Causes of Multiple Warts and Skin Tags
Multiple warts are primarily caused by human papillomavirus (HPV) infection, while skin tags are benign skin growths related to friction, aging, and genetic factors. 1
Warts: Causes and Types
Human Papillomavirus (HPV) Infection
- Warts are benign epidermal proliferations caused by HPV, of which there are over 100 types 2
- Common genital warts are typically caused by HPV types 6 and 11 2
- More concerning HPV types (16,18,31,33, and 35) are associated with cervical dysplasia and other cancers 2
Risk Factors for Developing Multiple Warts
- Use of communal showers and public swimming pools 3
- Occupational handling of meat 3
- Immunosuppression (HIV infection or other causes) 2
- Direct skin-to-skin contact with infected individuals 2
- Minor skin trauma that creates entry points for the virus 3
Types of Warts
- Common warts (verruca vulgaris): Rough, raised growths commonly found on hands and fingers
- Plantar warts: Found on the soles of feet, often painful due to pressure
- Flat warts (verruca plana): Small, smooth, flat-topped lesions often found on the face or legs
- Genital warts: Occur in the genital and anal areas, sexually transmitted
- Filiform warts: Thread-like projections, often on face or neck
Skin Tags: Causes and Characteristics
What Are Skin Tags?
- Skin tags (acrochordons) are benign, soft, flesh-colored or slightly darker growths that hang from the skin on a thin stalk
- Unlike warts, skin tags are not caused by viral infections
Causes of Multiple Skin Tags
- Friction: Common in skin folds (neck, armpits, groin) where skin rubs against skin or clothing 1
- Hormonal changes: Pregnancy and hormonal fluctuations can trigger their development
- Insulin resistance and metabolic syndrome: Associated with increased number of skin tags
- Genetic predisposition: Family history increases likelihood
- Aging: More common in middle-aged and older adults
Distinguishing Features
Warts
- Rough, cauliflower-like texture
- May have black dots (thrombosed capillaries)
- Can be painful, especially plantar warts
- Contagious and can spread to other body areas
- Often resolve spontaneously due to natural immunity within months or years 3
Skin Tags
- Soft, smooth texture
- Attached by a thin stalk (pedunculated)
- Typically painless unless irritated
- Not contagious
- Do not resolve spontaneously
Special Considerations
Immunosuppression
- Immunosuppressed individuals (including those with HIV) are more likely to develop multiple, persistent warts 2
- Warts in immunosuppressed patients may be larger, more numerous, and more resistant to treatment 2
- Immunosuppressed patients have higher risk of developing squamous cell carcinomas resembling warts 2
When to Seek Medical Attention
- Sudden increase in number or size of warts or skin tags
- Warts or growths that bleed, change color, or become painful
- Lesions that interfere with daily activities
- Genital warts (require specialized treatment)
- Warts or growths that are cosmetically bothersome
Management Approaches
For Warts
- Many treatment options available including salicylic acid, cryotherapy, and immunotherapy 1
- Treatment should be guided by patient preference, wart location, and provider experience 2
- No single treatment is ideal for all patients or all warts 2
For Skin Tags
- Usually removed for cosmetic reasons or if they become irritated
- Removal methods include snipping, freezing, or electrocautery
- No medical necessity to remove unless they cause discomfort
Prevention Strategies
- Avoid direct contact with warts (your own or others')
- Wear protective footwear in public showers and pool areas
- Keep skin clean and dry
- Avoid sharing personal items like towels or razors
- HPV vaccination can prevent genital warts caused by HPV types 6 and 11 2
Remember that while warts are caused by viral infections and can spread, skin tags are benign growths that pose no infectious risk. Both conditions are generally harmless but may require treatment for comfort or cosmetic reasons.