About Rubella

Rubella — commonly known as German measles or 3-day measles — is an infection that mostly affects the skin and lymph nodes. It is caused by the rubella virus (not the same virus that causes measles).

Rubella spreads when people breathe in virus-infected fluid, such as the droplets sprayed into the air when a person with rubella sneezes or coughs, or share food or drink with someone who’s infected. It also can pass through a pregnant woman’s bloodstream to infect her unborn child.

It’s a generally mild disease in children; the primary medical danger of rubella is the infection of pregnant women because it can cause congenital rubella syndrome in developing babies.

Before a vaccine against rubella became available in 1969, rubella epidemics happened every 6-9 years, usually among kids 5 to 9 years old, along with many cases of congenital rubella. Thanks to immunization, there are far fewer cases of rubella and congenital rubella.

Most rubella infections today appear in young, non-immunized adults rather than in kids. In fact, experts estimate that 10% of young adults are currently susceptible to rubella, which could pose a danger to any children they might have someday.

Signs and Symptoms

Rubella infection may begin with 1-2 days of mild fever (99-100°F, 37.2–37.8°C) and swollen, tender lymph nodes, usually in the back of the neck or behind the ears. A rash then begins on the face and spreads downward. As it spreads, it usually clears on the face.

The rubella rash is often the first sign of illness that a parent notices. It can look like many other viral rashes, appearing as either pink or light red spots, which may merge to form evenly colored patches. The rash can itch and lasts up to 3 days. As the rash clears, the affected skin might shed in very fine flakes.

Other symptoms of rubella (these are more common in teens and adults) can include headache, loss of appetite, mild conjunctivitis (inflammation of the lining of the eyelids and eyeballs), a stuffy or runny nose, swollen lymph nodes in other parts of the body, and pain and swelling in the joints (especially in young women). Many people with rubella have few or no symptoms.

Rubella in a pregnant woman can cause congenital rubella syndrome, with potentially devastating consequences for the developing fetus. Children who are infected with rubella before birth are at risk for growth problems; intellectual disability; defects of the heart and eyes; deafness; and liver, spleen, and bone marrow problems.

Contagiousness

The rubella virus passes from person to person through tiny drops of fluid from the nose and throat through sneezing and coughing. People who have rubella are most contagious from 1 week before to 1 week after the rash appears. Someone who is infected but has no symptoms can still spread the virus.

Infants who have congenital rubella syndrome can shed the virus in urine and fluid from the nose and throat for a year or more and may pass the virus to people who have not been immunized.

Prevention

Rubella can be prevented by the rubella vaccine. Widespread immunization against rubella is critical to controlling the spread of the disease, thereby preventing birth defects caused by congenital rubella syndrome.

The vaccine is usually given to children at 12–15 months of age as part of the scheduled measles-mumps-rubella (MMR) immunization. A second dose of MMR usually is given at 4–6 years of age. As with all immunization schedules, there are important exceptions and special circumstances. For example, if your child will be traveling outside the United States, the vaccine can be given as early as 6 months of age. Talk to your child’s doctor to see when the vaccine is needed.

The rubella vaccine should not be given to pregnant women or to a woman who may become pregnant within 1 month of receiving the vaccine. If you are thinking about becoming pregnant, make sure that you’re immune to rubella through a blood test or proof of immunization. If you’re not immune, you should receive the vaccine at least 1 month before you become pregnant.

Pregnant women who are not immune should avoid anyone who has the illness and should be vaccinated after delivery so that they will be immune during any future pregnancies.

Incubation

The incubation period for rubella is 14–23 days, with an average incubation period of 16–18 days. This means that it can take 2–3 weeks for a child to get rubella after being exposed to someone with the disease.

Duration

The rubella rash usually lasts 3 days. Lymph nodes may remain swollen for a week or more, and joint pain can last for more than 2 weeks. Children who have rubella usually recover within 1 week, but adults may take longer.

Treatment

Rubella cannot be treated with antibiotics because they do not work against viral infections. Unless there are complications, rubella will get better on its own.

