What to do about warts
Our hearts beat nearly silently in our chests. Our digestive systems go quietly (at least we hope so!) about their duties. Without even realizing it, our brains process literally millions of messages signals every day. Our skin, however, looks back at us in the mirror, shower or bath every day.
Dear Doc: I was looking at my son recently and saw some sort of growth on his arm. I think it could be a wart. I was hoping it would go away, but I think it has gotten bigger. What should I do?
– Puzzled in Eagle
Dear Puzzled: Warts are one of the most common skin problems but have a generally bad reputation. From the wart on the end of the witch’s nose in “Snow White” to the myth about getting them from toads, warts come with fear and loathing. Perhaps some of it is deserved. Warts are caused by a family of viruses called human papillomavirus (HPV). There are at least 60 types of HPV. Like other viruses, warts can be contagious and won’t go away with antibiotics. They can be passed on from person to person or even acquired from exposure to surfaces like towels and floors that were touched someone’s wart. Similarly, some people are more susceptible to infection with HPV and develop warts more easily. Warts can occur anywhere on our skin and may take many months to develop after the initial exposure.
Certain types of warts are passed through sexual contact and may even cause cervical cancer in women. While these are the most serious types of warts, their discussion will have to wait for another week. For the most part, warts are unsightly and uncomfortable. They may bleed easily and become raised and thickened. Warts are divided into three main categories: location (such as plantar warts, which occur on the feet), appearance (such as flat warts, which occur often in large clusters and more commonly on children), and type (such as common warts, which typically occur on the hands).
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A wart begins when HPV enters skin cells and causes them to change and give their characteristic appearance. Black dots often seen in the center of large warts are actually thombosed or clotted blood vessels. Because the virus lives within the skin cells, the method of treatment usually focuses on the destruction of those infected cells.
Your doctor may offer a variety of treatment options. Some treatments contain chemicals (often some type of acid) that you apply to the surface of the wart. While these can be very effective, care must be used to limit the treatment to the wart itself and not the healthy surrounding skin. If the healthy skin is treated, it will blister and become sore.
Surgery can also remove the wart, but it is invasive. This option is usually reserved for special cases, particularly after other treatments fail. Freezing, also called cryotherapy, is generally well tolerated even by children. In addition, it leaves no scars.
More than one treatment is usually required, however, and there is some discomfort afterwards.
Another option is to help our body’s immune system target and fight the warts. An immune-stimulating substance can be injected at the base of the wart and our body does the rest.
Finally, laser treatment is the gold standard. Special lasers can target the wart cells and destroy them instantly. While there is some discomfort, it may be the most effective treatment, especially for resistant warts.
Home treatments usually consist of applying one of the available over-the-counter wart preparations. These acids can be effective, but again, careful use is essential to prevent pain in the healthy surrounding skin. A surprisingly simple treatment may be just carefully covering the wart continuously with duct tape for six days to keep the skin from breathing. On the seventh day remove the duct tape, soak the wart in warm water and carefully debride the surface with an emery board or pumice stone. Clean and soak the area, then reapply the duct tape. Repeat this cycle for up to two months until the wart is gone. One study actually showed this to be 80 percent effective!
Perhaps most importantly is to be sure what you see is actually a wart. While warts may go away on their own, especially in children, persistent skin lesions or ones that change should be evaluated by your physician to confirm the diagnosis make sure a worrisome problem is not overlooked. Talk to your doctor about which treatment is best for you. Persistent warts might even require a referral to a dermatologist or podiatrist.
Please send me your questions. The only bad question is the unanswered one.
Remember your health is your responsibility! Health is our greatest asset it doesn’t happen by accident. If something doesn’t seem right, or questions are left unanswered, don’t wait, call your doctor.
Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to email@example.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.