Are plantar warts contagious

Warts

Warts (Verrucae): Infectious but benign growths of the cornea caused by viruses. The most common warts are common warts, plantar warts, flat warts, dellar warts and genital warts (sexually transmitted!).

In principle, warts can appear in all areas of the skin and mucous membrane and can be transmitted to other parts of the skin of the body as well as from person to person. They often heal on their own after months to years. However, targeted removal is sometimes necessary if the growths endanger others through infection (genital warts), cause pain (plantar warts on the soles of the feet) or cosmetically very disturbing.

Age warts do not belong to the group of viral, contagious warts.

Leading complaints

  • Painless, rough, pea-sized bumps on the skin with an irregular surface and white to yellowish color (common warts)
  • Flat growth on the sole of the foot, often surrounded by a thick horny layer, often with a dark point in the middle (plantar warts)
  • Flat, less noticeable, oval, skin-colored to reddish-brown, soft nodules 1–4 mm in diameter (flat warts)
  • Reddish or gray-white growths up to several centimeters in size, mostly in groups and predominantly in the anal and genital areas (genital warts)
  • Lentil-sized, pearl-like, painless, pink-colored nodules with a characteristic dent in their center (dellar warts).

When to the doctor

On occasion if

  • Cosmetically disrupt ordinary warts.

In the next few days if

  • Warts are inflamed or bleeding
  • Warts "sit down" on other skin diseases (e.g. neurodermatitis)
  • Dellar warts spread rapidly.

The illness

Disease emergence

Despite their different appearance, all warts are based on a viral infection of the skin. With the exception of the warts, which are caused by the molluscum contagiosum virus (a smallpox virus), warts are caused by human papilloma viruses (HPV for short).

The pathogens are transmitted both through direct skin contact and indirectly through virus-containing skin flakes in changing rooms, saunas, swimming pools, on doorknobs and towels. The viruses penetrate the epidermis through tiny cracks, multiply and trigger an excessive growth of horny cells in the affected area.

clinic

Appearance, discomfort and chances of recovery depend on the type of wart:

  • Common warts (Barbed warts, vulgar warts, Verrucae vulgaris) are by far the most common type of warts, characterized by painless, rough, to pea-sized bumps on the skin. Their surface is irregular and white to yellowish in color. Ordinary warts develop preferentially on the back of the hand, on the fingers and around the nail, where they appear individually or in bed-like groups and are cosmetically significant. As a rule, they heal without scars even without treatment and leave behind a certain immunity. Therefore, the risk of infection in adulthood is significantly lower than in children and adolescents.
  • Plantar warts (Piercing warts, verrucae plantares) occur on the soles of the feet, where they cannot grow outwards due to the pressure load. They are therefore flat and often surrounded by a thick horny layer. It is not uncommon for a dark point to be visible in the middle, which was caused by tiny hemorrhages. Plantar warts can flow together like beds and are then called mosaic warts (plantar warts). These warts are often painful, especially on the ball of the foot and on the heel (hence the name Mandrel- or. Nipple). Plantar warts often come back after removal.
  • Flat warts (Verrucae planae) are flat, inconspicuous, oval, skin-colored to reddish-brown, soft nodules 1–4 mm in diameter. They tend to spread over a large area, especially around the face, back of the feet and hands, and forearms. Flat warts usually resolve spontaneously without treatment.
  • Genital warts (Wet warts, condylomas, condylomata acuminata) appear as reddish or gray-white growths up to several centimeters in size, which usually occur in groups and are mainly found in the anal and genital areas of adults. They are highly contagious and are mostly transmitted through sexual contact. Although they heal spontaneously in 30% of cases, it is imperative that they be treated by a doctor as soon as possible. Certain types of genital warts virus can cause cervical cancer in infected women.
  • Dellar warts (Mollusks) are not actually warts, but they look similar and are also caused by viruses. They are lenticular-sized, painless, pink-colored nodules with a characteristic indentation in their center and resembling small pearls. When pressed, they release a whitish, virus-containing content. Dell warts often occur on the face, trunk, arms and legs, especially in adults in the genital and anal region. Affected are v. a. Children with dry skin (e.g. neurodermatitis) and young adults, who are often infected through sexual contact. An increased susceptibility exists with permanent external cortisone therapy as well as with general weakness of the immune system, e.g. B. after prolonged fever, organ transplantation or HIV infection. When the immune system is stabilized, they usually resolve spontaneously after six months.

course

Warts usually resolve on their own. Except for genital warts, which should always be treated by a doctor, one can therefore wait.