Any pregnant woman who has been exposed to rubella should contact her obstetrician immediately.

Rubella usually is mild in kids, who often can be cared for at home. Monitor your child’s temperature and call the doctor if the fever climbs too high.

To ease minor discomfort, you can give your child acetaminophen or ibuprofen. Remember, you should never give aspirin to a child who has a viral illness, as its use in such cases has been associated with the development of Reye syndrome.

When to Call the Doctor

Call your doctor if your child appears to be getting sicker than the mild course of symptoms described above.

Scabies is a common skin infestation of tiny mites called Sarcoptes scabiei. The mites burrow into the top layer of human skin to lay their eggs, causing small itchy bumps and blisters.

A child with scabies may have a bumpy red rash. Sometimes, raised wavy lines appear where the mites have burrowed, especially on the inner part of the wrist or between the fingers or toes.

How Do People Get Scabies?

Scabies is contagious and usually spreads through skin-to-skin contact with someone who is already infected. It spreads most easily in crowded conditions and those with a lot of close contact — among families, in childcare centers, college dorms, or nursing homes. So if someone in your child’s class or childcare group has scabies, it’s wise to have your child treated for the infection even before symptoms develop.

Mites can live for about 2 to 3 days in clothing, bedding, or dust, making it possible to catch scabies from people who share the same infected bed, linens, or towels.

It may take up to 4 to 6 weeks after infection for symptoms to appear in someone who’s never had scabies. In people who have had scabies before, symptoms may start in just a few days.

Signs and Symptoms

The most common symptom of scabies is severe itching, which can be worse at night or after a hot bath.

A scabies infection begins as small itchy bumps, blisters, or pus-filled bumps that break when scratched. Itchy skin may become thick, scaly, scabbed, and crisscrossed with scratch marks. The itching is due to a hypersensitivity reaction to the mite and/or its feces and eggs.

The areas of the body most commonly affected by scabies are the hands and feet (especially the webs of skin between the fingers and toes), the inner part of the wrists, and the folds under the arms. It may also affect other areas of the body, particularly the elbows and around the breasts, genitals, navel, and buttocks.

Infants and young children can have the rash on the scalp, palms, and soles of feet. Rashes in infants and young children can look redder or have larger blisters.

Scratching the itchy areas of skin can allow bacteria to get into the injured skin. Impetigo, a bacterial skin infection, may affect skin that’s already infected with scabies.

Treatment

Scabies infections need to be treated by a doctor. Call the doctor or dermatologist any time your child has a skin itch or rash that will not go away, especially if the itch is worse at night and occurs around the wrists or in the webbed part of the fingers.

If scabies is suspected, the doctor may scrape a small part of the affected skin and examine the scrapings under a microscope for signs of scabies mites.

Doctors treat scabies by prescribing a medicated cream or lotion to kill the mites. The cream needs to be applied to skin all over the body, not just the area with the rash, and usually must stay on the skin for 8 to 12 hours before it can be washed off.

In infants and young children, remember to also put the cream on the head, face, and scalp — even on the ears. If you forget these areas, you may not get rid of all the mites. Also trim your child’s fingernails and scrape off any dirt that’s on the fingertips, and put medicine on the fingertips as well. After applying the cream, don’t wash your own hands — scabies mites love the area between the fingers! You may want to apply the medication before your child goes to bed, then wash it off in the morning.

Most often, the treatment needs to be repeated in 1-2 weeks, especially if you see live mites on the skin 2 weeks after treatment.

Sometimes the doctor may choose an oral medication instead of topical lotion to treat scabies in older children.

Since scabies is highly contagious and can cause re-infestations, other members of your household also should be treated, even if they have no symptoms. Because scabies can be sexually transmitted, sexually active teens with scabies should be examined for other sexually transmitted diseases (STDs) too. Any sexual partners also should be treated for scabies.

The doctor might prescribe antibiotics if your child also develops a bacterial skin infection (such as impetigo) and an antihistamine to help relieve the itching.

