warts - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about warts or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Warts are benign tumors that can occur anywhere on the body but are most commonly found on hands and feet. The most common type of wart is asymptomatic; it is skin-colored and has a slightly raised rippled surface. Plantar warts on the soles of the feet often cause pain if they are near pressure points. If many plantar warts grow together, they are referred to as mosaic warts. Warts on the face tend to appear flat but may easily spread through shaving or waxing. Genital warts are skin-colored or brown and pose a significant health problem as some of the subtypes cause cervical cancer. Almost all warts are caused by the human papillomavirus (HPV), with many different subtypes being responsible for warts forming in various areas of the body. An individual can acquire warts from any object that harbors the virus such as dirty towels or shoes, but commonly people infect others through touch.
In most instances, the diagnosis is made through recognition of characteristic features on physical examination. Rarely, a biopsy is needed especially if a cancerous transformation is suspected.
Asymptomatic warts in non-genital areas do not need to be treated as the body will resolve them within 2-5 years. When warts are painful, bleeding, or even spreading, treatment is recommended. Unfortunately, there is no iron-clad treatment known to eradicate the human papillomavirus. Younger warts seem to respond to treatment faster than long-standing warts.
Most methodologies aim at triggering the body to recognize the root virus as a foreign object and resolve it with its own immune response. Treatment can be performed at home with keratolytic agents such as daily application of salicylic acid solution or tape, as well as duct tape. In addition, there are immune-system stimulating agents such as imiquimod or toxic agents such as podophyllin or glutaraldehyde.
If at-home treatments are ineffective, in-office treatments can booster the effects. They include monthly application of liquid nitrogen, podophyllin, cantharidin, trichloracetic acid, or pulsed dye laser. Rarely, chemotherapeutic or immune modifying substances are injected into the wart, or sensitization with DNCB or squaric acid is performed. Simple excision is as ineffective as any of the other methods yet may leave the virus behind in a scar, complicating treatment further. Therefore it has largely been abandoned for warts on hands and feet.
Fortunately, warts are fairly inconspicuous and most people will not notice them even while in public. Warts on the feet are usually concealed by shoes and even warts on the hand are not large enough to draw attention. Seeking immediate treatment can eliminate the wart in as little as two weeks. Genital warts often pose a strain on any relationship. Recurrences of warts are common as the human papillomavirus is not always eliminated at the time of clinical resolution of warts.
Since the wart is caused by a virus, eliminating sources will prevent contracting the disease. Also, if a wart is spotted, avoid frequent touching or picking because the virus can shed from the skin and then pass to surrounding skin or other people. Open wounds and moist skin promote the contraction of the virus. So bandage all wounds and avoid wearing wet socks. Since the virus is most commonly transmitted from person to person, wearing sandals in public locker rooms decreases the risk of contracting plantar warts. Condoms should be used if genital warts are present.