Diagnostic assurance

In the case of warts, a doctor's close inspection of the growth is usually sufficient for a diagnosis. In case of doubt, he takes a sample and has it examined in terms of tissue.

Differential diagnoses. Similar to warts can e.g. B. calluses on the soles of the feet, milia, lichen planus, skin tuberculosis or malignant melanoma (black skin cancer).

treatment

Genital warts must always be treated. In the case of other warts, the removal is only necessary if they present a cosmetic problem, cause discomfort due to an unfavorable location or if there is a skin disease that promotes further sowing of the warts, such as B. atopic dermatitis. Medicinal and surgical procedures are available for treating warts.

Medical therapy

Peeling of the wart by dissolving the horny layer. Various acids are suitable for application, such as salicylic acid (e.g. in Verrucid®), lactic acid, urea or corresponding combinations (e.g. Duofilm®). For flat warts on the face, the doctor prescribes the vitamin A acid known from acne therapy (tretinoin, e.g. in Airol®). The preparations can only be dabbed onto the affected area as solutions and applied as creams (e.g. salicylic petroleum jelly 3%) or as plasters (e.g. Guttaplast®).

In order for the horny layer to dissolve completely, it is necessary to apply the preparations several times a day, especially before going to bed. The swelling horny layer should be removed the next morning if possible, e.g. B. with a file or a pumice stone. This procedure requires caution in order to avoid damaging neighboring, healthy areas of the skin - otherwise wart viruses can be spread. It often takes 3–4 weeks for the wart to "peel off" completely.

Inhibition of Viruses. Often, removing the horny layer is not enough. Then the next step is to apply a virus-inhibiting cytostatic agent such as 5-fluorouracil (e.g. Verrumal®) to the base of the wart that has been "peeled off" as well as possible. This treatment is carried out two to three times a day for several weeks.

In addition to the preparations mentioned above, there are a number of other active ingredients that the doctor z. In some cases they can also be prescribed off-label. These include B. the active ingredient imiquimod as a cream, podophylline or preparations containing dithranol.

"Invasive" Therapies

They destroy the molecular connective tissue structure of the warts in various ways. However, it is not uncommon for "invasive" therapies to leave traces of warts and they must therefore be repeated.

  • curettage with a sharp spoon, usually after dissolving the horny layer with a plaster containing salicylic for 1–2 days
  • Cold treatment with liquid nitrogen or another refrigerant. This cryotherapy does not require local anesthesia, but it is painful. A blister appears a few hours after the treatment and is removed. Often a scar is left behind. Cryotherapy must be repeated many times until a wart disappears.
  • Laser therapy with the pulsed dye laser or the CO2-Laser. Scarring and pain should be less frequent after laser therapy.

Special case of dellar warts

For pelvic warts, treatment depends on the number. Isolated warts are best left alone. Sometimes it is sufficient to "squeeze out" the wart and then disinfect it with alcohol. Otherwise, dellar warts can be removed using the same procedures as other warts.

forecast

Warts often go away on their own or can be easily removed with the above measures. However, depending on the type and infestation, the relapse rates are high. In a study on patients with warts on the soles of the feet, 74% of the patients who had been treated with the dye laser were still free of warts 6 months after successful therapy. In the cryotherapy group this was 54%, in the CO2-Laser group 48% and of the patients whose warts had been treated by dissolving the horny layer 55%.

For example, warts come back particularly often when they

  • appear in people over 29 years of age
  • have existed for more than 2 years
  • are larger than about 2 cm
  • Sit on the palms of your hands or the soles of your feet
  • Affected people with compromised immune systems.

