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What's Up With Warts on Children?

Why children get warts, and what parents can do.

From the WebMD Archives

Children get a lot of warts. Maybe that’s why folklore attributes warts to touching frogs or toads. Forget that myth. Here are the facts on warts that every parent should know.

  • Between 10% to 20% of children have common skin warts.
  • Girls get more warts than boys.
  • Warts are most prevalent in children between the ages of 12 and 16.
  • Warts are contagious, but typically harmless.

"They're uncommon in infancy and as you go along in childhood they become more and more common," says Alfie Krol, MD, president of the Society for Pediatric Dermatology.

While medically harmless, warts bother some children more than others. Some children are embarrassed by warts. Others may be uncomfortable if the warts are on the soles of their feet. As a parent, it’s important to know what causes warts, how to help prevent them, and good treatments for warts.

Causes and Types of Warts on Children

Warts, caused by the human papillomavirus or HPV, are noncancerous skin growths. They form when the virus invades the skin, usually through a tiny cut or scratch. The virus causes rapid growth of cells on the outer layer of skin. Warts are usually skin-colored but can be dark. They can be rough or smooth.

Here are the types of skin warts, known medically as verrucae:

  • Common warts are found on the fingers, and the backs of the hands
  • Palmer warts are found on the palms, as the name suggests.
  • Plantar warts grow on the feet, typically the soles
  • Flat warts are typically smaller and smoother than other warts; they can grow in large numbers, even as much as 20 to 100 at a time. Flat warts on children are typically found on the face.
  • Filiform warts look like the kind that cartoon witches get on their chins or noses and stick straight out. They are often found on the face.

Genital warts don't typically affect younger children because they are usually sexually transmitted.

Reducing the Risk of Contagious Warts in Children

The viruses that cause common skin warts are passed from child to child. Once the virus infects the skin, it typically takes several months for the wart to become visible.

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Some children are more susceptible to warts than others. Children with a compromised immune system -- such as children who have had an organ transplant -- are more likely to get warts. Kids who bite their nails or pick at hangnails – creating tiny cuts in the skin -- are also more likely to get warts.

But even children with healthy immune systems and good nail habits may be more susceptible to getting warts, just as some people are more likely than others to catch colds often.

Children pick up the virus in many ways: By sharing towels and toys or playing with friends. However, there are ways to reduce the odds of your child developing warts. Here are Krol’s top tips:

  • Encourage your child to wear flip-flops around a public swimming pool and in public showers.
  • At home, if someone else has a problem with plantar warts, encourage the one with warts (if old enough) to spray a dilute bleach solution in the shower stall or bathtub after use and then rinse.
  • Assign one bath and hand towel to each child, and tell them not to share towels.

Of course, there’s no sure way to prevent warts. Simply playing with other children exposes kids to the possibility of catching warts, says Nanette Silverberg, MD, director of pediatric and adolescent dermatology at St. Luke's-Roosevelt Hospital in New York City.

A child with warts plays on monkey bars, for instance, and another child with small cuts on the hand touches the surface. The virus is transmitted and that other child develops warts.

"The virus tends to be fairly hardy on surfaces," Silverberg tells WebMD.

Should You Treat Warts on Children?

Fortunately, warts do not harm a child’s health, and often go away on their own.

Doing nothing for warts is perfectly OK, Krol says. In one study, researchers reported that warts spontaneously cleared in 40% of children within two years without any treatment.

Still, many children are bothered by warts and want them removed. Warts on feet can pose problems, leading to discomfort and inability to perform well in sports, for instance. Even common warts on hands may bother a child who is embarrassed.

Here is a rundown of common treatments to consider. But remember, no matter what treatment you use, Krol says not to expect too much. "No treatment is 100%," he says. And warts can come back.

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Home Remedies and OTC Treatments for Warts on Children

Home remedies run the gamut. People have put castor oil on warts, or a crushed paste of vitamin C. Among the most ludicrous treatment that Stephen Webster, MD, a dermatologist at Gundersen Lutheran Medical Center in La Crosse, Wis., has heard: rub the wart with a potato and then bury the potato, keeping its location a secret.

