Waiting for Warts to Wane?

Warts on children often may resolve themselves without treatment

(RxWiki News) Many people simply wait to see if their warts will go away naturally. Others turn to medical treatments for their warts, but these treatments often fail. For this reason, researchers recently studied the progression of warts that underwent different treatment options.

The researchers found that about half of the school-aged children who had warts at the beginning of the study no longer had warts in a year.

The study also showed that children with warts about one centimeter or more in diameter were more likely to seek treatment than children with smaller warts. Furthermore, the researchers found that warts were more likely to resolve in younger children with non-Caucasian skin types than in older children with Caucasian skin types.

According to the researchers, the insights of this study can help children and parents decide which treatment option for warts is best for them.

"Ask your pediatrician which wart treatment is best for your child."

Sjoerd Bruggink, MD, from the Department of Public Health and Primary Care at Leiden University Medical Center in Leiden, The Netherlands, and colleagues aimed to examine the relationships between warts over a period of time and various treatment decisions.

The study consisted of 1,099 children from 4 to 12 years of age from three Dutch primary schools. The children had their hands and feet examined for warts by a trained medical student and were re-examined 11 to 18 months later. In the first examination, 366 children had warts.

The researchers distinguished between plantar warts and common warts. Plantar warts are located on the soles of feet, whereas common warts are located on the hands and dorsum (top) of the foot. Other factors examined were the number and size of warts.

A wart was considered resolved in this study when it no longer could be seen.

Parents were asked to fill out a questionnaire about the troubles the warts may have caused their children, and what treatments, if any, were used before the follow-up examination.

Of the 366 children with warts in the first examination, 33 were not able to make the follow-up examination.

Among the remaining 333 children that did make the follow-up examination, 42 percent had common warts and 70 percent had plantar warts. About 43 percent of the children had multiple warts, and 37 percent had warts at least one centimeter in diameter.

A total of 276 of the 333 parent questionnaires were returned. Of the parents who responded, 73 reported that warts were a discomfort to their children, and 106 parents reported that their children had been given a treatment by a physician.

About 50 percent of the children's warts resolved within a year. The researchers also found that children who were given a treatment by a physician were less likely to have their warts resolve than children who were not treated.

The study did not examine warts on parts of the body other than the feet and hands. Because of this, some warts may have been overlooked. However, the researchers reported that those warts make up less then 4 percent of all warts.

“Our findings will be useful in the process of shared decision making with parents and children,” Dr. Bruggink and colleagues wrote.

“Patients and family physicians should weigh the benign natural course, the adverse effects of treatments, and the costs on the one hand, and the effectiveness of treatments and the risk of spreading untreated warts on the other,” they wrote.

"As physicians we should always make sure the treatment is never worse than the condition. The necessity and type of treatment should be a shared decision making process between child (when possible), parents, and the dermatologist. Large, painful, spreading warts that interfere with daily activity or involve cosmetically sensitive areas are more likely to receive treatment," Dr. Coyle S. Connoly, board certified dermatologist and president of Connolly Dermatology, told dailyRx News.

"This study encourages doctors to discuss the often self limited course of common and plantar warts. Freezing with liquid nitrogen, topical salicylic acid, laser, surgery, etc. may all be utilized. The risks versus benefits of these various treatments must be weighed on an individualized basis," said Dr. Connolly. 

This study was published online September 12 in the Annals of Family Medicine, and was funded by the Netherlands Organization of Health Research and Development Fund Common Diseases.

The authors declared no conflicts of interest.

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Review Date: 
September 12, 2013