Introduction

Warts are small, skin-coloured, rough lumps on the skin. They often appear on the hands and feet and look different depending on where they are on the body and how thick the skin is. A wart on the sole of the foot is called a Verruca. Genital warts are warts found on the genitals and around the rectum.

Warts are caused by infection with a virus called human Papilloma virus (HPV). The HPV virus causes a hard protein called keratin in the top layer of the skin (the epidermis) to grow too much, producing the rough, hard texture of a wart.

Warts are usually harmless, but they can look unattractive. They often clear up by themselves, although treatment can help to get rid of them more quickly. Warts aren't normally painful, although Verrucas can sometimes hurt.

Warts are very contagious. The skin cells in warts release thousands of viruses, so close skin-to-skin contact can pass on the infection. However, it can take weeks or even months for a wart, Verruca, or genital warts to appear after you've caught the infection.

People with weak immune systems (the part of the body that fights infection) are more likely to get warts. This is because the body is less able to fight off the HPV virus.

Most people develop warts at some point in their life, usually before the age of 20. About 1 in 10 people in the UK have warts at any one time. Genital warts are the most common sexually transmitted infection in the UK.

Symptoms

Warts can be different sizes, ranging from 1mm to over 1cm. You may have only one or two warts, or lots can develop on the same area of skin.

The size and shape of warts varies:

• Common wart (Verruca Vulgaris) - is a firm, raised wart with a rough surface that can look a bit like a cauliflower. They can occur anywhere, but are most common on the knuckles, knees and fingers.

• Plane wart (Verruca Plana) - is a round, flat topped, yellowish type of wart. They mainly occur on the back of the hands, especially around the nails and fingers.

• Filiform wart (Verruca Filiformis) - is a long, slender wart that is common on the thin skin of the eyelids, armpits or neck.

• Genital warts (Condylomata Acuminata) can be small, white lumps or larger, cauliflower-shaped growths on the penis, scrotum or vulva (the female external sex organs), or around the rectum. Warts can also develop inside the vagina or anus. Genital warts on the vulva are usually soft because the skin here is moist and hairless. Genital warts that develop on skin that is dry and hairy (such as the shaft of the penis) tend to be firm. The number of warts that develop varies. Some people have a few that are hardly noticeable, while others have a lot. Genital warts do not usually cause any symptoms, although they may be itchy if they are around the anus. However, the warts may be a sign of a sexually transmitted infection (STI), or, in rare cases, cancer.

• Verrucas (planter warts) - are warts on the soles of the feet. Verrucas don't stick up from the surface of the skin. Instead, the weight of the body pushing down on them makes them grow back into the skin, which can be painful. Verrucas often have a black dot in the centre, surrounded by a hard, white area. The dot is the blood supply to the wart and the white area is the skin of the wart that is closely packed together. Verrucas that grow in clusters are sometimes called mosaic warts.

You should see your GP if you have a wart mole or Verruca that bleeds, changes in appearance, or spreads.

Causes

Warts are caused by different strains of the human papilloma virus (HPV). The virus is present in the skin cells of a wart, and can be passed on through close skin-to-skin contact.

You are more likely to catch the infection if your skin is damaged, or if it is wet or in contact with rough surfaces. For example, public swimming pools are a common place to catch Verrucas. People with scratches or cuts on the soles of their feet are especially vulnerable.

You can also spread warts to other parts of your own body. For example, if you scratch or bite a wart it can cause the wart to break up and bleed, making it easier for the virus to spread.

People with a weak immune system (as a result of immune system diseases such as AIDS, or as a result of certain treatments such as chemotherapy) are more likely to catch warts. They may develop lots of warts that are particularly difficult to get rid of.

Genital warts are caused by a strain of the HPV virus that is passed on during sex, or very close sexual contact. However, most people infected with HPV don't develop visible warts. You can carry the virus without realising it, and pass it on to other people who may then go on to develop visible genital warts.

Diagnosis

Warts and Verrucas are easy to recognise. Warts are usually raised growths with a hard uneven surface. A Verruca may have been pushed in by the weight of your body and so appear as an area of very white skin on the sole of your foot, perhaps with a black dot in the centre.

Although genital warts can be embarrassing, it is important to have them checked out at your GP surgery or local sexual health (GUM) clinic. This is because genital warts can be caused by a sexually transmitted infection, and in rare cases can be a sign of cervical cancer in women. The doctor or nurse that you see will probably take a swab (sample of cells) from the area, to identify the infection that is causing the warts.

Treatment

Most warts clear up without treatment, although this can take years.

Mole & Wart EZ Clear^TM is a 20 minute, one off treatment. A scab is formed and will naturally dry and fall off in between 7 & 21 days. Natural skin healing will continue with the aid of one of our healing products.

Other types of treatment can be painful, and there is no guarantee that the warts wont come back again.

Treatment options depend on where the warts are and how many there are. Options include:

• Over-the-counter treatments - A variety of creams, gels, paints and medicated plasters are available from pharmacies. Most of these contain salicylic acid as their active ingredient. Salicylic acid and other wart treatments also destroy healthy skin. You need to rub the dead tissue off from the top of the wart once a week with a pumice stone or emery board. It usually takes months of continuous treatment for the wart to go completely, if indeed it does.

• Cryotherapy - Destroys the cells. A sore blister develops, followed by a scab. Treatment can be painful, so you might need a local anaesthetic beforehand. Cryotherapy treatment is usually carried out at hospital skin clinics or at your GP surgery. Large warts sometimes need to be frozen several times, a week or so apart, before they clear.

• Surgery - Surgery to remove warts is carried out under general or local anaesthetic. Warts can be cut out of the skin or the skin of the wart can be scraped off with a spoon-like instrument called a curette.

• Laser treatment - in which the wart is destroyed using a very precise laser beam

• Electrocautery - in which the wart is burnt off using an electric current.

Complications

A sudden outbreak of a large number of genital warts suggests there could be a problem with your immune system. It's important to see your GP immediately if this happens.

Certain types of HPV have been linked with cervical cancer. However, the types of HPV that cause visible genital warts do not increase the risk of cervical cancer. Women with genital warts should have cervical smear tests at the normal, routine intervals.

Prevention

To reduce your risk of getting a wart or Verruca:

• Don't touch other peoples warts.

• Don't scratch or pick at a wart as this may spread the infection to other parts of your body.

• Don't share towels, flannels or other personal items with a person who has a wart.

• Don't share shoes or socks with someone who has a Verruca, and wear flip-flops in communal showers and in swimming pool changing areas.

If you have a Verruca, you should cover it with a plaster when you go swimming. If you have a wart on your hand you should wear gloves if you are using communal equipment (for example, in a gym).

To avoid catching genital warts, you should practice safe sex. The best way to do this is to use condoms. However, condoms don't cover the entire genital area, and are usually put on after sexual contact has begun, so the virus that causes genital warts can still be passed on.

You should use a condom (as well as any other form of contraception you normally use) for 3-6 months following treatment for genital warts. This helps to stop you and your partner getting re-infected.