Other at-home treatments have research to back them up, say Webster and other experts.

Removing Warts With Duct Tape

For instance, covering the wart with duct tape has been shown to work as well as drugstore wart removers, but it takes perseverance.

Place duct tape over the wart and leave it on for about six days. Then remove the tape and soak the wart in water. Gently debride the wart with an Emery board. Repeat the whole process until the wart is gone. It may take a couple of months to completely remove the wart.

If that sounds like too much work, consider over-the-counter wart removers available at any drugstore. (First, check with your doctor or pharmacist to make sure the growth is really a wart. Sometimes corns and calluses are mistaken for warts.)

Using OTC Wart Removers

Common wart removers available at any drugstore include:

  • Adhesive pads or solutions with salicylic acid. Clean the area around the wart, apply the solution as directed, and later remove the dead skin with an Emery board or pumice stone. The success rate is about 75%, but the process may take six to 12 weeks, says Silverberg.
  • Solutions with propane or Freon that “freeze” the wart. The success rate is about 75% after two or three treatments, Silverberg says.

Silverberg cautions: Don’t use over-the-counter wart treatments on any wart on a child’s face or lips.

When to See a Doctor About Removing Warts on Children

If OTC wart removers don’t work, you can talk to a doctor about stronger treatments. Doctors generally take two general approaches to wart treatment, says Silverberg. They can destroy the wart or boost the immune system so it will clear the wart.

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Doctors typically remove warts in one of three ways:

  • Doctors may freeze the wart with liquid nitrogen, she says, a more potent medicine than found in over-the-counter freezing remedies.
  • Doctors can also give parents prescription-strength salicylic acid to apply to the wart at home.
  • Your dermatologist can also use a laser to destroy the wart. Less often, the doctor may remove it surgically, but this treatment can leave a scar so it’s usually the last resort.

Krol and Silverberg say doctors can build up the immune system to fight warts in a number of ways. Among them:

  • Your doctor may prescribe Tagamet to stimulate the immune system so it "attacks" and clears the wart. This medicine must be taken for two or three months to work.
  • Your doctor may inject the wart with substances such as Candida skin test antigen. Treatment success depends on the ability of the immune system to recognize viral and fungal antigens and "attack" the wart.
  • Your doctor may apply a topical preparation such as squaric acid to the skin to boost immune functioning. Silverberg says the acid is a "universal allergen." Nearly everyone reacts to it as a foreign invader, kicking the immune system into action.

Immune-boosting therapies may take up to three months to remove the wart, Silverberg says.

WebMD Feature Reviewed by Brunilda Nazario, MD on May 14, 2009

Sources

SOURCES:

 Alfie Krol MD, professor of dermatology and pediatrics and director of pediatric dermatology, Doernbecher children's Hospital, Oregon Health and Science University, Portland.

Linda Stein Gold, MD, director of clinical research, department of dermatology, Henry Ford Hospital, Detroit.

Nanette Silverberg, MD, pediatric dermatologist and director of pediatric and adolescent dermatology, St. Luke's-Roosevelt Hospital; assistant professor of clinical dermatology, Columbia University College of Physicians and Surgeons, New York.

Stephen Webster, MD, dermatologist, Gundersen Lutheran Medical Center, La Crosse, Wis.; and clinical professor of dermatology, University of Minnesota, Minneapolis.

American Academy of Dermatology: "What are warts?"

American Family Physician: Duct Tape More Effective than Cryotherapy for Warts."

Bacelieri, R. American Family Physician, Aug. 15, 2005, vol 72: pp 647-652.

Focht D. Archives of Pediatric and Adolescent Medicine, October 2002, vol 156: pp 971-974.

Gibbs, S. BMJ, Aug. 31, 2002; vol 425: p 461.

© 2009 WebMD, LLC. All rights reserved.

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