What is a wart?

Warts are a viral infection of the skin caused by the human papilloma virus (HPV). They can appear anywhere on the skin but are more common in areas of minor breaks or open skin.

On the soles of the feet, warts are called "plantar warts". Similarly warts on the palms may be termed "palmar warts". Sometimes they may appear in clusters referred to as mosaic warts or may be minimally elevated flat warts. In women genital warts in the cervical area may lead to cervical cancer.

Since warts are an infection they may occasionally be passed from person to person by direct contact. Warts may also spontaneously resolve without treatment.

How to treat warts:

There are many treatment options for warts. Depending on the size and location of the warts multiple treatments may be necessary. Over the counter gels and patches can be used that contain salicylic acid which is a peeling agent. The most common in office treatment is cryotherapy or freezing with liquid nitrogen.

Warts have a tendency to return, so repeated treatments may be necessary. There are additional treatment options for warts that are widespread, do not respond well to standard treatments, or keep returning.

Warts may go unrecognized or misdiagnosed as callus, corns or moles. If you’re unsure if you have warts or what treatment may be most appropriate you should consult with your doctor.

Moles are pigmented skin growths medically known as nevi. Moles are usually brown but can vary in color (skin colored to pink to light brown to dark brown to blue to black). Moles can be present at birth, but most moles develop during childhood until the age of 20. Some people have many more moles than others—the average person has 10- 40 moles.

Moles are made of cells called melanocytes. Melanocytes are found scattered throughout our skin and are the cells that make our skin become tan by generating a pigment called melanin. A mole is made of many melanocyte cells clustered together. When a mole becomes cancer it is called melanoma.

What is normal for a mole?

• Moles can be found anywhere on your skin, including your scalp, nails and genitals. (Moles can grow in areas of skin that are not exposed to the sun.)
• Moles can be flat or raised.
• Moles often grow slowly and become more dome shaped or raised with age.
• Hair in a mole is normal
• New moles develop during childhood until the age of 20
• Moles darken during times of hormonal change (adolescence, pregnancy, birth control pills)

When should I be concerned about a mole?

• When it is an "ugly duckling". No other mole on your body looks similar. It is different from your other moles.
• New mole develops after age 20.
• Pain.
• Itching or burning.
• Bleeding.
• Rough, scaly or crusty texture.
• "A" asymmetric shape (if you cut it in half and one side is different from the other).
• "B" irregular border (scalloped or ill-defined border).
• "C" variegated or uneven color.
• "D" diameter greater than a pencil eraser (6mm, ¼ inch).
• "E" evolving or changing mole.

How is a mole evaluated by your family doctor?

• Moles are looked at by your doctor. Your doctor will examine your skin, comparing one mole to the next, looking for the "ugly duckling" or stand-out mole. During your exam, point out any moles that you are concerned about. Your doctor may use an instrument that illuminates and magnifies the mole called a dermatoscope.
• If a mole is suspicious, a biopsy will be done. This involves numbing the affected skin and removing a small area to determine under the microscope if the mole is abnormal. Your biopsy may or may not require stitches.

What happens after a biopsy?

• Results are usually available within one – two weeks. You will be contacted by phone or mail.
• Normal moles: No further treatment is needed. If your entire mole was not removed with the biopsy, some color may persist or recur at your biopsy site
• Abnormal moles: This includes a variety of terms including "atypical" or "dysplastic". These moles are not cancer and may or may not need to be removed completely. Your doctor will recommend treatment based on the specifics of your results.  Annual full body skin exams are often recommended for patients with a history of abnormal moles as this diagnosis may increase your risk for melanoma.
• Malignant melanoma: This is the most concerning type of skin cancer. Expect that you will need to have skin surgery to remove the melanoma as well as a margin of normal skin surrounding the melanoma as soon as possible. You will be referred to a dermatologist for this surgery.  In some cases you will be referred for further evaluation of your lymph nodes at the time of your skin cancer removal.

What should I do at home for prevention?

• Monitor your moles by examining your skin carefully, including areas of skin not exposed to the sun, on a monthly basis.
• Avoid tanning and do not use UV tanning booths.
• Avoid burning.
• Use sunscreen: a broad spectrum SPF 15+ sunscreen that has coverage for both UVA and UVB. Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours—more frequently if in water or sweating.
• Seek shade, especially at times of peak sun between 10 AM and 4 PM.
• Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
• Have your primary care doctor examine your moles and provide a skin cancer screening at the time of your annual physical.

What if I have a mole that I want removed?

• Mole removals are a common procedure.
• You should schedule an appointment to evaluate the mole.
• Your physician will evaluate the mole and may recommend removal. 
• If a removal is recommended, the physician will ask you to schedule for a biopsy appointment, which takes place in our office.