Pediatric Warts

Warts on the skin are harmless growths. They are caused by a virus. Warts can spread to other parts of the body and to other people.

Warts are caused by a type of human papillomavirus (HPV). Different types of warts are caused by different types of papillomaviruses.

Warts are more common in children than adults, but they can happen at any age. A person is more at risk for warts if they have either of these:

• Close contact with someone who has warts
• A weak immune system

Warts are usually not painful, except when one is on the bottom of a foot. There are many different types of warts. They each look different. The types of warts and their symptoms include:

• Common warts. These usually have a rough surface. They are grayish-yellow or brown in color. They may be on the fingers, elbows, knees, or the face.
• Plantar and palmar warts. These grow on the soles of the feet or palms of the hand. Groups of plantar warts are called mosaic. These warts may be painful.
• Flat warts. These are small, smooth growths. They most often appear on children's faces.
• Filiform warts. These are small, long, narrow growths. They usually appear on eyelids, lips, or the face or neck.
• Periungual warts. These appear as thickened skin around the nails. They can cause painful splits in the skin (fissures).
• Genital warts. These are small and flesh-colored or gray. They show up in the genital area. They may cause itching and irritation. If a child has genital warts, it may be a sign of sexual abuse or early sexual activity. But HPV may also spread through nonsexual contact between child and caregiver, such as giving a child a bath or changing a diaper.

The healthcare provider will give your child a physical exam. A healthcare provider will usually diagnose warts based on their appearance. They may use a small blade to scrape away the top layers. There may be black dots beneath the top layers. These are tiny blood vessels that have clotted. Your child's healthcare provider may recommend that your child see a skin specialist (dermatologist). The dermatologist may do a shave biopsy to verify the diagnosis. A very small amount of the wart is shaved and sent to the lab to be examined.

Most warts go away in months to years with no treatment. Common warts can often be treated with over-the-counter products. Treatment of warts depends on:

• How long they have been in place
• Where they are on the body
• What type of wart they are
• How many of them are growing

Some treatment methods may cause pain and burning in the area treated. Talk with your child's healthcare provider about which treatments would cause the least pain and work best for your child. Treatment may include one or more of the following:

• Putting salicylic acid or other medicines on the wart (topical irritants)
• Freezing the wart with liquid nitrogen
• Applying an electrical current to the wart (electrocautery)
• Cutting out (excising) the wart
• Removing the wart with laser surgery

Warts may be difficult to treat and may return.

Warts can spread to other parts of the body and to other people. It can be spread by skin to skin contact. The virus may be spread by towels or other personal items. You can help prevent the warts from spreading. Make sure your child:

• Washes their hands for at least 20 seconds with soap and clean, running water after touching the wart
• Doesn’t touch the wart to other parts of their body
• Doesn’t touch the wart to other people
• Doesn’t share anything that touches their wart, such as towels
• Wears socks or slippers if they have warts on the bottom of the feet

Call your child's healthcare provider if your child has warts that:

• Are painful
• Cause problems with normal activities
• Are embarrassing