April 22, 2013
Kids mostly get warts from family members and classmates, not from public places, a new study suggests. The authors said advice on preventing warts may need to change. The study included about 1,000 schoolchildren. They were 4 to 12 years old when the study began. A medical student examined their hands and feet. Nearly one-third had warts. Parents answered questions about the history of warts for the child, family members, classmates and friends. Parents also were asked whether the child used public pools or showers. A different medical student examined the children for warts 11 to 18 months later. Warts occurred twice as often among white children and those who had other family members with warts. Having classmates with warts also increased risk somewhat. Using a public swimming pool appeared to increase risk. But the difference was so small it could have been caused by chance. Wart prevention now focuses on exposure in public places, such as advice to wear flip-flops in public showers. The authors said keeping warts covered with bandages at home might help more. The journal Pediatrics published the study. MedPage Today wrote about it April 22.
By Henry H. Bernstein, D.O.
Harvard Medical School
What Is the Doctor's Reaction?
Warts are really common. Children get them all the time. Do not believe the old wives' tale that touching frogs or toads causes warts. The human papillomavirus (HPV) causes warts.
The wart virus is contagious (passed person to person). It spreads by directly touching it (close physical contact). This also means touching something that someone with a wart recently used, such as a towel or surface. The virus then may make its way onto the body through tiny scrapes or cuts in the skin.
Current public health advice focuses on the spread of warts in public places, such as swimming pools and public showers. Children should wear flip-flops in communal showers and cover warts with waterproof bandages while swimming.
In a study just published in the journal Pediatrics, researchers looked more closely at the way warts are spread among schoolchildren. They checked the hands and feet of children from three Dutch grade schools to see if they had warts. A year later, the researchers returned to check the same children again for warts.
At each of these study visits, the parents filled out a survey. It focused on whether or not their child had factors that would increase their risk of getting warts. Some of the questions parents were asked included:
The results of this study were a bit of a surprise. Children are more likely to get warts from their classmates or family members. They do not always get them in public places. Being exposed to HPV in public showers or swimming pools did not put children at higher risk of warts.
The authors suggest that wart prevention strategies should focus more on protecting children at home and at school. For example, children should cover their warts with bandages even while at home.
What Changes Can I Make Now?
There is no way to totally prevent warts. But it is always a good idea to encourage kids to wash their hands and body regularly. If your child gets a cut, be sure to clean the area with soap and water. An open cut or scratch can allow warts and other germs to enter the body.
Thankfully, warts do not cause serious problems for your child's health. They sometimes can be uncomfortable. This is most true when they are on the soles of the feet or another part of the body that gets bumped or touched a lot.
Warts also can be embarrassing for older children. People do not like the way they look. Warts often will go away by themselves. However, your pediatrician may suggest these ways to treat them more quickly:
Do not forget that the 3-dose HPV vaccine series is recommended for all boys and girls when they turn 11. Genital warts can be spread during genital, oral and anal sex with a partner who is infected.
When warts occur on the genitals, they are considered a sexually transmitted disease. There also is a link between genital warts and cervical cancer. If your teenage daughter has genital warts, she should have a Pap smear. This test is used to check for abnormal cells in the cervix (a warning sign for cervical cancer).
What Can I Expect Looking to the Future?
You can expect researchers will continue to look for better ways to prevent the spread of warts among children. The pediatrician will recommend that your child keep a wart covered with a bandage at school and at home (not just in public places). This will help limit the spread of the virus.
You can learn more about warts and how to treat them from the patient website of the American Academy of Pediatrics.
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