.
Risk of Growth and Spread
While waiting for the immune system to act, an untreated wart remains an active source of the human papillomavirus. This viral activity carries a significant risk of both self-spread and transmission to others. The virus thrives in the wart tissue, and as the skin sheds, the viral particles are released.
The primary concern for the individual is autoinoculation, which is the spread of the virus to other, previously unaffected areas of their own body. This often occurs through picking, scratching, or shaving the wart, which transfers viral particles to new sites where the virus can establish a new infection. Autoinoculation can lead to a single lesion multiplying into a cluster of warts, such as a mosaic wart, or the development of satellite warts surrounding the original growth.
The untreated wart also poses a risk of transmission to other people through direct skin-to-skin contact or indirectly via contaminated surfaces. The HPV can survive on objects like shared towels, razors, or the floors of communal areas like locker rooms and swimming pools. While most adults have developed immunity to common wart-causing HPV strains, children and individuals with compromised immunity are more susceptible to acquiring the virus.
Potential Physical Complications
The prolonged presence of an untreated wart can lead to various physical discomforts and secondary complications, particularly when the lesion is in an area subject to friction or pressure. Warts located on weight-bearing areas, like plantar warts on the soles of the feet, often become painful and tender when standing or walking. This pain results from the wart being pushed inward by body weight, sometimes feeling like walking on a small stone.
Warts are also susceptible to secondary bacterial infection, especially if they are picked at, scratched, or crack open. Breaks in the skin barrier allow bacteria to enter, leading to signs of infection such as increased redness, swelling, pus, or discharge. Furthermore, warts contain tiny blood vessels to sustain their growth, which can cause them to bleed spontaneously or with minor trauma.
Depending on their location, untreated warts can physically interfere with normal function and daily activities. Warts on the fingers or near joints can impede fine motor skills, while those near the nail bed can affect nail growth. When left to grow, warts may also become cosmetically bothersome, affecting an individual’s self-esteem and potentially leading to psychological distress.
When Waiting is No Longer an Option
While the choice to wait for spontaneous resolution is valid, certain circumstances and physical changes signal that professional medical treatment is immediately necessary. A wart that exhibits rapid growth, changes color, or develops irregular borders should be evaluated by a healthcare provider to rule out other, potentially more serious skin conditions. This is especially true if a wart suddenly turns dark, purple, or black, which could indicate bleeding within the lesion.
Persistent, severe pain, or a wart that bleeds uncontrollably for an extended period, are definite warning signs that require medical attention. Signs of secondary infection, such as spreading redness, warmth, significant swelling, or pus, necessitate prompt intervention, often involving antibiotics.
Individuals with weakened immune systems, such as those with HIV or those taking immunosuppressant medication, should not delay treatment, as their warts are often more resistant to clearance and prone to spreading. Warts located on sensitive areas, including the face or genitals, should also be addressed by a specialist due to the higher risk of complications or scarring.