Once a child begins treatment for scabies, it usually takes about 1 to 2 days for the itching to stop. In some cases, though, itching can last for a few weeks. If your child has itching that’s severe, the doctor may prescribe a steroid cream for the skin, like hydrocortisone. Steroid cream should only be used if recommended by your doctor because it can make certain infections worse.

If the treatment is effective, there should be no new rashes or burrows after 24 to 48 hours.

Prevention

Direct physical contact — like holding hands — is the most common way to transmit scabies. But because the mites can live for several days in clothing, bedding, or dust, scabies can spread when people share infected bed, linens, or towels.

If someone in your family is being treated for scabies, all other members of the household should be treated, too. Wash clothing, sheets, and towels in hot water and dry on a hot setting. Put stuffed animals and any other items you cannot wash in a sealed plastic bag for at least 3 days. Vacuum each room in the house, then throw away the vacuum cleaner bag.

Most kids can return to school the day after the treatment is complete.

Scarlet fever is caused by an infection with group A streptococcus bacteria (usually strep throat). The bacteria make a toxin (poison) that can cause the scarlet-colored rash that gives this illness its name.

Not all streptococci bacteria make this toxin and not all kids are sensitive to it. Two kids in the same family may both have strep infections, but one child (who is sensitive to the toxin) may develop the rash of scarlet fever while the other doesn’t.

Usually, if a child has this scarlet rash and other symptoms of strep throat, it can be treated with antibiotics. So if your child has these symptoms, it’s important to call your doctor.

Symptoms

The rash is the most striking sign of scarlet fever. It usually begins looking like a bad sunburn with tiny bumps and it may itch. The rash usually appears first on the neck and face, often leaving a clear unaffected area around the mouth. It spreads to the chest and back, then to the rest of the body. In body creases, especially around the underarms and elbows, the rash forms classic red streaks. Areas of rash usually turn white when you press on them. By the sixth day, the rash usually fades, but the affected skin may begin to peel.

Aside from the rash, there are usually other symptoms that help to confirm a diagnosis of scarlet fever, including a reddened sore throat, a fever above 101°F (38.3°C), and swollen glands in the neck. The tonsils and back of the throat may be covered with a whitish coating, or appear red, swollen, and dotted with whitish or yellowish specks of pus. Early in the infection, the tongue may have a whitish or yellowish coating. A child with scarlet fever also may have chills, body aches, nausea, vomiting, and loss of appetite.

When scarlet fever happens because of a throat infection, the fever usually stops within 3 to 5 days, and the sore throat passes soon afterward. The scarlet fever rash usually fades on the sixth day after sore throat symptoms began, but skin that was covered by rash may begin to peel. This peeling may last 10 days.

The infection itself is usually cured with a 10-day course of antibiotics, but it may take a few weeks for tonsils and swollen glands to return to normal.

In rare cases, scarlet fever may develop from a streptococcal skin infection like impetigo. In these cases, the child may not get a sore throat.

Prevention

The bacterial infection that causes scarlet fever is contagious. A child who has scarlet fever can spread the bacteria to others through nasal and throat fluids by sneezing and coughing. If a child has a skin infection caused by strep bacteria, like impetigo, it can be passed through contact with the skin.

In everyday life, there is no perfect way to avoid the infections that cause scarlet fever. When a child is sick at home, it’s always safest to keep that child’s toothbrush, drinking glasses, and eating utensils separate from those of other family members, and to wash these items thoroughly in hot soapy water. Wash your own hands often as you care for a child with a strep infection.

Treatment

If your child has a rash and the doctor suspects scarlet fever, he or she will usually take a throat culture (a painless swab of throat secretions) to see if the bacteria grow in the laboratory. If a strep infection is confirmed, the doctor will prescribe an antibiotic for your child to be taken for about 10 days.

