Warts are caused by viruses in the human papilloma virus family.  It is an infection of the top layer of skin or epidermis.  The virus invades the outer layers of skin, usually through a small scratch, and then causes rapid growth of cells on the outer layer of skin which is called a wart. The appearance of a wart depends on its location on the body and the thickness of the skin. There is a  big difference between the appearance of a wart on the finger for example, and plane warts on the face which can easily be mis-diagnosed.  Warts on the fingers are unsightly but usually cause no symptoms, but a plantar wart or verruca can cause pain on walking. 

Warts in children are extremely common.  They may resolve by themselves but it could take years. They are contagious and can lead to bullying in the school.  These can be frozen off by liquid nitrogen at the GP surgery or at the Dermatology clinic.  They appear commonly on the fingers but also on the face and children can also get plantar warts (verrucas) from the swimming pool etc. 

Adult warts  are not so common and may not disappear spontaneously. Plantar warts (verrucas)  are much more difficult to treat than other warts and can be quite resistant to therapy. If home remedies and liquid nitrogen have already failed, laser therapy may be suggested.

Pulsed dye laser is a vascular laser aimed at destroying the blood supply to the verruca or wart. Several sessions 6-8 may be required for complete eradication and this is a 2nd line treatment where other treatments have failed.

Your Doctor may suggest a blood screen to check for immunosuppression as warts in adults are not that common. Remedies to help boost your own immune system may also be suggested.  The success rate with the pulsed dye laser is extremely high.  Surgical CO2 laser is often discussed and the wart can be surgically removed with this. 

Genital warts are very common. These are nearly always a sexually transmitted disease. The appearance again is different to warts in other areas of the body and they may be multiple.  They can becomes very large and multiply in pregnancy and develop around the anus.  Some female patients will also have visible warts on the cervix. The warts can be treated but can recur.  Generally, treating the external warts will cause the internal warts to also disappear. Pulsed dye laser is also used very successfully.  Patients should book in for full STI (sexually transmitted infections) screening if they are diagnosed with genital warts to rule out other STI’s as they will be much higher risk.  Partners also need to be treated and contact tracing can be discussed. This can be done at the GP surgery or local GUM clinic or with the Dermato-venerologist at the clinic.