A
wart is generally a small, rough tumor, typically on hands and feet, that
resembles a cauliflower. Warts are common, and are caused by a viral infection,
specifically by the human papillomavirus (HPV). They typically disappear after a
few months but can last for years and can recur. A few papillomaviruses are known
to cause cancer. Certain types of warts, depending on location and cause, can be
contagious from region to region, but are not transferable between species.
Types of Wart
A range of different types of wart have been identified, which differ in shape
and site affected, as well as the type of human papillomavirus involved. These
include:
- common wart (verruca vulgaris): a raised wart with roughened surface, most
common on hands and knees
flat wart (verruca plana): a small, smooth flattened wart, tan or flesh
colored, which can occur in large numbers; most common on the face, neck,
hands, wrists and knees.
- filiform or digitate wart: a thread- or finger-like wart, most common on
the face, especially near the eyelids and lips.
- plantar wart (verruca, verruca pedis): a hard sometimes painful lump,
often with multiple black specks in the centre; usually only found on pressure
points on the soles of the feet.
- mosaic wart: a group of tightly clustered plantar-type warts, commonly on
the hands or soles of the feet.
- genital wart (venereal wart, condyloma acuminatum, verruca acuminata):
wart affecting the genital areas.
Treatment
Prescription
Treatments that may be prescribed by a medical professional include:
- Keratolysis, removal of dead surface skin cells usually using salicylic
acid, blistering agents, immune system modifiers, or formaldehyde.
- Cryosurgery, which involves freezing the wart, after which the wart and
surrounding dead skin falls off by itself. Surgical removal of the wart is
sometimes also performed.
- Laser treatment.
- Imiquimod, a topical cream that helps the body's immune system fight the
wart virus by encouraging interferon production.
- Candida injections at the site of the wart, which also stimulate the
body's immune system.
- Cantharidin, a chemical found naturally in many members of the beetle
family Meloidae which causes dermal blistering.
None of these treatments are very effective on single uses; the wart often
returns after the skin has healed from the treatment, but repeated treatment
should get rid of the wart permanently. As they disappear after a few months and
maximally a few years, treatment is necessary only if the lesions are painful or
are a cosmetic problem.
One review of 52 clinical trials of various cutaneous wart treatments concluded
that topical treatments containing salicylic acid were the best supported, with
an average cure rate of 75% observed with salicylic acid compared with 48% for
placebo in six placebo-controlled trials including a total of 376 participants.
The reviewers also concluded that there was little evidence of a significant
benefit of cryotherapy over placebo or no treatment.
Over-the-Counter
There are also several over-the-counter options. The most common ones involve
salicylic acid. These products are readily available at most drugstores and
supermarkets. There are typically two types of products: adhesive pads treated
with salicylic acid, or a bottle of concentrated salicylic acid. Removing a wart
with this method requires a strict regimen of cleaning the area, applying the
salicylic acid, and removing the dead skin with a pumice stone or emery board.
It may take up to 12 weeks to remove a stubborn wart.
Another over-the-counter product that can aid in wart removal is silver nitrate
in the form of a caustic pencil, which is also available at drug stores. This
method generally takes three to six daily treatments to be effective. The
instructions must be followed to minimize staining of skin and clothing.
Over-the-counter cryosurgery kits are also available, however they can often
cost 3 times as much as the previously named products.
Like prescription treatments, over-the-counter treatments usually require
multiple applications, and are only necessary if the warts are problematic.
Additionally, these treatments are capable of destroying healthy skin as well as
warts, so caution must be exercised by those attempting them without medical
supervision.
Household Remedies
Duct tape occlusion therapy involves placing a piece of duct tape (or medical
tape) over the affected area for a week at a time. The procedure is otherwise
identical to that of using salicylic acid adhesive pads. One study found that
the duct tape method was 85% effective, compared to a 60% success rate in the
study's cryotherapy group. Another study, however, found no statistically
significant effect.
Other household remedies include the application of common household items, such
as bruised garlic (held in place with a bandage or duct tape), banana skin,
vinegar, hot water and washing liquid, aerosol sprays, tea tree oil and other
natural oils, un-skinned potatoes, potato or cauliflower juice, salt, or
vegemite to the affected area. Milkweed or dandelion sap is also used. Accounts
vary in regards to how long they must be applied in each session and how long
they take to work.
Without controlled studies for most household remedies, it is difficult to know
whether the warts disappear because the remedies work, or if they disappear due
to the individual's own immune system response to the virus (possibly augmented
by a placebo effect). The success of hypnosis in curing warts[6] at least
suggests that the condition may be cured by belief in a remedy, the placebo
effect or other psychological means.
Some household remedies are potentially dangerous. These include attempts to cut
or burn away the warts. Incense is sometimes used in Asian countries to burn
warts. These methods are very painful, and can lead to infection and/or
permanent scarring.
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