Demystifying Warts in Older Adults: Viral vs. Non-Viral
For many, the appearance of a new skin growth can be a cause for concern. For older adults, these growths are sometimes generically referred to as 'warts', but this term can be misleading and cause unnecessary worry. Medical science clearly distinguishes between two types of growths that are relevant for the elderly population: true viral warts and seborrheic keratoses, which are often colloquially called 'age warts'. Understanding the difference is crucial for proper care and peace of mind.
True Warts: The Viral Culprit
Real warts are caused by the human papillomavirus (HPV). There are more than 100 strains of HPV, and they cause warts to grow on different parts of the body, from common warts on the hands and feet to flat warts on the face and legs.
While HPV is a common infection, certain factors can make older adults more susceptible:
- Weakened Immune System (Immunosenescence): The aging process naturally leads to a decline in immune function, a phenomenon known as immunosenescence. This can make the body less effective at fighting off the HPV virus, potentially leading to warts that are more widespread or persistent.
- Chronic Health Conditions: Underlying medical conditions or medications that compromise the immune system, such as those related to cancer or organ transplants, can also increase the risk of developing viral warts.
Seborrheic Keratoses: The Non-Viral 'Age Warts'
The growths most frequently referred to as 'warts' in elderly individuals are actually seborrheic keratoses (SKs). These are benign (non-cancerous) skin growths that have no viral component and are not contagious. SKs are incredibly common, with the majority of adults over 60 having at least one. They are caused by an abnormal buildup of ordinary skin cells.
Appearance is a key differentiator for SKs:
- 'Stuck-On' Look: They often have a characteristic waxy or scaly appearance that looks as though they were pasted onto the skin.
- Color and Texture: They can range in color from light tan to black and vary in texture from smooth to rough.
Key Factors Contributing to Seborrheic Keratosis
While the exact cause is not fully understood, several factors are known to influence the development of SKs.
- Genetics: A family history of seborrheic keratoses can increase the likelihood of developing them. This suggests a genetic predisposition plays a significant role.
- Age: The primary risk factor is, of course, age. The growths become more common and numerous with each passing decade. This is linked to the natural slowing of the skin's ability to shed dead cells.
- Sun Exposure: UV radiation from the sun is a likely risk factor, with studies indicating a correlation between long-term sun exposure and an increased incidence of SKs, especially on sun-exposed areas like the face, shoulders, and back.
- Hormonal Changes: Hormonal shifts, such as those that occur during menopause, have been linked to an increased incidence of seborrheic keratoses.
Viral Warts vs. Seborrheic Keratoses: A Quick Comparison
To help visually distinguish between these two conditions, here is a comparison of their key characteristics:
| Feature | Viral Warts (True Warts) | Seborrheic Keratosis ('Age Warts') |
|---|---|---|
| Cause | Human papillomavirus (HPV) | Buildup of skin cells; non-viral |
| Appearance | Flesh-colored or gray-brown, rough, small bumps, sometimes with black dots | Waxy, scaly, often 'stuck-on' look, varied color (tan to black) |
| Contagious? | Yes, spread by skin-to-skin contact | No, not contagious |
| Risk Factors | Cuts, scrapes, weakened immune system, contact with infected surfaces | Age, genetics, sun exposure, hormonal changes |
| Common Locations | Hands, feet, face, knees, elbows | Face, chest, back, shoulders, neck |
When to Seek Medical Advice
While seborrheic keratoses are benign and usually harmless, it is important to have any new or changing skin growth evaluated by a dermatologist. SKs can sometimes resemble more dangerous skin conditions, including melanoma, so a professional diagnosis is crucial for proper identification and treatment.
Some signs that may warrant a visit to a healthcare provider include:
- A growth that is growing rapidly, changing in color, or bleeding.
- A large number of new growths appearing suddenly (a rare sign known as the Leser-Trélat syndrome, which can be linked to internal malignancy).
- The growth is painful, inflamed, or causing discomfort by rubbing against clothing.
For more information on skin disorders and when to see a dermatologist, consult authoritative sources such as the Merck Manual.
Treatment Options for Skin Growths
In many cases, true warts and seborrheic keratoses do not require treatment. However, if they are bothersome, unsightly, or a cause for concern, various removal methods are available. A dermatologist can recommend the best approach based on the type and location of the growth.
- Cryotherapy: Using liquid nitrogen to freeze off the growth is a common and effective method for both warts and SKs.
- Curettage: A dermatologist can scrape off the growth using a special tool. This is a frequent treatment for SKs.
- Laser Treatment: For persistent warts or SKs, laser therapy can be used to destroy the tissue.
- Topical Treatments: Over-the-counter and prescription creams or solutions, often containing salicylic acid, can be used for true warts to gradually remove layers of the growth.
Conclusion
Understanding what causes warts on the elderly requires distinguishing between two distinct types of growths. While true viral warts can be linked to a weaker immune system in seniors, the growths most commonly mistaken for them are seborrheic keratoses—harmless, non-contagious skin changes related to aging. Regular skin checks by a dermatologist are the best way to ensure any new growth is correctly identified and that more serious conditions are ruled out.
Please note: This content is for informational purposes only and does not constitute medical advice. Consult a healthcare professional for diagnosis and treatment of any medical condition.
