by Rob Lamberts, MD
A while back I wrote about when to worry about abdominal pain, a condition that can kill. This week’s article is not about a killer; in fact, it doesn’t even hurt very much. It just bugs people. It’s like that annoying relative who won’t leave your home. Today’s subject is warts and how you can get rid of them.
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What Are Warts?
The medical name for the most common kind of wart betrays the general attitude toward them: it’s called verruca vulgaris. Yes, that is latin and it translates as vulgar wart. Really, warts are just bumps of dead skin tissue covering a center infected by a virus. What’s so terrible about that? I’m not sure, but people don’t like them and so frequently ask me to rid them of this vulgar plague.
What Causes Warts?
Most warts are caused by the human papilloma virus, or HPV, which is highly contagious and transmitted through direct contact with other people with warts, or with things those warty folks have touched. So even though the whole kissing a toad causing a wart is a myth, it is technically possible--if someone rubs their wart on a toad before you kiss it. That doesn’t happen very often, though.
Viruses and Warts
Viruses like HPV are divided up into strains, which are small genetic variants of the same virus. HPV comes in over 150 strains, with certain ones having a predilection for certain parts of the body. A few of the strains infect only the skin in the genital tract. I’ll cover these in another article, but my statement at the beginning about warts not being killers does not apply to genital warts, as they are a direct cause of cervical cancer in women.
Where Can You Get Warts?
Warts occur most commonly in children and young adults, and can be found nearly anywhere on the body, but the hands, feet, knees, and elbows are the places I see them the most. Warts on the bottom of the foot are known as plantar warts. Many folks call them “planter’s warts,” as if you get them from planting things or from peanuts, but that is incorrect. The bottom of the foot is called the plantar surface, hence the name plantar warts. People don’t generally get sick or die from plantar warts, although people with diabetes should always be careful with their feet. The reason these warts are a problem because you have to walk on them, and that hurts.
There is one more wart treatment that has gained notoriety and has caused controversy: duct tape.
For some reason, people who handle poultry and fish (but not toads) and people with weaker immune systems are more likely to get warts. After contact with the virus, the wart won’t show up for 2-6 months, and then it can last for years.
How Can You Get Rid Of Warts?
The majority of warts go away on their own without treatment, but many people still opt to get treated. There are a number of wart treatments that have varying degrees of success. I’ll tell you about the most common ones:
Freezing - Warts can be frozen using liquid nitrogen. That causes local frostbite in the area of the wart, causing direct destruction to the wart as well as alerting the immune system to the presence of HPV in the skin. It may take several rounds of freezing to totally get rid of the wart.
Salicylic acid - This is the liquid preparation you can buy over-the-counter. It works in the same way freezing does, causing chemical destruction as well as recruiting the immune system to get rid of the virus. For both freezing and salicylic acid, first pare away the dead skin on top of the wart to expose the raw skin underneath. You can do this with a file, an emery board, or a pumice stone after taking a shower or bath, which serves to soften the skin.
Immune therapy - Unlike the first two treatments, which can be done at home, immune therapy is done in the office. It’s done by injecting a small amount of an immune-reaction causing substance underneath the wart. This too brings the HPV to the attention of the immune system and is quite effective in getting rid of warts. The most common substance used is an extract from candida, a yeast found on the skin.
More extreme treatments - Dermatologists will use lasers, apply caustic agents, and surgically remove large warts. All of that is safe, but these wart treatments do cause pain and require a period of recovery. With any treatments for warts, you have to ask yourself if the treatment is worse than the disease. People will go to great lengths to get rid of something that causes no harm.
Does Duct Tape Get Rid of Warts?
There is one more wart treatment that has gained notoriety and has caused controversy: duct tape. In 2002, a paper was published that suggested using silver duct tape on warts was actually significantly more effective than freezing them. News of this spread, and soon many were wearing silver shiny patches on their skin. The treatment goes as follows:
Cover the wart with duct tape and leave in place for 6 days.
Remove the tape on the 7th day, soaking the area of the wart and removing dead skin with a pumice stone or emery board.
Leave the duct tape off for the whole 7th day.
Reapply for another 6 days, repeating the cycle until the wart is gone.
This method of wart removal was cheap, easy, and appealed to us men who are genetically predisposed to a belief that duct tape can fix anything. Subsequent studies, however, were not able to verify this effectiveness, and so the validity was called into question (obviously by a bunch of women). Yet there were differences in the duct tape used in the follow-up studies, as the tape used had a different type of adhesive and so may have negated the positive effect.
All in all, the treatment with duct tape is worth trying, although I suggest using a skin-colored tape, or covering the skin with a bandage. By the way, duct tape is also quite useful in dealing with that annoying relative that won’t leave.
No charge for that last tip.
Let me once again remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.
Catch you next time! Stay Healthy!
Girl Kissing Frog, Wart Removal and Duct Tape images from Shutterstock