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Wart Types Common to Periungual Treatments

female's hand fingers bent back over palm wart on ring finger wart types

Last updated 06/13/2024

Warts are identified by the site affected and which type of HPV causes the wart. But, certain HPV strains can only infect a few specific areas on your body. There are some 130 known forms of human papilloma viruses. Wart types starts with common warts.

Various kinds of HPV cause a benign growth, typically known as a “wart” or “papilloma”, on the infected skin surface. Further, HPV infects the squamous layer often of the skin or mucus membranes.

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Wart Types History

According to ancient medical text which survived from the time of Hippocrates life, c. 460 – c. 370 BC, warts have been a documented disease. As of 1907 physician Giuseppe Ciuffo was the first to show how a virus infection caused warts. And in 1976 the virologist Harald zur Hausen was the first to connect this viral cause to the human papillomavirus (HPV). Astonishingly, his ongoing research provided evidence to create an HPV vaccine, with its start of availability in 2006.

Wart Types Common to Periungual

close-up image of a common wart showing blood vessels shutterstock wart types

Common Warts (Verruca Vulgaris)

Common warts can be an umbrella term for 5 cutaneous wart types. They are flesh colored growths that could have black dots resembling chia seeds. In fact, these dots are often referred to as “seeds”. But these are actually very tiny blood vessels.

However, they can feel like a rough and hard bump. These warts are round or oval shaped with a firm and raised surface. Likewise, the wart’s surface is irregular resembling a cauliflower.

In addition, their size range is 1mm to 10mm plus in diameter. Thus, common warts are small in size like a pinhead to a pea.

Typically, they are discovered on knuckles, on the backs of hands, the fingers, skin circling nails and the feet.  And can be observed as one wart or several.

Further, they show up where the skin is broken. That is to say, if you bite your nails. In addition, this action can also transfer the virus from your hand to your face.

On dermatoscopic examination they have thickening of skin layers and large blood vessels at the dermoepidermal junction. Commonly they will have fingerlike or knoblike extensions as well.

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Common Warts Cause

HPV types 2 and 4 are mainly responsible for common warts. In addition, types 1, 3, 26, 29, and 57. But, there could be more.

High risk HPV types are linked to these cancers:

  • Cervical
  • Vulvar
  • Vaginal
  • Penile
  • Anus
  • Certain oropharyngeal cancers

Filiform Warts (Verruca Filiformis)

Filiform warts also called digitate warts due to the thread or finger-like appendage arise long and slender. In appearance they can also look spiky or like tiny brushes. Further, they are fast growing.

They usually occur on the face especially on the eyelids or around the mouth, eyes and nose. As a result, another name for them is facial warts. In other words, they are discovered in skin folds of sensitive areas. So, they can be annoying even though they are normally painless.

Because they occur in these sensitive areas you could experience:

  • Itching
  • Bleeding
  • Soreness
  • Irritation

Often, these are removed by your dermatologist for cosmetic reasons. That is to say, you could feel embarrassed or put off by their look.

Filiform Warts Cause

The HPV types that cause filiform warts are 1, 2, 4, 27, and 29.


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Flat Warts (Plane Warts/Verruca Plana)

Flat warts also called juvenile wart, because they are usually found on children and young adults. Mostly they affect the hands, face and legs. Further, they are smooth textured, flattened and brownish or flesh colored.

They could be 1/8 inch wide possibly the thickness of your phone cord for charging. And flat warts often show in large numbers typically 20-100 at a time.

The human papillomania virus (HPV) is spreadable through shaving. That is to say they often are observed due to a scratch or break in your skin. Thus, men could get a wart in the beard area from shaving nicks. And women could notice them for the same issue on their legs.

Most common areas they are discovered:

  • Face
  • Neck
  • Hands
  • Wrists
  • Knees

Flat Warts Cause

The causes for these warts are HPV types 3, 10, 28 and 49.


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Genital Warts

Yes, you can get warts down here. You might have figured this out. In short, this form develops after having sex with someone who has them.

However, you may not be able to see them. But even if you can’t observe them these can spread. Appearance is small, scattered skin-colored bumps as well as a cluster of bumps resembling cauliflower on your genitals.

Most importantly, you don’t want to attempt to get rid of genital warts yourself. They can be difficult to treat.

Areas where genital warts are found:

  • Vagina
  • Vulva
  • Cervix
  • Urethra
  • Penis
  • Scrotum
  • Anus

Genital Warts Cause

The majority of genital warts are due to HPV types 6 and 11. But HPV types 16, 18, 31, 33, and 35 can also be responsible.

Periungual Warts (Subungual Warts)

Periungual warts form beneath and around your fingernails or toenails. Above all, if you have a habit of biting your nails you should stop. Thus, they can normally spread beneath the nail.

They have cauliflower-like clusters and a rough surface. As a result, this wart can alter the shape of your nail and cause pain. In addition, their location can form treatment difficult.

Periungual Warts Cause

HPV types linked to periungual warts are 1, 2, 4, 5, 7, 27 and 57.

Plantar Warts (Verruca, Verruca Plantaris/Palmer Warts for Hand)

Plantar warts can give you the sensation of pebbles in your shoe. The name “plantar” derives from “of the sole” which is Latin. In short, as you apply pressure when you walk and stand this makes the warts grow into your skin.

They are often confused with calluses because they are flat, tough and thick. However, the skin appears white usually with multiple black dots (blood vessels) in the middle. Thus, if the wart is on a weight bearing area of the foot it can be painful. To sum up, this kind can be one wart or a cluster, also known as Mosaic Warts.