Your pharmacy recommends

What you can do yourself

Lots Wart remedies for removing warts are freely available in drug stores and pharmacies. In addition to dissolving the horny layer with acids such as salicylic acid, acetic acid or formic acid, the gradual etching of the wart tissue (e.g. with silver nitrate in Höllenstein Etching Pen®, use once a week) is also possible. Over-the-counter products for icing are also available (e.g. Scholl Freeze® Wart Remover), which are said to be effective even for very stubborn warts.

Dellar warts are easily inflamed when mechanically irritated. After that, they often resolve spontaneously within 1–2 weeks. Some authors recommend using this property for self-help: namely, piercing the hard, white core of the wart with a clean needle or "poking it out" and thus provoking its inflammation. However, healthy areas of the skin must not be touched, as the wart viruses are spread through the secretion.

Another self-help procedure takes into account the psychological aspects of the development and control of warts. Since a well-functioning immune system can destroy warts, methods that stimulate the immune system can speed healing of warts. Many sufferers have also gotten rid of their warts with treatment methods from folk medicine, the effect of which is based exclusively on suggestion.

Complementary medicine

Wart viruses remain in the body and occur repeatedly when the immune system is weakened. Accordingly, complementary medicine focuses on strengthening the immune system and treating the symptoms with antiviral plant extracts with the aim of healing warts from the inside.

Hydrotherapy. In order to strengthen the immune system, all measures to stimulate the blood flow, such as B. cold-blooded arm or foot baths, Kneipp casts, alternating baths and treading water make sense. Warts often heal even after cryotherapy: Here, liquid nitrogen is applied to the warts for up to 20 seconds. Treatment with isopropanol solution (70%) was also very successful: the tincture is applied three times a day for several weeks.

Homeopathy. Homeopathy recommends Thuja occidentalis as a tincture for application, as globules for ingestion or as a complex agent Thuja Oligoplex. Echinacea is used for immune stimulation, and Causticum or Antimonium crudum for cracked or keratinized warts.

Herbal medicine. From herbal medicine, garlic (put on or tied up in slices) and celandine (nickname: warthog) come into question. Celandine juice is available ready-made in the pharmacy, but it can also be applied directly from the fresh plant to the wart (break off the stalk and apply the yellow juice that emerges. As it is poisonous, nothing should get on the mucous membrane or in the eyes!) . Lemon juice, applied twice a day, is also said to help warts heal. The same applies to self-made apple cider vinegar tincture: dissolve as much table salt as possible in 1 teaspoon apple cider vinegar, then add three drops of lavender oil and drizzle this solution onto the wart twice a day.

To strengthen the immune system (immune stimulation), herbal preparations such as coneflower (e.g. Echinacin® Madaus as juice or dragees) or combination medications such as Esberitox® are recommended.

Acupuncture. Acupuncture is primarily used to stimulate the immune system.

Relaxation procedure. In about half of the patients, the warts can be influenced by autosuggestion, which can be coupled with relaxation techniques (e.g. autogenic training).

Prevention

  • Don't scratch warts! If you scratch a wart, you risk spreading to the surrounding skin area because warts are contagious.
  • Wart viruses survive best in a moist environment. The viruses responsible for plantar warts are often found on moist soils, e.g. B. in bathrooms or saunas, but also in damp towels. Therefore, do not walk barefoot in public facilities and only use your own towels.
  • Make sure your skin is healthy and dry. Dry yourself and your feet well after bathing, showering or sauna, use air-permeable shoes.
  • Do not share roll-on deodorants with others.
  • Use condoms when having sex with strangers.

HPV vaccination. Since 2006 there has been a vaccination against human papilloma viruses to protect against cervical, penile and anal cancer. Boys and girls between the ages of 9 and 17 are vaccinated; the costs are covered by the statutory health insurance companies. With Cervarix® and Gardasil 9®, there are two vaccines on the market that both protect against the high-risk HPV types 16 and 18 and thus against the development of cervical cancer. Gardasil 9® also protects against 7 other types of HPV, 5 of which are potentially carcinogenic (types 31, 33, 45, 52 and 58) and 2 are responsible for genital warts (types 6 and 11). Cross protection against types 31, 33 and 45 is described for Cervarix®.

Authors

Dr. med. Arne Schäffler, Dr. Bernadette Andre-Wallis in: Health Today, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 10:22


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.