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Updated: Aug 16, 2025
Author Spotlight: Dermatopathology and the Treatment of Sexually Transmitted Diseases
Published on: November 8, 2024
Paediatric Cutaneous Warts and Verrucae: An Update
1Private Practice, Lymington, Hampshire SO41 9AH, UK.
Insights
Human Papilloma Virus (HPV) causes common warts in children, which often resolve on their own. Plantar warts are difficult to treat, but new therapies like immunotherapy show promise.
Area of Science:
- Dermatology
- Pediatrics
- Virology
Background:
- Cutaneous warts, caused by Human Papilloma Virus (HPV), are highly prevalent in children, affecting over 40% in their second decade of life.
- Wart virus carriage is higher in children with active lesions and their families.
- Specific HPV subtypes (2, 27, 57, 63) are common in pediatric populations.
Purpose of the Study:
- To review the current understanding of pediatric cutaneous warts, focusing on plantar warts (verrucae).
- To evaluate the efficacy of existing treatments for recalcitrant warts.
- To explore promising novel therapeutic modalities for challenging wart cases.
Main Methods:
- Systematic review of studies and literature published over the last decade.
- Analysis of treatment outcomes for common and plantar warts in pediatric populations.
- Review of emerging treatment options, including immunotherapy and hyperthermia.
Main Results:
- Most childhood warts resolve spontaneously, irrespective of treatment.
- Plantar warts are more treatment-resistant than other cutaneous warts.
- Limited evidence of significant treatment innovation for recalcitrant warts over the past 30 years.
Conclusions:
- Despite spontaneous resolution in many cases, plantar warts present therapeutic challenges.
- Novel treatments like immunotherapy (vaccine injections) and microwave-induced hyperthermia offer potential for improved management of recalcitrant pediatric warts.
Abstract:
Cutaneous warts are common lesions in children caused by the Human Papilloma Virus (HPV) and for most lesions spontaneously resolve within months of the initial infection, regardless of treatment. The infection is most prevalent in the second decade of life affecting over 40% of children. Studies have demonstrated wart virus carriage on normal skin is higher in children with active lesions and family members. Subtypes HPV 2, HPV 27, HPV 57 and HPV 63 are particularly common in paediatric populations. Warts arising on the plantar surface of the foot (verrucae) can be particularly problematic owing to the location. They may interfere with daily activities causing pain and embarrassment. Plantar lesions have been shown to be more resistant to treatment than warts elsewhere on the skin. Systematic reviews and studies conducted over the last decade have demonstrated little evidence of innovation or effective improvements in treatment of recalcitrant lesions over the last 30 years. However, newer modalities such as immunotherapy (using injected vaccines) and hyperthermia using microwave treatment may hold promise in improving the treatment of these common and therapeutically frustrating lesions.
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