How to Remove Warts

 

 Warts are unsightly and vexing, and they never seem to go away quickly enough. Treatment may hasten their departure.

Warts are generally harmless and often go away on their own, but they're unsightly, and some, such as those found on the soles of the feet, can make walking and exercise painful. Wart removal can be difficult, but the most effective treatments are the least invasive.

Warts develop in the epidermis, the top layer of skin. The surface of a typical wart is raised and rough. (Some may be smooth and flat, such as those on the face.) A wart's centre may be flecked with dark dots, which are capillaries that supply it with blood.

What exactly are warts?

Warts form when skin cells grow faster than usual due to infection with the human papillomavirus (HPV). Approximately 10 of the 150 HPV strains cause cutaneous (skin) warts, including common, plantar, and flat warts (see "Common types of skin warts," below). Other strains are responsible for anal and genital warts. Some sexually transmitted HPV strains have been linked to cervical and other genital cancers, but skin wart strains have rarely been linked to cancer.

We all come into contact with HPV on a regular basis — for example, when we shake hands or touch a doorknob — but only some of us develop warts, which is difficult to explain. Children and people with immune system deficiencies are especially vulnerable. For example,  People in certain occupations, such as meat, fish, and poultry handlers, are also affected for unknown reasons. The most likely explanation, however, is that some people are simply more susceptible to warts than others. Skin warts are not contagious. They can be passed from person to person through direct contact, primarily through skin breaks. In theory, you can get warts from surfaces like locker room floors or showers, but there's no way of knowing how common this is. Warts on one part of the body can spread to other parts, so wash your hands and anything that comes into contact with your warts, such as nail files or pumice stones.

What exactly are warts?

Warts form when skin cells grow faster than usual due to infection with the human papillomavirus (HPV). Approximately 10 of the 150 HPV strains cause cutaneous (skin) warts, including common, plantar, and flat warts (see "Common types of skin warts," below). Other strains are responsible for anal and genital warts. Some sexually transmitted HPV strains have been linked to cervical and other genital cancers, but skin wart strains have rarely been linked to cancer.

We all come into contact with HPV on a regular basis — for example, when we shake hands or touch a doorknob — but only some of us develop warts, which is difficult to explain. Children and people with immune system deficiencies are especially vulnerable.

1. The acid salicylic. Aspirin's main ingredient, and it should always be your first choice. Salicylic acid is the only topical treatment (treatment applied directly to the skin) that clearly outperforms a placebo, according to one study. (The study, published in the British Journal of Dermatology in August 2011, combined and reanalyzed data from several previous studies.) Salicylic acid is inexpensive, has few side effects, and is available in a variety of over-the-counter preparations such as liquids, gels, and patches. Concentrations range between 17% and 40%. (stronger concentrations should be used only for warts on thicker skin). Soak the wart for 10 to 15 minutes (in the shower or bath), then file away the dead warty skin with an emery board or pumice stone and apply the salicylic acid. For 12 weeks, do this once or twice a day. Warts on thick skin, such as the bottom of the foot, may respond best to a patch that is applied for several days. Continuing treatment for a week or two after the wart has disappeared may aid in preventing recurrence.
   
   2. Freezing. A clinician swabs or sprays liquid nitrogen onto the wart and a small surrounding area in this treatment, also known as cryotherapy. The extreme cold (which can reach -321 F) burns the skin, causing pain, redness, and, in most cases, a blister. This method usually requires three or four treatments, one every two to three weeks; any more than that is unlikely to help. Apply salicylic acid after the skin has healed to encourage more skin to peel off. Individual trials have found that salicylic acid and cryotherapy are equally effective, with cure rates ranging from 50% to 70%, but there is some evidence that cryotherapy is especially effective for hand warts.

2. Duct tape. Although findings have been mixed, anecdotal evidence suggests that this low-risk, low-tech approach may be worth a try. In one study comparing 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 followed this regimen for two months or until the wart disappeared. In this study, duct tape was about 45% more effective than cryotherapy. Two other studies found no benefit, but those studies used clear duct tape rather than the standard silver type, which is stickier and has a different kind of adhesive. Given this limited evidence, if you plan to try duct tape, it makes sense to use the silver kind. Why duct tape works isn't clear — 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.
   Using duct tape. Despite mixed results, anecdotal evidence suggests that this low-risk, low-tech approach is worth a shot. In one study, subjects wore duct tape patches over their warts for six days to compare it to cryotherapy.Given the limited evidence, it makes sense to use silver duct tape if you intend to experiment with it. It's unclear why duct tape works — it could deprive the wart of oxygen, or it could remove dead skin and viral particles along with the tape. Some people apply salicylic acid to the wart before covering it with duct tape.
   
   
   

3. Agents from other agencies Prescription drugs may be used to treat warts that do not respond to standard therapies. Skin warts can be treated with the topical immunotherapy drug imiquimod (Aldara), which is commonly used to treat genital warts. Imiquimod is thought to work by inducing an allergic reaction and irritation at the wart's site. Intralesional immunotherapy involves injecting a skin-test antigen (such as mumps or Candida) into a wart in people who have shown an immune response to the antigen. Other chemotherapy drugs that may be used to treat recalcitrant warts include fluorouracil (5-FU), which is applied as a cream, and bleomycin, which is injected into the wart. All of these treatments have side effects, and there is no evidence that they work.

4. Cutting and zapping Electrodesiccation (or cautery) and curettage are the technical terms for this treatment. Using local anaesthesia, the clinician dries the wart with an electric needle and scrapes it away with a curette, which is a scoop-like instrument. This usually results in scarring (so does removing the wart with a scalpel, another option). It is typically used to treat warts that have not responded to other treatments and should be avoided on the soles of the feet.

When should you see your doctor?

Some skin cancers initially resemble warts. You probably don't need to see a clinician if your wart doesn't change much in size, colour, or shape. However, if you are in your 50s and develop new warts, see a dermatologist. Be wary of any wart that bleeds or grows rapidly.

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