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Verruca vulgaris, known as common warts, is rough, thickened growths on the skin caused by human papillomavirus (HPV). The infection is most prevalent in children but does affect people of all ages.1 Common warts are most frequently found on the hands and feet but can appear anywhere on the body. They are medically benign, meaning they are not harmful or cancerous, but they can be bothersome and affect quality of life.2,3
HOW DO YOU GET COMMON WARTS?
Common warts are spread through direct contact with the HPV virus. This can happen by touching a wart on someone else or on yourself. The virus can also spread through contact with surfaces that have been in contact with warts, such as towels or floors. Risk factors can include walking barefoot and fingernail biting.1 Unlike genital warts, common warts are not sexually transmitted.1
PRESENTATION
Common warts are often small, rough bumps on the skin that may range in size from 1 mm to several centimeters.4 They can be skin-colored or gray-brown and may have black dots inside. Common locations include the hands and feet. While often asymptomatic, warts can be painful.1,3,5 Diagnosis is usually made during a clinical examination; however, if it is unclear whether the problem a patient has is common warts, a biopsy may be performed.4
TREATMENT
Effective management of verruca vulgaris can range from watchful waiting to minor procedures, depending on the duration and level of physical or social discomfort. While no treatment has been shown to be completely curative, the most effective management options include the following:
- Watchful Waiting: A reasonable option for new warts which often resolve on their own, although resolution may take 1-2 years.1
- Salicylic acid: A topical agent that slowly destroys the HPV-infected layer of skin. It is the most effective treatment option, has minimal adverse effects, is low-cost and available over the counter.1
- Cryotherapy: A method that involves freezing the wart with liquid nitrogen. Two to three sessions of cryotherapy show similar effectiveness to salicylic acid. This can be done at home or by your provider.1
WHY SEEK MEDICAL EVALUATION?
For some, visible warts and the stigma of a contagious condition may affect self-esteem, social interactions, and overall emotional well-being.2 Warts can also be painful, especially on the feet.5 Discussing treatment options with a provider can provide opportunities to alleviate these burdens. It’s important to note that treatment failure and recurrence are common, regardless of the modality used.4 For those concerned about the risk of malignancy, a medical evaluation can provide reassurance that common warts are not typically linked to an increased risk of cancer.4
CONCLUSION
Understanding verruca vulgaris, its symptoms, and treatment options allows for patients to make an informed decision on how to proceed. Whether that includes watchful waiting or medical intervention, the alleviation of physical and psychological burdens is important. If you experience common warts, consult your healthcare provider for an accurate diagnosis and to discuss therapeutic options.
REFERENCES
Mulhem E, Pinelis S. Treatment of nongenital cutaneous warts. Am Fam Physician. 2011;84(3):288-293.
Adusumilli N, Shoen E, Friedman A. Psychosocial burden of verruca vulgaris: A cross-sectional survey. J Drugs Dermatol. 2022;21(6):614-617. doi:10.36849/JDD.6773
Mesgarzadeh S, Myrdal C, Stratton D, Curiel-Lewandrowski C. Intralesional bleomycin combined with cryotherapy in the treatment of recalcitrant verruca vulgaris. J Drugs Dermatol. 2022;21(2):195-196. doi:10.36849/jdd.6424
Al Aboud AM, Nigam PK. Wart. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 14, 2023.
Wortsman X, Jemec GB, Sazunic I. Anatomical detection of inflammatory changes associated with plantar warts by ultrasound. Dermatol. 2010;220(3):213-217. doi:10.1159/000275607