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By Charles E. Crutchfield III, MD 

 

Warts are rough surface bumps that can occur mainly on the hands and feet but may occur anywhere on the body. Warts can be very tender, painful, can get infected, and are transmissible. Some warts can be associated with a certain type of reproductive cancer. Because this is an infectious disease with other healthcare ramifications, most warts should be treated. Discuss treatment options with your doctor.

 

What causes warts?

Warts are caused by the human papilloma virus. There are over 100 subtypes of the human papilloma virus. Some subtypes, such as those that cause genital and cervical warts, can be associated with a higher rate of cancerous transformation. Warts are an infection spread by contact with the wart or surfaces harboring the virus (shower floors, for example).

 

How common are warts?

Warts are exceedingly common. There are at least seven types of warts including common warts, flat warts, plantar (foot) warts, mosaic warts (large clusters), periungual warts, and genital warts.

 

How are warts diagnosed?

Warts can be diagnosed by their rough surface and small tiny black dots within them, which represent tiny blood vessels with clots. Warts can also be diagnosed via biopsy.

 

Can warts be prevented?

Warts can be prevented. Warts are transmitted by contact, especially in the areas of small cracks in the skin. Wear foot protection like flip-flops around common showering areas. Treat the warts on your hands to prevent their spread when touching others. There’s also a new vaccine for the prevention of warts associated with cervical cancer.

 

How are warts treated?

Warts are notoriously difficult to treat. In order to treat warts, doctors must recruit your own immune system to do a better job at detecting cells infected with the wart virus. There is nothing a doctor can directly do to get rid of warts. The key is to irritate the area where the warts are so the viral proteins are exposed, and the patient’s immune system can do a better job recognizing and attacking infected cells.

In fact, a significant amount of normal skin around a wart has the viral infection present. The key is to expose the viral proteins to stimulate the immune system. This can be done by freezing, lasers, immune stimulators, or topical preparations.

The list of things to treat warts is a mile long, and that means nothing works exceptionally well. In our clinic, we use a combination of salicylic acid in a special cream with laser and/or freezing treatments.

 

Action steps 

Always wear foot protection in common showering areas and athletic venues.

Treat your hand warts so they don’t spread to other people when touching.

If you are a woman, discuss with your physician the appropriateness of the HPV vaccine.

Try over-the-counter remedies first — many can be successful. Ask your pharmacist for help.

If warts are not responding or spreading, consult your physician.

 

Remember, warts are very difficult to treat. Treatment success is dependent on your immune system waking up and getting rid of the infected cells. Sometimes patience, discomfort and several treatments are necessary for success.

 

Charles E. Crutchfield III, MD, is a practicing dermatologist in the Minneapolis/St. Paul area (Crutchfield Dermatology). He is a graduate of the Mayo Clinic Graduate School of Medicine and is a professor of dermatology at the University of Minnesota Medical School. 

 

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