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Plantar Warts Cause

Plantar warts are caused by HPV type 1 most of the time. After that, types 2, 3, 4, 27, 28, and 58 could also be responsible.

Mosaic Type Plantar Warts (Recalcitrant Plantar Warts)

Mosaic type plantar warts develop in tight clusters and take on a “tile-like” pattern. This type occurs on the palms of the hands (Palmer Warts) and soles of the feet. And they are typically flatter than and not as painful as Myrmecial Warts.

Mosaic Type Plantar Warts Cause

Mosaic warts are caused by HPV type 2.

Myrmecial Type Plantar Warts

Myrmecial type plantar warts materialize as domed shaped, smooth-surfaced lesions growing inward due to pressure from walking and standing. Thus, this direct pressure can result with pain.

The wart can be yellowish similar to a callus or corn. They can include black or brownish spots, which are tiny burst blood vessels.

Myrmecial Type Plantar Warts Cause

Myrmecial warts are caused by HPV type 1.

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Wart Types Treatments

Typically, warts are self-diagnosed and don’t require lab tests or imaging. And they are self-healing if left alone, often resolving in about a month.

To treat the wart you could consult your dermatologist. Most treatments work to remove the warts, but they don’t remove the virus. There’s no cure for HPV at the moment, however symptoms can be managed.

Vaccines can prevent certain HPV strains. None of the current vaccines target the strains that cause filiform warts, though. Filiform treatment could include laser therapy, cryotherapy, salicylic acid, and other topical treatments. Most importantly, since filiform warts develop on the face this requires sensitive treatment.

Medical Procedures

Burning and Cutting

Your dermatologist could use one or two of these methods once the area is numb.

Cauterization

Cauterization is a pretty routine medical procedure for some dermatological conditions. An area of the body is burned to remove or shut off this part. It destroys granulated tissue to remove tissue growths like warts.

Thus, the wart is removed while minimizing any potential medical harm, such as infections. As a result, the technique prevents bleeding and damage.

Curettage (Tissue Scraping)

Curettage is a surgical instrument with a sharp knife or small, spoon-shaped tool. Tissue is taken away by scraping or scooping it.

Electrosurgery

Electrosurgery utilizes an electric charge through the tip of a needle to burn your wart. This method is good for common warts, filiform warts and plantar warts. Further, your derm could also add a laser.

Excision

Excision is another option where the wart is sliced off or cut out with a sharp blade.

Freezing (Cold Therapy/Cryotherapy)

This is when your dermatologist applies liquid nitrogen which is extremely cold to the area. In other words, in the medical field the local or general use of low temps. Cryotherapy is common to remove many tissue lesions. I have had Seborrheic keratosis removed this way.

Injections

Your dermatologist could inject medicine into the wart with a needle to aid getting rid of it. Bleomycin is a cancer drug that can prevent infected cells from multiplying. Interferon gives your immune system a boost to assist with fighting the HPV, typically for genital warts.

Over-the-Counter Treatments

Cantharidin

Referred to as “painting” the wart this liquid creates a blister below it. Around a week this blistered skin will dry and lift your wart off with it. Usually, Cantharidin is the treatment used with young children because it doesn’t hurt at first. However, it can tingle, itch, burn or swell a couple hours after applying.

Peeling Products

You can purchase products from your local pharmacy. These over-the-counter gels, liquids and pads contain salicyclic acid. As a result, the ingredient slowly peels off the dead skin cells dissolving it. In addition, you can soak the wart in warm water first.

After that, gently sand it down with a disposable emery board. Then apply the product. Certainly, use a new emery board each time. And be patient, this method can take several months.

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Prescription Creams

You could request a peeling cream containing either glycolic acid, stronger salicyclic acid, or tretinoin for stubborn warts.  Diphencyprone (DCP) and imiquimod (Aldara) irritate your skin to bring your immune system to work that spot.

5-Flourouracil is a medicine used to treat cancer. It works by stopping the body from producing more skin cells. In other words, it prevents tumors from growing.

pair of feet wearing sandals held up to matching blue sky pexels-this-is-zun-1721020 wart types
Wrapping it up

Common Warts is actually an umbrella term that includes five cutaneous warts on different body areas. But these are caused by different strains of HPV. The size, shape and number of warts can vary. Some forms have black dots in the centers resembling seeds but these are actually blood vessels.

Your wart can be treated, this usually means removing it. However, the HPV virus remains. So, the wart may reoccur. Certain strains can be managed with the HPV vaccine.

Mary

Mary is the founder of All About Our Skin. Former esthetician and CPC. Enjoys researching skincare and has been studying our skin for the past fifteen years.

Researching content:

https://www.aad.org/public/diseases/a-z/warts-heal How to Heal Warts More Quickly and Prevent New Ones, American Academy of Dermatologist Association, accessed 07/26/2023

https://www.healthline.com/health/essential-oils-for-warts 7 Essential Oils that Treat Warts, Healthline, accessed 07/26/2023

https://en.wikipedia.org/wiki/Wart Wart, Wikipedia the Free Encyclopidia, accessed 08/23/2023

https://www.msn.com/en-us/health/condition/genital-warts/hp-genital-warts?source=bing_condition

Genital Warts, MSN, accessed 07/26/2023

https://health.howstuffworks.com/skin-care/problems/medical/common-warts.htm  Periungual Warts Overview, Health, accessed 09/06/2023

https://www.hpv.org.nz/about-hpv/hpv-strains HPV, HPV strains, accessed 09/06/2023

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