Paging Dr. Frischer - Warts

You just finished a wonderful, relaxing bath, and while drying off you notice a new rough-appearing growth on your skin. It's quite possible that this new intruder is a wart. No…you didn't kiss a frog. But where did it come from, and how do you get rid of it?Warts are caused by a virus, and just like the common cold virus, a wart is contagious. The virus enters the body by direct exposure to another wart, through small breaks in the skin. There are about 130 strains of the human papilloma virus (HPV), which produce 10 different types of warts. The most common type of wart is considered the most harmless. Some of the other strains of HPV are associated with cervical, vulvar, penile and oral cancers (for example, strains 16 and 18 cause 70% of the cases of cervical cancer). The typical wart is a raised, round or oval growth on the skin with a rough surface, and its color may be light, dark, or black. A common wart tends to cause no discomfort unless it is in an area that is subject to friction or pressure. Plantar warts, for example, can become extremely painful because they are located on the bottom of the foot, and can cause difficulty with walking or running. Some warts simply disappear without treatment, although it may take months or years. However, since the virus can still reside within the body, a wart may reappear in the same spot or even spread to new areas of skin that are exposed to the virus from one part of the body to another. Typically, the diagnosis is made simply by inspection of the skin, noting the location and appearance of the lesion. A biopsy is not usually necessary, but can be done to diagnose or confirm the initial finding. There are a variety of treatments for warts. Topical treatments containing salicylic acid have the most support in the literature, and a cure rate of roughly 75%. These can be purchased over-the-counter in a variety of brands, and come in the form of adhesive pads or a bottle of concentrated solution. (Salicylic acid is also a common, effective, and safe acne treatment.) An alternative treatment, perhaps less effective, is silver nitrate, sold over-the-counter in the form of a caustic pencil. Therapies performed by a doctor include removal by freezing (cryotherapy) or electrical current (electrodessication); surgical removal; laser treatment; and immunotherapy, where a substance is injected that results in a local allergic reaction. Some consider another treatment: duct tape! Duct tape occlusion therapy (DTOT) endorses placing a piece of duct tape over the wart for six days, followed by soaking the area in water and scraping it with a pumice stone or emery board. Study results are quite mixed, with some concluding that duct tape therapy is not much better than placebo. The common wart is indeed annoying, but it has no long-term health impact other than appearance and being contagious. As noted above, however, some of the other strains of HPV can lead to cancer, and prevention is critical. For example, Gardasil is a fairly recent vaccine, recommended to young women for the prevention of some strains of cervical cancer. (It has no impact on other strains of HPV, however, including warts.) Speak with your doctor about whether this vaccine is appropriate for you or a love one. Treat your common wart early, before it grows or spreads. Good health to you all! Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: June 9, 2011 - Volume 10 - Issue 8