Randy Jacobs, M.D. Patient Education
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Warts
WHAT
YOU SHOULD KNOW ABOUT WARTS
Warts
are common growths on the skin caused by a virus. Warts may grow on any part of
the skin. For example, warts on the feet are called plantar warts. It takes one
to six months to develop warts after exposure to the wart virus. Like the
common cold virus, the wart virus is contagious and is spread by direct
person-to-person contact. Once a person has warts, he may spread warts to other
parts of his own body. When considering treatment, about 65% of warts disappear
within two years without any treatment at all. The problem is contagion. If
warts are untreated, they will certainly spread to others. Warts are due to a
slow growing virus and may take many weeks to months to grow. Despite what you
have heard, frogs do not cause warts.
What
Causes Warts?
Warts occur as a result of infection
with the human papillomavirus. We have
identified over 41 HPV subtypes. Unique HPV subtypes cause warts on specific
body areas.
Are
there different kinds of warts?
Yes. Common warts are thick and rounded
with a rough, grayish surface. They are usually found on the fingers, hands,
elbows, chest, back, and knees. Plantar warts appear on the soles of the feet
and, unlike other warts, grow inward. Flat warts are thin and smooth and are seen
most often on the back of the hands and on the face. Genital warts affect the
genitalia and rectal area of both men and women.
Are
warts contagious? Can their spread be prevented?
Warts are contagious and are usually
spread by skin-to-skin contact. Condoms may provide protection against the
transmission of genital warts. Children acquire warts by touching other people
with warts, usually a playmate. Plantar warts are usually contacted at the gym
or from a contaminated shoe, shower, or bathroom floor.
Should
warts be treated?
Most warts require treatment. Common
and flat warts should be removed to prevent multiplication or spread to other
areas. Plantar warts can cause pain and discomfort as they grow and may make
walking difficult. Warts can destroy fingernails and can spread.
How
are warts removed?
There are a number of different
therapies. Certain therapies may not be FDA recognized. The wart may be coated
with a topical agent, such as salicylic acid, 5-fluorouracil cream, Verrusol, or Cantharone “blister beetle juice.” Laser surgery and
electrical destruction are becoming widely used, especially for genital warts.
Warts can also be frozen with liquid nitrogen, surgically scraped, burned, or
cauterized. Aldara is a new wart medicine FDA approved for genital warts.
Aldara is not FDA approved for common warts, but many dermatologists prescribe
Aldara for their wart patients, especially for difficult warts of the fingers
and face. Please understand that most wart removal methods cause irritation,
pain, blisters, and wounds.
Is
it possible for warts to return?
Recurrence rates may be as high as
30%-45%. Treatments destroy visible warts, but may not eradicate the virus,
which can persist in a latent state. At some point the virus may begin
replicating, causing warts to recur. Until there is a drug to kill HPV or a
vaccine to give immunity, all we can do is treat visible warts and depend on
the body's immune system to keep the HPV virus in check.
Do
warts ever go away without treatment?
After several months or years, a wart
may disappear spontaneously in response to the body's immune system. The body
slowly builds up its defense against the wart, and a triggering event makes it
suddenly launch an attack. People with suppressed immune systems, such as
patients who have undergone transplantation or chemotherapy, may be unable to
rid themselves of warts, no matter what treatment is used.
Can
the wart virus cause cancer?
Certain HPV types have been linked with
a variety of premalignant and malignant conditions. Genital warts are the
greatest cause for concern. Women who have had genital warts or sexual contact
with someone with genital warts have a significant risk of developing cervical
neoplasia (cancer). For this reason, among others, it is critical that genital
warts be treated.
CHEMICAL
REMOVAL OF WARTS
Ask your pharmacist
for “40% Mediplast,”
or “40% Wart Stick,” or an equivalent over the counter Salicylic Acid wart
medicine and a Pumice
Stone.
Here
are the steps:
1. At bedtime, put the wart-destroying
medicine on the warts.
2. After applying the medicine, cover
your warts with adhesive tape. Use the old-fashioned fabric type of adhesive
tape. The tape keeps your skin moist. The moisture softens the surface of the
warts so the wart medicine can penetrate and go to work.
3. After a few days the outside of the
warts will start to turn gray. This means the chemical has begun to destroy
them. Scrape this gray wart tissue off with a pumice stone every second or
third day. Do the scraping after your bath or shower has softened the wart's
surface.
4. Be sure to
remove every bit of dead wart tissue. Sometimes small curved scissors can help
in trimming the dead wart tissue. Whatever you use for scraping your warts
should not be used for anything else, because warts are contagious. Do not let
anyone else use your pumice stone. Clean your pumice stone by dipping in
alcohol.
5. If the warts become too sore, stop
the wart treatments for a few days.
6. If your plantar warts hurt when you
stand or walk, wear a pad cut out of Dr. Scholl's Adhesive Foam (available
without prescription). Cut a hole (or holes) corresponding to where the warts
are. This pad will take pressure off and can relieve your pain.
7. Continue the treatment until you
believe the warts are gone. If you can see the lines of your skin crossing the
treated area, the warts are probably gone. If it turns out that after you stop
treatment you see that the warts are still there, start treating them again
until you feel more certain that the warts have gone away.
8. If necessary, continue the treatment
for two to four months. If the warts haven't been significantly destroyed after
four months of treatment, return to the derm clinic.
9. If your warts become excessively
painful or infected, return at once to the clinic.