Caring for Your Child

A child with severe strep throat may find that eating is painful, so serving soft foods or a liquid diet may be best. Include soothing teas and warm nutritious soups, or cool soft drinks, popsicles, or slushies. Make sure that your child drinks plenty of fluids. You can give over-the-counter acetaminophen or ibuprofen for the throat pain.

If the rash itches, make sure that your child’s fingernails are trimmed short so skin isn’t damaged through scratching. Try an over-the-counter anti-itch medicine to help relieve the itching.

When to Call the Doctor

Call the doctor whenever your child suddenly develops a rash, especially if it is accompanied by a fever, sore throat, or swollen glands. This is especially important if your child has any of the symptoms of strep throat, or if someone in your family or in your child’s school has recently had a strep infection.

About Toxic Shock Syndrome

Toxic shock syndrome (TSS) is a serious but uncommon infection caused by either Staphylococcus aureus (often called staph) and Streptococcus pyogenes (often called strep) bacteria, with most cases related to staph bacteria.

TSS was originally linked to the use of tampons because the earliest cases, in the late 1970s, were related to super-absorbent tampons. Research led to better tampons and better habits for using them, such as changing them often. The number of TSS cases dropped dramatically. Today about half of all TSS cases are linked to menstruation.

But TSS isn’t strictly related to tampons. The contraceptive sponge and the diaphragm, two types of birth control methods, have been linked to TSS. It also can affect someone who has any type of staph infection, including pneumonia, an abscess, a skin or wound infection, the blood infection septicemia, or the bone infection osteomyelitis.

Most strep-related TSS cases are due to bacteria getting into areas of injured skin, such as cuts and scrapes, surgical wounds, and even chickenpox blisters.

Symptoms of TSS can include sudden high fever, a faint feeling, diarrhea, headache, a rash, and muscle aches. If your child has these symptoms, call your doctor right away.

Symptoms

Toxic shock syndrome starts suddenly, often with high fever (temperature at least 102°F [38.8°C]), a rapid drop in blood pressure (with lightheadedness or fainting), confusion, vomiting, diarrhea, headache, or muscle aches.

A sunburn-like rash may appear anywhere on the body, including the palms of the hands and the soles of the feet. A person also might have bloodshot eyes and an unusual redness under the eyelids or inside the mouth (and in the vagina in females). The area around an infected wound can become swollen, red, and tender, but might not even appear infected.

Other symptoms can include confusion or other mental changes, decreased urination, fatigue and weakness, and thirst.

If TSS is untreated, organs such as the liver and kidneys may begin to fail, and problems such as seizures, bleeding, and heart failure can develop.

Prevention

The bacteria that cause toxic shock syndrome can be carried on unwashed hands so good hand washing is extremely important.

Girls can reduce their risk of TSS by either avoiding tampons or alternating them with sanitary napkins. Girls who use only tampons should choose ones with the lowest absorbency that will handle menstrual flow, and change the tampons often. On low-flow days, girls should use pads instead of tampons.

Between menstrual periods, store tampons away from heat and moisture (where bacteria can grow) — for example, in a bedroom rather than in a bathroom closet.

Because staphylococcus bacteria are often carried on hands, it’s important for girls to wash their hands thoroughly before and after inserting a tampon. If your daughter has gotten her menstrual period, talk to her about taking these precautions. Any female who has recovered from TSS should not use tampons.

Clean and bandage all skin wounds as quickly as possible. Call your doctor immediately whenever a wound becomes red, swollen, or tender, or if a fever begins.

Diagnosis and Treatment

TSS is a medical emergency. If you think your child has TSS, call a doctor right away. Depending on the symptoms, a doctor may see you in the office or refer you to a hospital emergency department for immediate evaluation and testing.

If doctors suspect TSS, they will probably start intravenous (IV) fluids and antibiotics as soon as possible. They may take a sample from the suspected site of the infection, such as the skin, nose, or vagina, to check it for TSS. They also may take a blood sample. Other blood tests can help monitor how various organs like the kidneys are working and check for other diseases that might be causing the symptoms.

