3 treatment options help to remove warts
Q: I have ugly warts on my hands. I've heard that if I wait it out, they may go away. But I hate looking at them and would like to treat them now. What are my options?
A: Warts are generally harmless. They do usually disappear on their own over time. But, as you point out, they can be unattractive. And some, like those found on the soles of the feet, can make walking and exercise painful.
Although your warts will probably go away without treatment, that can take many months, so it's reasonable for you to try to speed up the process. Unfortunately, getting rid of warts can be a challenge. But fortunately, the most effective treatments are the least invasive.
Warts crop up when your skin cells grow faster than normal due to a human papillomavirus (HPV) infection. Among the 150 strains of HPV, about 10 cause skin warts, including those classified as common, plantar and flat warts.
Some sexually transmitted types of HPV are implicated in cervical and other genital and anal cancers, but the strains that cause skin warts are not linked to cancer.
All of us come into contact with HPV repeatedly - when we shake hands or touch a doorknob, for example - but only some of us develop warts, and that's hard to explain. Children and people with immune system abnormalities are particularly vulnerable. For unclear reasons, so are people who work as meat, fish and poultry handlers. But the most likely explanation is that some people are simply more prone to warts than others.
Skin warts aren't very contagious. They can spread from person to person by direct contact, mainly through breaks in the skin. Theoretically, you can also pick up warts from surfaces such as locker room floors or showers, but there's no way to know how often this occurs.
Warts on one part of your body can be spread to other areas, so it's important to wash your hands and anything that touches your warts, such as nail files or pumice stones.
About half of all warts go away on their own within a year, and two-thirds within two years. So "watchful waiting" is definitely an option for new warts. If you'd prefer not to wait it out, you have several treatment options, including these, considered to be the top three:
SALICYLIC ACID. This is similar to the ingredient in aspirin, and it should usually be your first choice. Salicylic acid costs little, has minimal side effects, and comes in various over-the-counter preparations, including liquids, gels and patches. To treat a wart, soak it for 10 to 15 minutes (you can do this in the shower or bath). Then file away the dead warty skin with an emery board or pumice stone, and apply the salicylic acid. Do this once or twice a day for 12 weeks. Warts in thick skin, like the bottom of the foot, may respond best to a salicylic acid patch that stays in place for several days. Continuing treatment for a week or two after the wart goes away may help prevent recurrence.
FREEZING. In this treatment, also called cryotherapy, a clinician swabs or sprays liquid nitrogen onto the wart and a small surrounding area. The extreme cold (which may be as low as minus-321 degrees F) burns the skin, causing pain, redness and usually a blister. Getting rid of the wart this way usually takes three or four treatments, one every two to three weeks. After the skin has healed, apply salicylic acid to encourage more skin to peel off.
DUCT TAPE. Duct tape does appear to work for treating warts. One research study compared duct tape with cryotherapy. Subjects wore duct tape patches over their warts for six days. Then they removed the patches, soaked and filed the warts, left them uncovered overnight, and reapplied the tape in the morning, leaving them in place for another six days. They repeated this process for two months. The study found duct tape was about 45 percent more effective than cryotherapy. This study used silver duct tape - clear duct tape does not appear to have the same effect.
Why duct tape works isn't known. It may deprive the wart of oxygen, or perhaps dead skin and viral particles are removed along with the tape. Some people apply salicylic acid before covering the wart with duct tape.
Some skin cancers resemble warts at first. If you have a wart that doesn't change much in size, color or shape, you probably don't need to see a clinician. But if you're in your 50s and develop new warts, consult a dermatologist. Be suspicious of any wart that bleeds or grows quickly.
When compared with other health problems, warts are bit players. But since they can be unsightly and sometimes uncomfortable or even painful, we understand why you're worried about warts.
Submit questions to harvard_adviser@hms.harvard.edu.