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The Curious Case of Cutaneous Warts

By Scott Hamilton, MD
March 30, 2023
Hamilton Blog Headshot Updated 12.21.21

This week's guest columnist is Jason Adekoya, MD, a family practice resident at Ochsner University Hospital & Clinics.

Like many children, I was told that handling toads caused warts. I still enjoyed playing with my hopping friends, but I'd check my skin to make sure none showed up. Then one day, one appeared on my thumb. Gasp...the grown-ups were right!

There are over 200 types of warts and many different viruses that cause them (no, toads don't). They can pop up on faces, hands, feet and genitals. Hand and face warts bother kids and parents because they're so visible. When they're on fingers, kids pick at them.

Most bothersome are “plantar” warts, those found on the bottom of feet. They can't grow outward like on hands and faces because of walking. They're pressed inward on sensitive soles and hurt, like walking with a rock in your shoe. Genital warts can worry parents and doctors concerned about sexual abuse.

Plantar warts are treated like other warts: they can be frozen, burned, injected or shaved off by a doctor. One home remedy is duct tape. Apply a small square to the wart, peel it off in 4-7 days, clean the wart, and buff it off with an emery board. Repeat the process, and in a month or two, the wart is often gone.

Genital warts are more troublesome. Fortunately, they're rarely transmitted by sexual abuse. Babies and toddlers most commonly pick them up from moms who have the Human Papilloma Virus (HPV). They're in sensitive spots, so regular wart remedies don't apply. They often require outpatient laser surgery. Good news: the HPV vaccine prevents this.

We noticed a bump on our six-year-old' daughter's knee. My wife squeezed it, and our girl cried to the heavens! We left it alone and soon one bump became three and three became seven, all clustered on that knee. Then more appeared on her back. My wife asked, “what are these?” Peering closer, I noticed they looked pale, with a little dimple in the middle. “This is Molluscum Contagiosum,” I replied. Molluscum are warts caused by a virus picked up from skin-to-skin contact. It can also be on towels or surfaces that someone else's wart has touched.

As the nickname “water wart” implies, they look like tiny water-filled, thick-skinned blisters. They're translucent-white and can have a dimple on top. The “Contagiosum” means they're contagious between kids, but also self-contagious: one wart begats three, then seven, then more. Your immune system eventually recognizes that the virus and its warts don't belong, attacks them, and in 6-18 months they go away. But they look odd, and kids pick at them; how do you get rid of them sooner?

Like the other warts mentioned above, there's several options for treating Molluscum. Doctors can freeze them or core them out with a procedure called curettage. These procedures can hurt and scar, so instead there's medicines to apply directly. These can sometimes irritate surrounding skin. If you pluck them off at home by squeezing or tweezers, be sure to clean the skin, your hands and your tweezers first, and dress the open sore with a bandage to prevent infection. The good news about wart removal: Molluscum is “reverse-contagious,” meaning if you remove some, the rest disappear by themselves.

Or you could leave them alone and they'll go away anyway.