Medical staff will remove tampons, contraceptive devices, or wound packing; clean any wounds; and, if there is a pocket of infection (an abscess), a doctor may need to drain pus from the area.

People with TSS usually need to stay in the hospital, often in the intensive care unit (ICU), for several days so doctors can monitor their blood pressure and breathing and watch for signs of other problems, such as organ damage.

TSS is a very rare illness. Although it can be fatal, if recognized and treated promptly it is usually curable.

When to Call the Doctor

Call your doctor immediately if your child has any signs or symptoms of toxic shock syndrome. Once you realize that something is wrong, it’s important to get medical attention right away. The sooner treatment begins, the better.

Whether fair, dark, or any shade in between, most kids have skin that is generally the same color all over their body. But this isn’t the case for those with vitiligo.

Vitiligo is a loss of skin pigment, or color, that causes white spots or patches to appear on the skin. No one knows exactly why this happens, but we do know it affects people of both sexes and all races. In the United States alone, an estimated 1 to 2 million people have the condition, and more than half of them are kids and teens.

The good news is that vitiligo — upsetting as it can be to those who are living with it — isn’t medically dangerous. It’s not a form of skin cancer, it’s not an infection like MRSA, and it’s definitely not contagious. In fact, most kids who have it are every bit as healthy as everyone else.

About Vitiligo

Vitiligo (vih-tih-LY-go) is a skin disorder that affects the melanocytes, cells deep within the epidermis (the outermost layer of the skin) whose function is to produce melanin. Melanin is the pigment that gives skin its color and helps protect it from the sun.

Our skin color is determined not by how many melanocytes we have (we’re all born with a similar amount), but rather by how active they are. Dark-skinned people have cells that naturally produce a lot of melanin, while light-skinned people produce much less.

Sometimes, though, skin cells suddenly stop producing melanin. At first, this might cause a spot, called a macule, whose color is much lighter than the skin around it. But in time these light patches may spread and grow to cover a larger portion of the body. Sometimes the spread happens quickly, and then remains stable for a number of years; other times it happens slowly, over a longer period of time.

Dermatologists label the types of vitiligo according to the amount and location of the patches:

• focal vitiligo happens when there are just a few spots in a single area
• generalized vitiligo is associated with many spots all over the body that tend to be symmetrical (they affect the right and left sides of the body like a mirror image). This is the most common form of the condition.
• segmental vitiligo is characterized by spots only on one side of the body and usually nowhere else. This type of vitiligo is relatively uncommon.

Although vitiligo can appear anywhere on the body, it’s more likely to happen in:

• areas that are exposed to the sun, such as the face or hands
• skin that has folds, such as the elbows, knees, or groin
• skin around orifices (body openings), such as the eyes, nostrils, belly button, and genital area

Although kids of all races are affected equally, spots tend to be more visible on those with darker skin.

Sometimes kids with vitiligo have other symptoms, such as premature graying of the hair or a loss of pigment on the lips, since pigment cells are found in these places, too.

Causes

Theories vary on what causes vitiligo. Some experts think it is an autoimmune disorder (in which the immune system mistakenly attacks healthy melanocytes). Others think it is a genetic condition, since over 30% of affected kids have a family member who also has it.

What is known is that the risk of developing vitiligo increases in kids with a family or personal history of thyroid disease, diabetes, and certain conditions like alopecia (an autoimmune disease that causes hair loss). And vitiligo is never contagious — kids can’t “catch” it from someone else.

Diagnosis

A dermatologist usually can make a diagnosis of vitiligo just by looking for the telltale white patches on the skin. On kids with very fair skin, a special tool called a Woods lamp might be used. This lamp uses ultraviolet light in a dark room to illuminate areas of affected skin that would otherwise be hard to see with the naked eye.

The doctor will also ask lots of questions about your child’s medical history, including whether anyone in the family has had skin conditions or autoimmune problems in the past; whether your child recently has had a rash or sunburn; or whether he or she has had any other illnesses or been under stress. A blood test may be done to check for thyroid problems and diabetes, as these can increase the risk of vitiligo.

