Dermatology

What to know about filiform warts

Filiform warts are made up of long, thin projections of skin, giving them a distinctive appearance. They often occur around a person’s eyes or lips.

These warts are also called digitate or facial warts. They are harmless and usually disappear without treatment. However, many people prefer to remove them.

Home removal may cause complications, so it is always best to have a wart removed by a doctor.

In this article, we look at how to identify filiform warts, prevention, and the treatments, medications, and home remedies that can remove them.

Identifying a filiform wart

Filiform warts on an eyelid
Filiform warts often form around a person’s eyes or lips.
Image credit: Schweintechnik, 2008

The following characteristics give filiform warts their unusual appearance.

Filiform warts are:

  • made up of thin projections of skin that can be 1–2 millimeters long
  • usually found around a person’s eyes and lips
  • brown, pink, yellowish, or flesh-colored
  • usually isolated, not in clusters

These warts, like others, are caused by the human papillomavirus (HPV). This virus can be spread through skin-to-skin contact, and the risk of infection is higher if the skin is broken.


Medical treatment

Filiform warts may disappear on their own over time. Facial warts tend to be harder to treat than those located elsewhere.

Anyone who wishes to remove a wart quickly should seek medical treatment.

Filiform warts can be removed in several ways. However, there is currently no cure for HPV, so warts can reappear.

A doctor may recommend the following methods for removing filiform warts:

  • Topical creams. Doctors often prescribe creams containing 5-fluorouracil, imiquimod, or benzoyl peroxide, which make it easy to peel warts away from the skin.
  • Excision. In this procedure, a doctor cuts or shaves warts away, using a scalpel. A doctor may need to repeat this several times, to increase effectiveness.
  • Burning. Also known as electrosurgery, this involves a doctor using a laser or electrical current to burn the wart away. The doctor then scrapes any remnants from the skin.
  • Cryotherapy. In this procedure, a dermatologist applies liquid nitrogen to the wart. It may take several treatments before the wart falls away, and some find cryotherapy painful.
  • Cantharidin. This chemical causes a blister to form under the wart, killing it. A doctor can cut off the wart after about a week.

For warts that do not respond to the methods above, a doctor may suggest:

  • laser treatments
  • chemical peels
  • immunotherapy

If a person has a weakened immune system, due to a chronic illness or conditions such as HIV or AIDS, it may be more difficult to remove warts.


Home removal

Salicylic acid used on a finger
Salicylic acid may be used to help remove filiform warts. A person should ask their doctor before using this treatment.

Several home remedies can remove warts. However, there has not been enough research to show that these remedies work. The medical community has not confirmed the safety or effectiveness of home remedies for warts.

Filiform warts appear on sensitive areas, and attempting to remove them with home remedies can result in scarring. Importantly, do not use home wart-freezing kits on sensitive parts of the body.

The following are home remedies that some people attempt to remove filiform warts:

  • Salicylic acid. With a damp cloth, apply a product containing this chemical to the wart. To increase effectiveness, soften the wart by soaking the area in warm water before each application. It may still take several weeks for the wart to disappear.
  • Apple cider vinegar. This vinegar contains acetic acid, which may reduce and eventually eliminate a wart. A person may soak a cotton ball in apple cider vinegar and place this on the wart. This treatment is not advised, however, as apple cider vinegar may cause chemical burns when applied to the skin.

If pain or a burning sensation follows the use of any home remedy, discontinue it immediately.

Home removal remedies may be especially dangerous for people with diabetes and warts on their feet. Diabetes can cause a loss of feeling in the feet, so an initial injury may go unnoticed.


Causes

Filiform warts are caused by HPV strains 1, 2, 4, 27, and 29. However, exposure to these strains does not guarantee that warts will develop.

HPV usually spreads through skin-to-skin contact. Clothing or objects that have touched warts can also spread the virus.

A person is more likely to develop filiform warts if they have:

  • a cut on the skin, through which the virus can enter
  • a weakened immune system
  • warm, moist skin
  • been repeatedly exposed to HPV

Prevention

A person can reduce their risk of contracting HPV by having an up-to-date vaccine and using condoms during sexual activity.

An individual with HPV can lower the risk of infecting others by:

  • washing their hands thoroughly and often, particularly after touching warts
  • refraining from picking at warts
  • keeping the skin around warts clean and dry
  • keeping any affected area covered with a bandage

Get tested for HPV, even if no symptoms are present. Many people are unaware that they have the virus.


When to see a doctor

patients speaking to her GP
If a filiform wart is accompanied by itching, bleeding, and irritation, a person should see their doctor.

Filiform warts are benign, meaning that they are not cancerous. However, they can cause discomfort.

See a doctor if any of the following symptoms accompany a filiform wart:

  • itching
  • bleeding
  • soreness
  • irritation

Many people who do not experience discomfort choose to remove their filiform warts for cosmetic reasons.

Outlook

Filiform warts are not cancerous, and very rarely cause complications. They often disappear without treatment.

However, these warts are highly contagious and may cause irritation, such as an itchy feeling. Many people opt for medical treatment to eliminate filiform warts.

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