Warts - Everything you ever wanted to know...

What are warts?
Warts are benign skin growths caused by a microscopic DNA virus called human papillomavirus. The virus gains access to me body through tiny cracks in the skin on mucous membranes. It "sets up house" in this warm moist environment and shelters itself from the immune system by forming layers of skin around itself. These callus-like growths can appear anywhere on the skin. They axe always benign, and do not cause any serious disease! They are a cosmetic nuisance! Plantar warts, large flat warts on the sole of the foot, cause pain due to pressure against adjacent nerves.

Are warts contagious?
Most warts are contracted by direct exposure to the virus through the skin. Plantar warts are commonly acquired by walking barefoot in locker rooms, gymnasiums, pool areas, etc. They are mildly contagious and have an incubation period that ranges from 1-8 months. Animals do not spread warts to people (but you probably still don't want to kiss any frogs). Children and adolescents have the highest incidence of warts. Warts spread from one area of the skin to another without any apparent protection from our immune system. Often one wart will produce many smaller warts around it, all seeming to mesh into one large mosaic wart.

How can you tell a wart from a callus?
Warts on the palms and soles are indeed difficult to distinguish from calluses! If you take an emery board or pumice stone and file down through the thickened skin layers, warts often have tiny black dots inside them. These are remnants of the fine blood vessels that give the wart its nutrients.

Do you have to treat a wart?
The vast majority of warts in children will resolve without treatment in less than two years. Simply applying a band-aid over a wart for several weeks will often eradicate it. However, warts tend to spread, and may produce several more before the first one resolves.

How do you treat warts?
For many centuries doctors have treated waits with a variety of agents. Some warts spontaneously resolve after applying a bandage daily for weeks at a time. Electrosurgery, also known as 'burning them off' was popular and effective, but can cause infection and may leave scarring. The use of salicylic acid, such products as Compound W, Occlusal, or Duofilm, is effective if applied for many weeks. Stronger agents such as cantharidin or dichioroacetic acid are even more effective, but must be applied by a physician trained in their use. Liquid nitrogen therapy, also known as "freezing", is simple, quick and effective, but more painful. If all else fails, the wart can always be completely cut out or excised, but this is invasive and will scar. No one method works well with all warts and because they are caused by viruses, not bacteria, there are no antibiotics to just make them go away. Unfortunately, warts can recur after any type of removal.

What side effects may occur after treatment?
The application of an acid or liquid nitrogen may cause stinging to the healthy skin surrounding the wart. If this happens, put an ice pack against the band-aid until the area is numb. You may need to put the ice on and off the area several times until the pain is gone. If this is not effective, and the pain is severe, remove the band-aid and wash off all the acid using plenty of water. Some warts develop a blood blister, a large purple swelling over the wart, after a treatment. This is due to an aggressive response to the treatment and usually kills the wart. Do not try to open a blood blister, as it will be a source of infection. Allow the blister to dry and peel on its own. If the wart peels off after a treatment, there may be raw tissue exposed. Keep this area clean and covered with an antibiotic ointment such as Neosporin or Bacitracin. Be aware that partially treating a wart will cause it to grow, and it may become much larger than it was before treatment!