To get rid of warts, Huckleberry Finn recommended throwing a dead cat into a cemetery. That can’t be a whole lot of fun even if you happen to run into a dead cat on your way to the graveyard.
But it’s easier than Tom Sawyer’s elaborate cure: put your hand into stagnant water that has collected in the hollow of a tree stump at the exact stroke of midnight and recite a “barley-corn, barley-corn” verse. Then walk away quickly 11 steps with your eyes shut, turn around three times and walk home without speaking to anybody.
You have to really want to get rid of warts to be willing to try such remedies. But then people often are desperate because warts are disfiguring and embarrassing. A young baseball pitcher had a wart on his index figure that often bled and became painful when he threw too many breaking pitches. Although warts often go away on their own, his didn’t.
A wart is a small skin infection caused by the human papillomavirus, also known as HPV. The virus probably enters through a cut or tear in the skin and inserts DNA into the genome of the host, leading to the rapid growth of cells that represents the wart.
It’s believed that the virus can be on the skin for several weeks or longer before an actual wart starts to show. And the virus can be spread either before or after the wart is apparent.
As a result, warts are easily spread to another person or from one part of the body to another. It’s also common to reinfect yourself in approximately the same place, as the baseball pitcher did.
Often Disappear on Own
About a third of warts disappear on their own within a year, leaving no scar or other sign. By the end of three years, 75 percent of warts are gone. This explains the effectiveness of many folk remedies. Wait long enough, no matter what you do, and the wart will go away...or not.
Nearly everyone has a wart at one time or another, and we generally know what they look like, although there are different types and some are hard to distinguish from other kinds of skin growths.
Common warts, often resembling a tiny cauliflower or a solid blister, can occur anywhere but most commonly on the hands. You’re most likely to make contact with a contaminated surface with your hands, of course. And your hands are also instrumental in spreading the virus to other parts of your body.
Children tend to pick at warts, and this facilitates their spread. Except when continually irritated, as they are when scratched, common warts are usually painless.
Flat warts usually appear on the face, forehead or neck. They are typically small, smooth and flesh-colored and can easily be missed or mistaken for freckles or sun spots.
When you shave over a flat wart on your neck, it can multiply into a hundred or so. This type of wart is generally more common in children, however.
Plantar warts are so-called because they occur on the underside of the foot, typically on areas that carry direct pressure when standing or walking–the heel, the toes and the balls of the feet. These are the areas of your foot that will have contact with a contaminated surface when you walk barefoot. They are also the areas that will press against the wart when you stand or walk, eventually leading to irritation and pain.
Subungual and periungual warts occur, often in a cauliflower-like cluster, under and around the fingernails and toenails.
Genital warts occur in the pubic area, on the genitals or even inside the vagina or anal canal. These are generally the most troublesome because they represent an STD that is strongly associated with cervical cancer.
HPV is the most common sexually transmitted disease in this country, and most Americans do not realize that the virus can be transmitted through any intimate sexual contact (even without intercourse) and cannot be prevented through use of a condom. Skin-to-skin contact can spread warts and HPV.
Even though common among sexually active persons, most genital warts are harmless. A few, however, such as types 16 and 18, are strongly associated with cervical cancer. Vaccines such as Gardasil are currently recommended to prevent infection with these HPV types as well as types 6 and 11, which are responsible for 90 percent of genital warts. To protect against cervical, vulvar, vaginal, penile and anal cancers, this vaccine is recommended for young, sexually active females and males.
Unfortunately, the vaccine does not protect against common, flat, plantar, subungual or other warts. These types are generally harmless although plantar warts can become painful.
Even if they bother you (and they usually do) you should not attempt to remove warts by cutting, tearing or picking at them. The only folk method that has been medically researched is duct tape. The tape presumably triggers an immune response that eliminates the virus from the body. This may require several weeks, however.
Over-the-counter medications are available–usually salicylic acid in the form of a liquid, gel or bandaid-like strip that can be placed over the wart. There are also over-the-counter freezing products containing dimethyl ether. Follow the instructions carefully and do not use these products for warts on the face or genitals.
Doctors can remove warts with liquid nitrogen (freezing), electrocautery, laser energy or surgery. Immunotherapy can be provided through injection of a substance that causes an allergic reaction. There are also skin medicines such as imiquimod, bleomycin and 5-fluorouracil. A new skin medicine, veregen, can be used against even genital warts.
A Cochrane Database review of treatments for non-genital warts concluded that salicylic acid had the greatest effectiveness with a cure rate of 75 percent. Cryotherapy (freezing) caused more pain but performed no better than salicylic acid or duct tape, according to one analysis. Other studies, however, have found cryotherapy to be the most effective treatment..
Bothersome warts on the face or genitals require a doctor’s care. For warts elsewhere that are causing you no pain, you can choose to wait them out, cover them with duct tape or try the over-the-counter products. Steer clear of internet advice, graveyards, hollow stumps and dead cats.
REFERENCES:
American Academy of Dermatology, “Warts.”
Laurie Barclay, M.D., “Cryotherapy may be most effective for removal of common warts,” CMAJ, published online September 13, 2010.
Richard S. Ferri, Ph.D., ANP, ACRN, FAAN, “What can be done about a hand wart that keeps reappearing after removal,” Medscape Nurses, May 31, 2007.
Jeanne Findlay, DNP, CPNP, CCRP, and Bernard A. Cohen, M.D., “Warts and molluscum in kids: those bothersome bumps!” Medscape Pediatrics, June 2, 2011.
Brenda Y. Hernandez, et al, “Genital and extra-genital warts increase the risk of asymptomatic genital human papillomavirus infection in men,” Sexual Transmission and Infection, 2011;87:391-395.
F.M. van Haalen, et al, “Warts in primary schoolchildren: prevalence and relation with environmental factors,” British Journal of Dermatology, 2009;161(1):148-152.
Vanessa Lichon, M.D., CWS, and Amor Khachemoune, M.D., CWS, “Plantar warts: a focus on treatment modalities,” Dermatology Nursing, 2007;19(4):372-375.
Becky McCall, “ISSTDR 2009: HPV vaccination program reduces the incidence of genital warts in both women and men,” Medscape Medical News, July 8, 2009.
Bruce Soloway, M.D., “Cryotherapy is more effective than salicylic acid for common warts,” Journal Watch, 2010;30(23).
“Treatment of warts,” U.S. Pharmacist, 2005.
“Warts,” KidsHealth.org., reviewed by Joel Klein, M.D., November, 2010.
“Warts,” A.D.A.M. Medical Encyclopedia, reviewed by Kevin Berman, M.D., Ph.D., November 22, 2011.
“Warts and plantar warts–topic overview,” WebMD Medical Reference from Healthwise, reviewed September 2, 2010.
05/28/2012
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