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Warts - What are they, Treatment, Transmission, Symptoms

Warts are benign skin hyperplasia caused by the Human Papilloma Virus (HPV). Over 70 types of HPV viruses are responsible for these lesions and each type is responsible for the appearance of warts on a specific part of the body. The warts are also known as verruca or beetle warts or carnivorous.

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Diagnosis and Treatment

The diagnosis of warts should be made exclusively by a dermatologist, who is the only expert for the correct diagnosis and choice of treatment. Usually, their diagnosis is not difficult and is done clinically and epidemiologically. Rarely, a biopsy may be needed, especially when they look like epitheliomas or skin carcinomas in adults.

Also, when a wart is found in the genital area it should be differentiated from genital warts and this can only be done by HPV – DNA Test.

At Cosmetic Derma Medicine we apply the following treatments for warts, always taking into account the form and location of the warts, as well as the age of the patient.


Warts usually appear on the hands, feet and face. However, their appearance on any other part of the body is not excluded. Most commonly, they occur in summer, due to the non-use of footwear, as well as because of the increased contact with water, which makes the lower limbs vulnerable to the attack by HPV virus. Depending on their clinical picture, warts can be divided into:

  • Common warts (Verruca vulgaris): These warts may be round or irregularly shaped and can be white, grey or brown in color. They may be flat or form patches the size of a pea. Common warts usually develop around the fingernails, fingers and palm, but they can also appear on the knees and face in cases of skin trauma. In terms of symptoms, common warts do not present anything special or dangerous. There may be mild pain and discomfort in the patient. Usually, a wart on the arm or a wart on the foot falls into this category. The difference in their clinical picture is that the wart on the sole due to constant pressure and friction cannot grow extraplanar (outward) so it may appear flat, but has a lot of depth and is usually quite painful. The wart on the hand usually protrudes from the epidermis.
  • Flat (plane) warts (Verruca vulgaris): Flat warts are asymptomatic, slightly healed or flat lesions with a smooth surface and a light brown or blue-yellow color. Smooth warts are usually found on the forehead, dorsal surface of the hands, chin, neck and legs. They usually take the form of a straight line, as a result of spreading due to scratching of the area (Koebner effect).
  • Papular warts: Warts of this category usually occur in men and are distributed on the face or neck area. Often, these warts form small clusters on the beard of men and on the scalp.
  • Filiform or Digitate warts: These warts look like papillomas and are mainly found on the sides of the neck, underarms and thighs. They are called warty papillomas and multiply by friction or by the use of chains around the neck.


They are transmitted by simple contact with infected persons or objects, often at sites with minor skin continuity lesions, abrasions or other minor injuries, and can be transmitted from one part of the body to another after contact with the infected area. Therefore, the human papilloma virus (HPV) that causes warts can be transmitted by shaking hands or contact with infected objects. This is because the virus can live for several days outside the human body and therefore the possibility of transmission is increased.

It is quite common for the virus to be transmitted when swimming in a swimming pool, as HPV viruses are resistant to the chlorine contained in these pools. This, combined with the habit of people walking barefoot in such environments, leads to a high probability of infection.

Often warts are transmitted to oneself by inoculation at sites of injury. For example, warts that form in the palm area can lead to warts on the face or any other spot due to frequent contact of these areas with the hands.


Depending on their location, warts are classified into the following types:

  • Plantar warts

    Plantar warts appear as a clearly excoriated circular lesion with a rough supra-vertebral surface. They are skin-colored, and if the thick coating is removed, black spots are seen which are pathognomonic for the disease. Plantar warts usually develop at the sites of greatest pressure on the foot.

    In women, plantar warts prefer the anterior part under the toes. In some cases, plantar warts may flock together creating plaques with a “mosaic” appearance.

    Plantar warts are usually extremely painful if not treated and cause difficulty and severe pain when walking. Due to the pressure from walking they usually do not develop in the form of bumps but in the form of hard nodules. A differential diagnosis must therefore be made in the case of a foot wart from a possible foot callus.

  • Palmer or Periungual warts

    It is the most common location of warts. Palmer warts are very common. They can be located on the palm or even the back of the hands. Often hand warts are located around the nails so they are called periungual warts.

    Palmer warts are a common manifestation of children who can touch infected objects with their hands and do not yet have a strong immune system to protect them. Toe warts often occur in people who, because of their work, have frequent contact with water, e.g. housewives, hairdressers. Palmer or Periungual warts often experienced by these people cause severe discomfort and pain that makes it difficult for them to work.

    A finger wart can occur either around the nails or on the palmar surface. Often finger warts are also found between the fingers with severe pain or even bleeding. Due to the prolonged wetting of the skin, it becomes more vulnerable and palmer/periungual warts develop.

  • Facial warts

    The face is a frequent manifestation of warts. Face warts usually occur in children and are mostly asymptomatic. Facial warts are smooth and flat and often multiply due to scratching.

    Facial warts are often an aesthetic problem for the patient. Special care is required by the dermatologist to properly diagnose and treat facial warts and to distinguish them from possible hyperplasias and nevi.

  • Warts on genitals

    These warts are similar to the well-known genital warts but they might not have been transmitted through sexual intercourse, but through transmission from hand warts.