Warts

Warts are small, rough growths resembling blisters that develop on a person’s skin, most often on the skin of the hands or feet. They are usually harmless, although in some cases there may be mild irritation or pain. However, warts can still be traumatic because of their unpleasant appearance, which can cause a great deal of social embarrassment to the sufferer, especially when they occur on the face or hands.

There are many different types of warts, of which the most common are flat warts, genital warts, plantar warts, periungal warts, and the “common wart”. All of these types of warts are caused by variations of a virus known as the human papilloma virus (HPV).

Symptoms of Warts

As mentioned earlier, warts are often asymptomatic, apart from the appearance of the wart itself. However, these are some of the typical indications of warts:

• Warts are typically smooth, flat protrusions from the surface of the skin. They are typically round or oval in shape. Warts are also usually hard to the touch – unlike a boil, for example, which is soft to the touch.
• In some cases, only a few of these lesions may occur, perhaps even a single one; at other times, there may be numerous lesions.
• The skin around a wart may change color, becoming either lighter or darker than normal.
• Plantar warts appear on the soles of the feet, and these warts are more likely to be painful than any other warts. This is because of the amount of pressure that the feet almost constantly receive. Pressure on a hard growth such as a wart can become painful over time.
• Genital warts appear on the genitals and the surrounding areas, such as the entire groin area, the thighs, and the anal area. Genital warts are also more likely to be accompanied by other symptoms such as itching and vaginal discharge.
• Warts sometimes appear around the fingernails and toenails – these are known as periungal and subungal warts, with the latter appearing under the nails themselves. Subungal warts in particular tend to be accompanied by other symptoms, since they tend to damage the affected nail. These warts can cause the nail to detach from the nail bed, and may also lead to other, secondary infections.

Although warts can usually be identified by their appearance alone, and often by their location as well, in some cases a doctor might need to perform a biopsy in order to rule out other possibilities such as calluses and certain cancers, which sometimes have similar symptoms.

Causes of Warts

An infection of the squamous epithelium by the HPV virus is the basic cause of warts. There are over a hundred different types of human papilloma viruses, each of which typically affects the skin in only a certain part of the body. A particular HPV usually cannot affect another part of the body, which is why these infections are usually localized. There are however a few HPVs that can infect the skin on any part of the body – HPV types 2 and 4, which are two of the HPV types that cause “common warts,” are one such example. Common warts usually appear on the hands, but they are known to appear on almost any other part of the body too.

Remedies for Warts

Warts treatment usually consists of over the counter medications and home remedies. In most cases, surgery and other more invasive procedures are unnecessary. However, it is always advisable to first get your doctor to confirm that the growth that is bothering you is in fact a wart. Once this has been confirmed, you can try one of the following home remedies for warts:

• The most commonly used and most effective treatment for warts is salicylic acid. There are numerous formulations of salicylic acid available over the counter, many of which are made specifically for treating warts. The two main options are salicylic acid pads and salicylic acid solutions. The pads are adhesive pads that need to be applied on the warts daily. The salicylic acid solution is also to be applied daily, followed by the use of a pumice stone to scrape away the dead skin. This can take several months, and in some cases you may need to ask your doctor to prescribe a more concentrated solution.
• Silver nitrate is another common cure for warts, typically available over the counter in the form of a stick known as a caustic pencil. However, if you decide to try this treatment, be extremely diligent about following the instructions provided. As the name “caustic pencil” indicates, silver nitrate can cause irritation and burning. It can also stain the skin. You should be particularly careful about keeping it out of your eyes.
• Salicylic acid and silver nitrate are both harsh substances that are quite obviously not suitable home remedies for warts on the face and the genitals. Such warts should be treated more carefully, with other over the counter medications. Zinc sulfate is one such option, since it can be taken orally. However, stick to the recommended dosage of zinc sulfate, because an excess of zinc is known to cause copper deficiency. If topical medication seems necessary for warts on the face or genitals, it is best to leave treatment to a doctor.
• Cryotherapy devices are sometimes available over the counter, and are another option for treating warts. However, this is a relatively tricky procedure. One difficulty lies in applying the medication to such a small surface area as that of a wart. In addition, if the treatment is not properly applied, the surrounding healthy skin might develop blisters as a result of the extremely low temperatures.
• Duct tape occlusion therapy (DTOT) is another home remedy for warts. This is done by covering a wart with duct tape for a week, then soaking the affected area in water, and finally scraping away the dead skin with a pumice stone or similar implement. The evidence for DTOT is as yet inconclusive, but this treatment does seem to work in many cases. DTOT is one of the most suitable home remedies for warts on the hands, and is not always a viable option for other warts, due to the soaking required, as well as the need to keep the duct tape on for such a long period of time.
• Garlic and onion are sometimes recommended as home remedies for warts, and there is no harm in trying them out. Simply crush a clove of garlic or cut a small onion, and tape it to the wart for a day.
Treating warts can be quite difficult, and if you find that home remedies and over the counter treatments are not working, you should ask your doctor about other options. Your doctor can perform more skilful and effective versions of many of the home remedies described. Keratolysis is one such procedure that can be performed, using agents similar to salicylic acid. Cryosurgery is another option, and is more effective than treatment with over the counter cryotherapy products. Other possible treatments include immunotherapy, laser treatment, and simple surgical removal of the wart.

Diet for Warts

Since warts are the result of localized infections, diet has no real direct effect on them. Some people recommend a raw food diet to treat warts, but there have been no studies to show that this is effective, and there is no scientific reason to believe that this approach will work. At the same time however, you should remember that good health always helps fight any infection, and a healthy diet is a major contributor to good health. A healthy immune system is particularly important when fighting viral infections such as warts. There are no specific foods that will help you fight warts – simply ensure that your diet is balanced and well-rounded, with all the necessary nutrients.

Suggestion for Warts

When treating warts yourself, remember to always maintain strict hygiene. Although HPVs are usually restricted to a single part of the body, some of them can spread. Touching a wart and then touching another part of your body could give rise to new warts. You should also avoid physical contact between other people and the affected part of your body. Transmission of most wart infections is not common, but it can happen and should be avoided. You should be particularly careful about genital warts..

Sometimes, you may simply need to be patient with warts, as they often disappear on their own. If there are no other symptoms and the warts are not particularly unsightly, you may just choose to wait out the infection. If you suffer from pain due to plantar warts, you could simply use wart cushions in your shoes – these are available over the counter – while you wait for the warts to disappear. This however takes a long time to happen – warts may sometimes persist for a year or even two, and will then suddenly disappear without any treatment. If however, the warts start to spread, or if they disappear and then return, you should consult your doctor.

References

1. Thomas KS, Keogh-Brown MR, Chalmers JR, Fordham RJ, Holland RC, Armstrong SJ, Bachmann MO, Howe AH, Rodgers S, Avery AJ, Harvey I, Williams HC. Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model. Health Technol Assess. 2006 Aug;10(25):iii, ix-87. PubMed PMID: 16849001.