Warts or verruca vulgaris are one of the most common dermatological complaints. Warts are contagious. They can spread from one part of the body to another, either by touching or shaving. Warts can occur at any age. Children and young adults are more prone to getting warts because they have a weaker immune system.
There are several over-the-counter treatment options such as products that contain salicylic acid or liquid butane. There is no single best treatment for warts. Getting rid of warts takes time and regular use of over-the-counter products for a few weeks. If warts are unsightly or there is no improvement with over-the-counter products, a doctor would be able to treat warts effectively.
People who have diabetes, a weak immune system or other serious medical conditions should consult a doctor for the treatment of warts instead of using over-the-counter products. Women who have genital warts should seek medical attention because it can sometimes be associated with cervical cancer. Those older than 60 years old; who have rapidly growing and spreading warts; or who have warts that have suddenly changed in color, size or characteristics should visit a doctor to rule out the possibility of skin cancer.
What causes warts?
Warts are caused by the human papillomavirus (HPV). HPV strains that cause warts are 31, 33, 45, 58 and few others. HPV strains 6 and 11 cause genital warts that can rarely develop into cancer. HPV strains 16 and 18 are high-risk strains that cause 70 percent of cervical cancers.
HPV enters the skin and multiplies rapidly. Warts spread through direct contact. However, not everyone who will be exposed to HPV will develop warts.
What are the signs and symptoms of warts?
Different types of warts that occur in different parts of the body are caused by human papillomavirus (HPV) and they present differently.
- Common warts: These are small, hard, rough bumps that are round and elevated. They are flesh-colored, pink or white. They commonly appear on the hands and fingers.
- Filiform warts: They are thin and thread-like. They commonly appear on the face and neck.
- Flat warts: These warts appear in groups of up to a several hundred. They are slightly raised and are smooth and rounded. They commonly occur on the face, neck, chest, hands, wrists, forearms and knees.
- Plantar warts: They typically occur on the soles of the feet. They are firm lump with tiny black dots, which are small, clotted blood vessels.
- Periungual warts: They are usually seen at the edges of fingernails and toenails. They are rough, irregular and elevated. They can extend under the nails, causing pain and irregular nail growth.
How are warts treated?
Sometimes, warts don’t need any treatment and may go away by themselves in six months to one to two years. Over-the-counter and medical treatments can help get rid of warts.
Over-the-counter medications are available in liquid, gel, pad or ointment form. If the medication spills onto normal skin, it can result in ulcers, so be very careful. Before applying over-the-counter medication, doctors suggest soaking the wart in warm water for 5 to 10 minutes to help the medication penetrate the skin better. The dead skin can be gently scrubbed with a washcloth or pumice stone to remove the dead skin cells. Getting rid of warts at home takes time. Daily treatment is required for at least several weeks to see results. Some effective over-the-counter medications includes
- Medications that contain salicylic acid: Salicylic acid helps soften, dissolve and exfoliate abnormal skin cells. After applying the medication, the area should be covered with duct tape. This would help the salicylic acid adhere to and better penetrate the skin.
- Freezing spray: Freezing sprays usually contain liquid butane. It can be sprayed directly onto warts to freeze and kill the tissue. The temperature can reach as low as minus 212°F, but it may not freeze the wart deeply enough to be effective. The treatment can be painful. There is a risk of blister formation after using the freezing spray. The area should be kept clean and dry. An antibiotic ointment may be applied after.
If over-the-counter treatment fails, the doctor can remove warts in the following ways
- Freezing with liquid nitrogen
- Burning or cautery with an electric needle or a laser
- Applying acids stronger than over-the-counter ones to help destroy the wart
- Injecting bleomycin into the wart. Bleomycin is a medication that kills viruses, which is an effective treatment used for severe cases.
- Injecting medication to promote the body’s immune system to fight off warts
- Prescription topical medication called imiquimod to help improve the body's ability to fight warts (mainly helpful for genital warts)
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