Warts in children

What are those hard lumps on your children’s feet, fingers, and knees?

Most likely, a hard lump on the finger or bottom of the foot is a wart. Warts are caused by a virus, and when they are on the bottom of the foot, they are called plantar warts. Children often pick up these viruses by going barefoot in the gym, locker room, or pool area. They are somewhat contagious, and more commonly seen in children than adults.

Warts can occur anywhere, but they tend to like fingers, toes, bottoms of feet, and legs. Warts can be flat (flat warts) or raised, like a hard pimple. When on a foot bottom where they are trod upon, a layer of callus may develop over the core of the wart. Warts around the nail beds are called periungual warts.

Usually, warts do not hurt. The plantar warts can be quite painful, however, because they can get inflamed due to the constant pounding they receive. Similarly, if a child picks at a wart, they can become inflamed and even infected.

Treating Warts

Warts can take days, weeks, months, or even years to disappear. There is no reason to treat a wart, as warts usually go away on their own. The body’s own immune system will eventually rid itself of this intruder. However, we do treat warts when the wart is causing pain, if the wart is unattractive and the patient wants it off, or if the person is tired of it and wants it gone.

Making a wart disappear, however, is difficult. There are many home remedies and over- the-counter preparations that may or may not be helpful. Many of these products contain salicylic acid which, when applied, can stimulate the body’s immune system to get to work and eliminate the wart.

In doctors’ offices, we used to use trichloracetic acid to try to kill the wart, which was somewhat painful when applied topically.

The treatment doctors use most commonly today is liquid nitrogen, which freezes the wart tissue in hopes of killing the virus. The treatment is applied with a cotton applicator or a “gun.” The operator needs to be careful only to freeze the wart tissue and not the healthy tissue around the wart. After freezing, the tissue may turn black or discolored and then fall off. We ask patients to return in two weeks if the wart is still present. Liquid nitrogen should not be used on warts that are small or are around the nail bed area, as the treatment can damage the nail bed.

Studies comparing the use of duct tape to more traditional remedies have found that duct tape was as effective or more effective than other treatments. The duct tape was applied to the wart for six days and nights and then removed. Next, the wart was soaked in warm water to soften the tissues, and then the tape was reapplied for another six days and nights. This process was repeated until the wart fell off. The tape probably worked by irritating the tissue and stimulating an immune response.

We never guarantee any of these treatments, as warts are stubborn. Watchful waiting is the best policy, provided the wart is not interfering with your life.

Has your child battled with warts? Do you have any remedies for warts?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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