From the Guidelines
Warts are almost always caused by the Human Papillomavirus (HPV). HPV is a group of more than 150 related viruses, and different types cause different kinds of warts. According to the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1, common warts are typically caused by HPV types 1,2,4,27, and 57, while plane warts are caused by HPV types 3 or 10.
Key Points to Consider
- The development of epidermal thickening and hyperkeratinization occurs following infection at the basal layer and clonal proliferation, which eventually results in a visible wart, weeks or even months later 1.
- Genital warts are caused by different HPV strains, most commonly types 6 and 11, as reported by the Centers for Disease Control and Prevention in 2002 1 and further supported by the Advisory Committee on Immunization Practices (ACIP) in 2007 1.
- While extremely rare, there are a few skin conditions that can resemble warts but aren't caused by HPV, such as molluscum contagiosum (caused by a poxvirus) or certain skin tags and benign growths.
- Treatment options for warts include over-the-counter salicylic acid products, cryotherapy (freezing), prescription medications like imiquimod, or procedures like laser therapy or surgical removal for persistent warts.
Considerations for Diagnosis and Treatment
- Diagnosis of genital warts can be confirmed by biopsy, although biopsy is needed only under certain circumstances, such as if the diagnosis is uncertain or the lesions do not respond to standard therapy 1.
- The average time to development of new anogenital warts after infection with HPV types 6 or 11 is approximately 2--3 months, and recurrence of anogenital warts is common, whether clearance occurs spontaneously or following treatment 1.
From the Research
Causes of Warts
- Warts are primarily caused by the Human Papillomavirus (HPV) 2, 3, 4, 5, 6.
- There are over 100 types of HPV, some of which are associated with cancer, while others cause non-cancerous conditions like external genital warts 4.
- HPV types 6 and 11 are commonly associated with external genital warts, which are typically non-cancerous 4.
Relationship Between HPV and Warts
- HPV infection is a necessary factor for the development of warts, but it is not the only factor 2, 3.
- Other co-factors, such as ultraviolet radiation and immune suppression, may also play a role in the development of warts 3.
- The majority of HPV infections do not lead to cancer, and additional factors like cigarette smoking may be required for malignant transformation to occur 2.
Treatment and Prevention of Warts
- Current treatments for warts do not directly target the cause of the lesion, resulting in variable treatment efficacies and high recurrence rates 5.
- Combination therapies, such as AV2-Salicylic acid, are being explored to improve treatment outcomes for cutaneous warts 5.
- Alternative treatments, like Energetics of Living Systems acupuncture, have shown promise in inducing immune modulation and clearing persistent warts 6.