The trouble that comes with warts, and how to fix it
By Allen Douma, M.D.
Tribune Media Services
Q. I have warts on my two thumbs and have a terrible time trying to get rid of them. I had surgery on both thumbs six years ago, which was quite painful. But after a year they came back.
I’ve been to a dermatologist many times and had them frozen. I’ve tried all sorts of home remedies but to no avail. Have you heard about a vaccine that can be used to get rid of these terrible warts? — L.R., Minneapolis
A. The human papilloma virus (HPV) is the cause of warts, and most recently these viruses have been shown to be the greatest risk for, if not the cause of, cervical cancer.
Although warts appear most commonly on the hands, they can occur anywhere on the surface of the body. That includes all of the skin and the mucous membranes, which include the labia or lips of the vagina and the area surrounding the anus.
The virus is passed from one person to another by direct contact. Although genital warts are more likely to be passed through direct genital contact, transmission is possible without it. Newborns can pick up the virus from contact during birth and develop warts inside the throat.
The time from contact to the appearance of the wart, called the incubation period, can be anywhere from two to 18 months. Over half the time warts will go away without any medical treatment. Perhaps that’s why some home remedies seem to work.
It’s not known what percentage of people will harbor the human papilloma virus after their warts have gone away. But a high percentage of people will have the warts come back, indicating that they may not have gotten rid of the warts in the first place. Some people will have multiple episodes of warts.
Most of the time a wart will not cause any symptoms. But if located on the bottom of the foot, called plantar warts, they can cause pain. Genital warts will often itch. Also, warts found in the end of the urinary tract and in the nasal passages may cause an obstruction.
Although warts usually have a distinctive appearance, they can be confused with large aging spots on the skin called keratoses and even with skin cancer.
Because none of the treatments for warts guarantee a cure, and because no one approach has been shown to be vastly superior to the others, there are many ways to treat warts.
Warts may be removed by using liquid nitrogen, lasers or surgical removal. A recent study has also shown that applying duct tape on a daily basis is an effective way to treat warts.
Applying salicylic acid, podophyllum, or imiquimod, or even soaking them in hot water for 20 minutes daily for six weeks have been shown to be helpful. Oral retinoids or cimetidine has helped some people.
Because there are so many approaches to choose from and because over half of all warts will go away on their own, it’s especially important to discuss the risks, benefits and costs of any recommended treatment.
Recently a vaccine has been developed for the human papilloma virus, and preliminary tests have shown promising results. Hopefully this vaccine will be available soon to prevent genital warts as well as cervical cancer.
UPDATE ON STATINS: Statin drugs are some of the most widely used drugs, but some experts estimate that a only about one-third of people who could benefit are taking them. And a major reason is the cost and inconvenience due to their status as prescription drugs.
So a recent approval in England to allow one of the statins (simvastatin) to be sold over the counter (OTC) is beginning to create a lot of discussion. Since the chance of a side effect occurring with a statin is less than 1 in 1000, many suggest that OTC status makes sense.
