The Medical Minute: The worry with warts

Aug 04, 2010 By David Adams and Michael Lynch

Common warts are harmless skin lesions that are usually found on the hands or soles of the feet, the latter referred to as plantar warts. Warts have a fleshy and hard feel to them, can be associated with skin thickening, and often are described as having a cauliflower-like appearance. Warts, especially plantar warts and those developing near fingernails are sometimes painful. Plantar warts are also slow to spontaneously heal and can be more difficult to treat.

Collectively, these non-genital warts are harmless lesions that for most people heal completely, without treatment in several months to years. Unless warts cause pain, there are no immediate reasons for treatment. Many people find warts to be aesthetically unpleasing and warts carry a degree of social stigma that drives many to seek medical treatment.
What causes warts?

Warts are caused by members of a virus family known as papillomaviruses. (HPV), of which there are more than one hundred types, infects the cells that comprise the outer layer of skin. The virus enters the and incorporates itself into the DNA. There, the virus multiplies, induces abnormal growth of the skin, and is released by the natural shedding of skin to potentially infect others. HPV types 1, 2, and 4 cause most common warts, but other HPV types have been implicated. These viruses are in the same family of viruses that causes (an entirely separate topic), but it is important to emphasize that common warts are not sexually transmitted.

How do you get warts?

HPV can be spread by direct contact with the warty skin of an infected person, although most contacts do not result in transmission. That is, warts are contagious, but not highly contagious. The virus also may be spread via contact with contaminated towels or surfaces such as gymnasium equipment, locker room floors, or swimming pool decks. Proper hand and foot hygiene is recommended to reduce infections.

Self-inoculation may explain multiple warts on the same person and people with damaged skin or who are immunosuppressed are at increased risk for HPV infection. When warts are treated immediately, this reduces risk of transmission to self or others.

What are the treatment options for warts?

If you are not immunosuppressed, and the warts are not painful, bothersome, or increasing in number, a cautious watch and wait approach can be used, but with some increased chance of transmission to others. Your body will often fight off the viral infection in time, and the warts will heal without treatment in many cases. This however may take months to years and generally occurs much faster and more consistently in children.

For those who desire medical therapy, there are several options available both over the counter and from your doctor.

Over the Counter Options

The most popular and effective therapy is a combination of salicylic acid 17 percent liquid preparation covered by a plaster which contains 40 percent salicylic acid in a cotton material. This can all be taped in place with medical tape, a bandaid, or vinyl waterproof tape. The tape is removed every 1-3 days, and the “dead” skin is removed and followed by reapplication of the above preparation. Applying this method for several weeks or months provides a cure in most cases.

Over the counter “freeze” products containing dimethyl ether and propane take the down to negative 57 degrees Celsius but generally are not cold enough to treat most .

Physician Options

If the wart is not responding to over the counter therapies or you are not sure if it is a wart, consulting your primary care physician or dermatologist is recommended. A variety of medications and procedures can be offered to you.
Cryotherapy involves freezing the wart with liquid nitrogen (negative 196 degrees Celsius). This procedure may require several treatments before the wart resolves.

An In office application of trichloroacetic acid and other agents.

Immunotherapy may include imiquimod 5 percent cream which improves host immune response to the virus or 5-fluorouracil 5 percent cream which inhibits viral proliferation.

Bleomycin injections, with repeat injection in 4 weeks if needed. The drug causes local death of infected cells.
Laser treatment is expensive but sometimes useful.

Explore further: More than 20 companies bid to supply legal pot in Uruguay

More information: For additional information about common warts, visit www.aad.org/public/publication… ts/common_warts.html

add to favorites email to friend print save as pdf

Related Stories

Cancer vaccine's added benefit

Jul 06, 2010

Vaccination against the virus that causes cervical cancer has had an additional benefit - a marked decline in cases of genital warts, a new study has found.

The HPV vaccine that doctors would recommend

Oct 24, 2008

Despite the government's decision to choose the vaccine Cervarix for the UK human papillomavirus (HPV) vaccination programme, every doctor I have spoken to has chosen Gardisal for their own children, says a doctor on bmj.com ...

FDA: Merck's Gardasil stops genital warts in boys

Sep 04, 2009

(AP) -- Merck's blockbuster vaccine Gardasil, which is already used to prevent cervical cancer in women, also stops viruses that cause genital warts in men, the Food and Drug Administration said Friday.

Genetic differences help protect against cervical cancer

Mar 12, 2009

Women with certain gene variations appear to be protected against cervical cancer, according to a study led by scientists at Albert Einstein College of Medicine of Yeshiva University and reported in Clinical Cancer Research. Knowi ...

HPV vaccines may reduce a wide range of genital diseases

Feb 05, 2010

High-coverage human papillomavirus (HPV) vaccinations among adolescents and young women may result in a rapid reduction of genital warts, cervical cell abnormalities, and diagnostic and therapeutic procedures, researchers ...

Recommended for you

A VA exit strategy

3 hours ago

As the federal government plans its exit strategy from the war, now may be the time for it to rethink its role in providing health care to veterans, says a Perspective piece in the New England Journal of Medicine.

Real tremors, or drug-seeking patient? New app can tell

3 hours ago

A 42-year-old investment banker arrives at the emergency department with complaints of nausea, vomiting, anxiety and tremor. He drinks alcohol every day—often at business lunches, and at home every evening. ...

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

justinius
not rated yet Aug 04, 2010
I have had the best results with electrolysis with my finger warts. I have not had much success with the over the counter options, and my sister has also had numerous painful doctor 'freezing/acid' sessions without success, and hers finally 'left' after electrolysis. Could be that the particular virus was more susceptible to that treatment, but it's a great option, and fairly cheap. (Also amazing for moles, and any other barnacles you might grow)