Warts

Warts are a common and often persistent skin infection that affects the palms, soles, face and potentially any part of the skin. They are very common in children as they often come into contact through play, sports or other common activities with other children who may be affected.

The warts on the soles of the feet are mainly caused by the strain 1, while those on the hands are caused by the strains 2 and 4. The flat warts that mainly appear on the face are caused by the strains 3 and 10.

Warts have an incubation period of 2-9 months and appear on the hands as painless papules, while on the soles, they seem as hyperkeratosis that can be confused with calluses and they may cause pain when walking. In fact, the child, in his/her attempt to avoid the pain from the warts, may walk in the wrong way, straining his/her joints or the other leg. Also, on the surface of the warts, especially if the surface layer of skin is removed, black spots corresponding to clotted blood vessels are observed. If left untreated, they may increase in size and number.

The flat warts are different because they appear mostly on the face as small painless papules that look like skin-colored pimples without pus that persist and spread.

In general, the warts is a type of skin condition with an unpredictable course that depends significantly on the defense of each person, while there are also cases of self-healing.

Several therapeutic methods are used to destroy the skin affected by the virus, such as cryotherapy with liquid nitrogen, diathermocoagulation, the topical use of chemical agents (imiquimod, podophyllotoxin, 5-fluorouracil, keratolytics), the use of lasers, the surgical removal and in some special cases the use of topical retinoids (flat warts) or systemically in large infestations (epidermodysplasia verrucifiormis). Several sessions may be required to eliminate the problem. In children, we often use a topical anesthetic that is applied 30 minutes before the microsurgery to make it as painless as possible.

When they appear on the face, sun protection must be taken after cauterization to avoid a scar (hypopigmentation or hyperpigmentation) at the cauterization points.