Age warts: removal and treatment on face

Age warts are one of the most common benign skin lesions. An age wart is a non-contagious skin condition that usually occurs after the age of fifty. Age warts are not harmful at all. The way they look can be cosmetically disturbing. It is not known what causes them. There is no virus involved, as with other warts. Age warts are therefore not contagious. Age warts occur anywhere on the body, but preferred locations are the face near the temples, on the back, under the breasts and on the stomach. Treatment is not necessary from a medical point of view. Treatment may be considered for cosmetic reasons (an age wart on your face or other visible place) or because the age wart is constantly being scratched open and bleeds.

• What are age warts?

• Benign skin abnormality
• Preferred places

• Cause of age warts

• Cause unknown
• Not contagious

• Risk factors

• Older age
• Family members with age warts
• Frequent sun exposure

• Symptoms of age warts

• Phenomena
• Pigmented horn dust

• Preventing age warts
• Examination and diagnosis

• Physical and diagnostic examination
• Differential diagnosis

• Treatment and removal of age warts

• Cryotherapy
• Electrosurgery and curettage

• Prognosis

Age wart / Source: Lmbuga, Wikimedia Commons (Public domain)

What are age warts?

Benign skin abnormality

The medical name of age wart is verruca seborrhoica or verruca senilis . An age wart is a benign skin condition that usually develops in adulthood. An age wart is therefore not malignant. It will not hurt. The way they look may be cosmetically disturbing, but they are not harmful.

Preferred places

Age warts can appear anywhere on the body, but preferred locations are the trunk and face. They grow slowly, and they may appear as solitary growths or in groups. The course of age warts cannot be influenced and the development of the warts cannot be prevented. Age warts are not contagious.

Cause of age warts

Cause unknown

As of 2023, it is not known what the cause is. Research has shown that age warts run in families and sun exposure may also play a role.

Not contagious

Warts are caused by the human papillomavirus (HPV), but age warts are not. Age warts are therefore not contagious.

Risk factors

Risk factors for developing age warts include:

Older age

Age warts often appear from middle age onwards. The risk of this increases with age.

Family members with age warts

This skin condition is more common in certain families. The risk of age warts increases with the number of family members involved.

Frequent sun exposure

There are indications that skin that is often exposed to the sun is more likely to develop an age wart. However, an age wart can also appear on areas of the skin that have hardly been exposed to the sun.

Symptoms of age warts

Phenomena

Sometimes there is itching, but usually the abnormality is asymptomatic. In addition to itching, age warts can bleed easily or become red and irritated with friction or other manipulation. The external appearance can vary greatly per age wart. The age wart lies on top of the skin and can take many forms. Age warts:

• Vary in color from light brown (yellow-brown) to dark brown to even black. Most are brown. Some are multi-colored.
• Range in size from small to larger than 3 cm in diameter.
• Range in texture from flat to raised, from waxy, smooth and velvety to rough and bumpy.

Pigmented horn dust

They are often seen on the trunk, but also on the head and face. Several can occur at the same time. What is typical of age warts is that the pigmentation does not come from melanocytes (pigment-forming skin cells), but is caused by pigmented horny substance.

Preventing age warts

Age warts can develop from the age of 30 and the percentage of people with age warts increases as they get older. They are often seen from the age of 50. They are mainly seen in people with a fair skin color. It is a common benign skin disorder with a favorable course.

Examination and diagnosis

Physical and diagnostic examination

The doctor will make the diagnosis after inspecting the site. Additional examination by means of dermatoscopy or taking a biopsy may be necessary if there is uncertainty about the diagnosis.

Pigmented basal cell carcinoma on the nose / Source: Sand, Thrandorf, Paech, Altmeyer, Bechara, Wikimedia Commons (CC BY-2.0)

Differential diagnosis

Similar syndromes are:

• melanoma;
• pigmented basal cell carcinoma (a form of skin cancer);
• nevus naevocellularis (birthmark), papillomatous type.

Treatment and removal of age warts

An age wart is benign, so treatment is not necessary. Treatment may be considered for cosmetic reasons or because the wart is constantly being scratched open and bleeding. Removal of an age wart can take place using liquid nitrogen (cryotherapy), (shave) excision (cutting away), or scraping away with a sharp spoon (curetage).

Cryotherapy

The dermatologist uses liquid nitrogen, a very cold liquid, to mark the wart with a cotton swab or a spray gun. This causes the age wart to freeze. The age wart will fall off within a few days. Sometimes a blister forms under the age wart, after which it dries and a scab forms. The scab will fall off just like the wart.

Electrosurgery and curettage

During electrosurgery (electrocautery), the wart is first anesthetized and then burned away using an electric current. The doctor then uses a special surgical instrument (a curette) to scrape away the wart. No stitches are needed after treatment. Sometimes a small bleeding occurs.

Prognosis

The skin may be lighter where the age wart was removed. The difference in skin color often diminishes over time. An age wart will often not return after treatment, but it is not unlikely that one will reappear elsewhere on your body.

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