Are All HPV Warts Genital Warts?

Cane Toad
Cane Toad (bufo marinus), close up. Bob Elsdale/The Image Bank/Getty Images

Contrary to what many people believe, warts aren't actually caused by toads. Instead, most warts are caused by viral infections with various types of human papillomavirus or HPV. There are more than 150 types of HPV, some of which cause STDs such as genital warts and various cancers. Others cause more common, and less stigmatized, types of warts. These include hand warts and warts on the feet (plantar warts).

Interestingly, there is very little clear data on transmission of common warts and plantar warts. Common wisdom is that these warts are not transmitted from person to person contact. Instead, they're thought to be transmitted by walking on moist surfaces where virus can live, such as near pools or bathroom floors. However, the data isn't actually that clear. Some studies have shown that walking barefoot on risky floors is a risk. On the other hand, other studies have found that the risk of having such warts is more linked to the number of other people with warts in the home or classroom than with such environmental exposures. (Most of these studies are done in elementary school children.)

Another mistaken belief is that HPV viruses will only infect one type of skin. There IS a great deal of data suggesting that warts prefer specific skin types. However, that's only a preference. In addition to general evidence of warts being transmitted from one site to enough, there is also some specific evidence that there can be transmission of warts from the hands to the genitals, at least in children.

In other words, even if  there is a preferred infection site for these viruses, they can move to alternate sites. This is similar to how herpes viruses have preferred infection sites, but the "oral" virus HSV-1 can also easily infect the genitals.

What does that mean for people with warts? If you're in intimate contact with people, or even familial contact, be aware that your warts may be transmittable.

Furthermore, that risk may or may not go away fully with treatment to remove the wart. That's why you may also want to cover any infected skin that might rub on another person in order to avoid infecting them. For small warts, all that takes is a band-aid. You should be aware that you can infect yourself through auto-inoculation. So, practice good hygiene. Reduce the risk to rub and scratch. Don't shave over warts. Keep your skin dry and clean. And talk to your doctor. There are numerous options for treatment aside from over the counter creams and folk remedies.

Sources:

The American College of Foot and Ankle Orthopedics and Medicine. "Plantar Warts." Accessed 12/9/15 at http://www.acfaom.org/information-for-patients/common-conditions/plantar-warts

Bruggink SC, Eekhof JA, Egberts PF, van Blijswijk SC, Assendelft WJ, Gussekloo J. Warts transmitted in families and schools: a prospective cohort. Pediatrics. 2013 May;131(5):928-34. doi: 10.1542/peds.2012-2946.

Fairley CK, Gay NJ, Forbes A, Abramson M, Garland SM. Hand-genital transmission of genital warts? An analysis of prevalence data. Epidemiol Infect. 1995 Aug;115(1):169-76.

Lipke MM. An armamentarium of wart treatments. Clin Med Res. 2006 Dec;4(4):273-93.

Rigo MV, Martínez-Campillo F, Verdú M, Cilleruelo S, Roda J. [Risk factors linked to the transmission of papilloma virus in the school environment. Alicante, 1999]. Aten Primaria. 2003 Apr 30;31(7):415-20.

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