Warts (Verruca)

Warts (verrucae) are benign infections of the skin and mucous membranes caused by the human papillomavirus (HPV). Although more common in children and young adults, they can appear at any age. The virus enters through small cracks in the skin, infects skin cells and over time causes a wart to form.

Warts appear most often on the hands and fingers, the soles of the feet, around the nails and on the face. Warts on the soles can be painful when pressed and can be confused with a callus. Warts around the nails, in turn, can lead to distortion of the nail structure over time.

Warts can spread through direct contact or shared items such as towels and slippers. Swimming pools, gyms and communal areas in particular can pose a risk of transmission. However, not everyone who comes into contact with the virus develops a wart; the characteristics of the immune system also play an important role.

The diagnosis is usually made by dermatological examination. Where needed, dermoscopic examination allows warts to be distinguished from other skin conditions and treatment to be planned more accurately.

Some warts can disappear on their own over time through the effect of the immune system; however, this process can take months or even years, during which warts can grow, multiply or spread to others. Treatment is planned according to factors such as the wart's location, number and size and the patient's age and immune system. Cryotherapy (freezing), topical treatments, immunotherapies and, where necessary, surgical methods may be used. Some warts clear in a single session, while warts that are long-standing or numerous may require several treatment sessions.

Genital warts (condylomata) are warts caused by HPV infection that appear in and around the genital area. In women they can appear on the external genitalia, the vaginal opening and around the anus; in men, on the penis, scrotum and around the anus. They can appear as a single lesion or, over time, increase in number and form clusters. They spread most often through sexual contact; the immune system plays an important role in whether the infection appears.

The great majority of genital warts are associated with low-risk HPV types (particularly HPV 6 and HPV 11), which do not usually lead to cancer. However, some high-risk HPV types can be associated with cancers of the cervix, anus, penis and some head-and-neck cancers. It is important, particularly for female patients, to keep up regular gynaecological check-ups and the necessary screening tests. In treatment, the appropriate option among cryotherapy, topical treatments, electrocautery, laser or surgical methods is chosen; because the virus can remain in the skin for some time, new warts can develop and treatment may need to be repeated.

The HPV vaccine, particularly when given before disease develops, provides significant protection against genital warts and some HPV-related cancers. The vaccine can be given to both women and men in the recommended age groups.