Very rarely, the doctor may do a biopsy (where a small piece of the affected skin is removed to be analyzed in the lab). A biopsy lets the doctor check for pigment cells in the skin. If the biopsy shows there are no pigment cells, this may confirm a case of vitiligo.

Treatment

There is no “cure” for vitiligo. Some patches will clear up without treatment. For those that don’t, treatments can help to even out the skin tone. You can try some at home; others require treatment by a doctor. Just remember that results can vary — what works for one person may not work for another, and no treatment is likely to be 100% effective at making the spots disappear.

Here are ways to help if your child has vitiligo:

• Sunscreen. One of the most important things your child can do is wear sunscreen every day to protect against skin cancer. And because vitiligo spots can’t tan (they have no melanin), they may burn and scar. Getting a tan on the rest of the body will only highlight white patches even more, especially if a child has light skin.
• Cosmetics. Different kinds of over-the-counter concealers are available. Ask your doctor for recommendations and try different brands until you find the one that works best for your child.
• Corticosteroid creams. Corticosteroids are a type of medication which, when applied to white patches very early in the disease, may help to “repigment” the skin. They reduce the inflammation that causes a loss of pigment so that pigmented cells can return to the skin. Some non-steroidal creams also produce a similar effect.
• Photochemotherapy with ultraviolet A (also known as PUVA). PUVA has two steps: first, a medicine called psoralen is either applied to the white patches of skin or taken orally; then, the skin is exposed to ultraviolet light, sometimes from the sun but usually from an artificial source, like a UVA lamp. This turns the affected skin pink, which in time tends to fade to a more natural (often slightly darker) color. There are side effects, which may include severe sunburn and skin blistering. Other side effects may be more serious, so talk to your doctor about the risks involved.
• Narrow-band ultraviolet B (UVB) therapy. This treatment is more widely used than PUVA. It’s similar to PUVA, except that the ultraviolet light used is UVB instead of UVA. Also, no psoralen is required beforehand, which eliminates some of the side effects.

Researchers are also looking into a new procedure called a melanocyte transplant. It works by removing a sample of normally pigmented skin and using it to grow new melanocytes in the lab. These can then be transplanted back into the depigmented skin to return some of the missing color.

When deciding which, if any, treatment to try, be wary of quick-fix “miracle” remedies you might see advertised. If it seems too good to be true, it probably is. Always work with your child’s doctor to help you decide what’s best for your son or daughter.

Dealing With the Emotional Impact

If your child has vitiligo, you know that even though it isn’t dangerous to his or her physical health, it can still be a big deal. Any condition that makes kids look different from their peers can be emotionally tough, especially during the preteen and teen years when everyone’s trying so hard to fit in.

Some kids are naturally more resilient and do just fine against these challenges. But others need a bit more help. As a parent you can do a lot to arm your child with confidence and self-esteem. Here are a few tips:

• Don’t focus on the vitiligo or put pressure on your child to cover it up. He or she needs to know your love and acceptance are unconditional.
• Remind your child of all the things at which he or she excels — and how they have nothing to do with skin color.
• Teach your child to be comfortable explaining what vitiligo is — and isn’t — to other kids. Once the mystery is taken away, most kids will stop staring and asking questions.
• Encourage your child to say yes to play dates, pool parties, trips, and any other experiences he or she might be tempted to pass on because of the vitiligo.
• Urge your son or daughter to volunteer or get involved in the community. Giving back makes kids feel powerful.

Finally, get emotional support if your child needs it — especially if you see any signs of withdrawal, depression, or anxiety. Counselors, therapists, and vitiligo support groups can help.

About Warts

Many of us have had a wart somewhere on our bodies at some time. Other than being a nuisance, most warts are harmless and go away on their own.

Warts are skin infections caused by viruses of the human papillomavirus (HPV) family. They’re more common in kids than in adults. Warts can affect any area of the body, but tend to invade warm, moist places, like small cuts or scratches on the fingers, hands, and feet.

Most warts are painless unless they’re on the soles of the feet or another part of the body that gets bumped or touched all the time.

Kids can pick up HPV — and get warts — from touching anything someone with a wart has used, like towels and surfaces. Kids who bite their fingernails or pick at hangnails are at risk for warts because they expose less-protected skin and create open areas for a virus to enter and cause the wart.

Types of warts include:

• Common warts. Usually found on fingers, hands, knees, and elbows, a common wart is a small, hard bump that’s dome-shaped and usually grayish-brown. It has a rough surface that may look like the head of a cauliflower, with black dots inside.
• Flat warts. These are about the size of a pinhead, are smoother than other kinds of warts, and have flat tops. Flat warts may be pink, light brown, or yellow. Most kids who get flat warts have them on their faces, but they can also grow on arms, knees, or hands and can appear in clusters.
• Plantar warts. Found on the bottom of the foot, plantar warts can be very uncomfortable — like walking on a small stone.
• Filiform warts. These have a finger-like shape, are usually flesh-colored, and often grow on or around the mouth, eyes, or nose.

Sometimes warts are sexually transmitted and appear in the genital area, but most warts are on the fingers, hands, and feet.

Are Warts Contagious?

Simply touching a wart on someone doesn’t guarantee that you’ll get one, too. But the viruses that cause warts are passed from person to person by close physical contact or from a surface that a person with a wart touches, like a bathmat or a shower floor. (You can’t, however, get a wart from holding a frog or toad, as kids sometimes think!)

A tiny cut or scratch can make any area of skin more vulnerable to warts. Also, picking at a wart can spread warts to other parts of the body.

The length of time between when someone is exposed to the virus that causes warts and when a wart appears varies. Warts can grow very slowly and may take weeks or sometimes longer to develop.

Preventing Warts

Although there’s no way to prevent warts, it’s always a good idea to encourage kids to wash their hands and skin regularly and well. If your child has a cut or scratch, use soap and water to clean the area because open wounds are at risk for warts and other infections.

It’s also wise to have kids wear waterproof sandals or flip-flops in public showers, locker rooms, and around public pools (this can help protect against plantar warts and other infections, like athlete’s foot).

Treating Warts

Warts don’t generally cause any problems, so it’s not always necessary to remove them. A wart that’s not treated can take anywhere from 6 months to 2 years to go away on its own.

A doctor might decide to remove a wart if it’s painful or interferes with activities because of the discomfort. There are different ways of removing warts, including:

• using over-the-counter or prescription medicines to put on the wart
• burning the wart off using a light electrical current
• freezing the wart with liquid nitrogen (called cryosurgery)
• using laser treatment

Within a few days after the doctor’s treatment, the wart may fall off, but several treatments might be necessary. Doctors don’t usually cut off warts because it can cause scarring and the wart may return.

If an older child has a simple wart on the finger, ask the doctor about using an over-the-counter remedy that can help remove the wart. This treatment can take several weeks or months before you see results, but eventually the wart should crumble away from the healthy skin. Wart medicines contain strong chemicals and should be used with care because they can also damage healthy skin. Talk with your doctor before using any over-the-counter wart medicine on the face or genitals.

Also make sure that your child:

• soaks the wart in warm water and removes dead skin on the surface of the wart with an emery board (that’s never going to be used for nails) before applying the medicine. Be careful not to file into the normal skin around the wart.
• keeps the area of the wart covered while the medicine works
• knows not to rub, scratch, or pick at the wart — doing so could spread the virus to another part of the body or cause the wart to become infected

You might also have heard that you can use duct tape to remove a wart. Talk to your doctor about whether this type of home treatment is OK for your child.

When to Call the Doctor

Before you try to remove a wart with a store-bought remedy, call your doctor if:

• you have a young child or infant with a wart anywhere on the body
• your child (of any age) has a wart on the face, genitals, or rectum

Also call the doctor if a wart or the skin around it is:

• painful
• red
• bleeding
• swollen
• oozing pus