Wart Treatment

Dr. Greene’s Answer:

Under a magnifying glass the roughened surface of a wart often looks like a tiny cauliflower. The little black dots sometimes seen are the ends of blood vessels that the wart has recruited to bring it food. Contrary to well-established belief, the underside of a wart is smooth and round, and the entire wart is confined to the epidermis — the outermost layer of the skin. There are no ‘roots’!

Even without roots, warts can be difficult to destroy.

Warts are infections caused by viruses that are present everywhere, making them among the most common of all childhood skin conditions. The culprit will be one of more than 70 types of human papillomaviruses (HPV). They are contagious, and they are spread when the virus touches a part of the skin where the outer protective layer is broken, either by minor trauma or by moisture. This happens most commonly on the fingers, elbows, knees, and the bottoms of the feet. Warts on the bottom of the feet are called plantar warts – named for the plantar surface (sole) of the foot.

Some people get warts more easily than other people. Warts are more common in children than in adults, partly because of their less mature immune systems and partly because they spend more time in wet-floored locker rooms and in active, close play. Wearing something on the feet in locker rooms and at the pool can prevent many plantar warts.

Most warts will eventually go away on their own, expelled by the body’s immune system. About 25% are gone within 3-6 months and 65% disappear within 2 years. Unfortunately, some warts may persist for years. Warts will not leaves scars, though some of the more aggressive wart therapies might.

Plantar warts often make running, jumping, and even walking, uncomfortable. The tenderness can change posture and cause strain elsewhere in the body. A little wart can be a big problem. Sometimes filing with an emory board and/or wearing a doughnut bandage can alleviate the discomfort. The warts are usually most tender when they are growing most rapidly. Often, the pain will disappear within a few days even if nothing is done. Warts should be treated if they are spreading, unsightly, or continue to be painful.

Treatments abound, varying from as gentle and simple as taping a patch of banana peel on before bed, to as high-tech and powerful as superpulsed carbon-dioxide-laser vaporization.

The active ingredient in most over-the-counter remedies is salicylic acid, a natural substance found in many plants (willow bark) and most fruits. It can be applied either as a liquid or a patch (I prefer the patch). With regular application, many warts will disappear within 12 weeks. These topical treatments often work best if the surface of the wart is disrupted with warm soaks and/or an emory board before application.

If you are not certain that your child has a wart, you may want to have your child’s doctor examine his or her skin before trying an over-the-counter treatment, since some other skin conditions can look similar but need different treatments.

Physicians use many options to treat warts (surgery, lasers, chemical cautery, electrodesiccation, lasers, and even chemotherapy) but freezing is the most common, especially for smaller warts. Gentle freezing repeated every week or two — usually at least 4 times — is the more effective than a single aggressive attempt to freeze. This approach is less painful and much less likely to scar.

Even though these techniques destroy the bulk of the wart viruses, direct destruction is only a part of the story. This can be seen by how poorly they work in people who have immune deficiencies. In the final analysis, it’s our own immune systems that are activated and engage to eliminate the warts. Several newer treatments aim to boost the body’s own immune response, including Imiquimod cream, alpha interferon injections, or oral cimetidine.

Hypnosis has also been tried as a means of activating the immune system. When studied scientifically, hypnotic suggestion has proven to be as powerful as many conventional medical treatments at getting rid of warts. ‘Charming warts’ is particularly effective with children, and is discussed in leading medical textbooks (including the classic Color Textbook of Pediatric Dermatology by Weston, Lane, and Morelli), since many warts regress without therapy. I’ve had success with dabbing warts with paint and letting children watch them glow under a black light! For added impact, I’ve sometimes pressed a painted wart onto a piece of filter paper to make a spot, and then burned the paper. I tell the child it will fall off in two weeks – and it does!

Mark Twain’s quaint solution, then, is consistent with the latest medical science:

“Why, you take your cat and go and get in the graveyard ‘long about midnight when somebody that was wicked has been buried; and when it’s midnight a devil will come, or maybe two or three, but you can’t see ’em, you can only hear something like the wind, or maybe hear ’em talk; and when they’re taking that feller away, you heave your cat after ’em and say, ‘Devil follow corpse, cat follow devil, warts follow cat, I’m done with ye!’ That’ll fetch ANY “wart.”

February 3, 2008

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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  1. Anne

    I have had flat warts on my right hand for about 4 years now. I have tried so many different therapies, such as freezing, burning with acid, and using efudex cream twice a day. The freezing and burning left scars on my hands that isn’t pretty. I am still using the efudex on my warts but am not seeing the best results. Only in one area are the warts starting to look like they are peeling (not sure if it’s from the cream or dry skin). These warts have caused me so much embarrassment throughout the years, and I would greatly appreciate some help!!

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    • Jennifer

      Hi! I had plantar watts for almost 15 years! I tried all methods of treatment. I found that when I started taking a fish oil supplement and eating more whole food nutrition, they went away. They used to come back in weeks or months but these have been gone almost 5 years now! I still have the scars from surgery but it warts! I really believe it is an immune system issue. My son just had 1 pop up on the back of his heel and he’s had a recent series of strep infections so I know his immune system is overworked. I’m starting him on fish oil soon!

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  2. Amber

    I have had a wart for about a month on my foot and it’s causing extreme pain. It causes me to barley walk. I have treated it since I’ve had it and it’s still there.. What do I do?

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  3. Heather

    My daughter has a type of wart on her big toe. It looks like a little cauliflower has grown engulfing most of the tip of her big toe, even growing under her toenail? I need help because she is only 11 and struggles with the look of it. What can I do? Please help.

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    • This would be a good time to take her to a doctor for treatment.

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  4. Vanga RatnaKumar

    It is obvious that somebody can mistake between corns or calluses with warts and vice versa. Sometimes it is also possible that some serious skin problem like certain types of cancerous or malignant tissue growth on the foot are mistakenly identified as plantar warts.

    Thanks for informative post

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  5. Bev

    What about getting rid of papilloma warts on the eyelid?

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  6. Sweettea

    Im not sure if this just worked for me or can even work for others. I am 53 years old, a female from NY state.
    When I was a child growing up in the mountains, I ran around most of the spring, summer and fall with bare feet. At about age 8 I noticed a wart on the bottom of my left foot and showed it to my mother. My mom told me it was a plantars wart and that if it doesnt go away within a short time she would take me to the doctor.
    Im a bit obsessive about things on my skin so I started picking at the wart, noticing it had roots and little black spots. A week or so went by and I was nearly crazy with this thing on me so I grabbed a sewing needle and started jabbing at the wart.. it didnt hurt but there were sensitive areas and the wart bled a drop or two.. I threaded the needle and began pulling the thread through the wart. A week later the wart was gone. Completely with no evidence of it ever having been there. I never got another wart in my life. Through the years I did the same with my children (let them have at it) with the same procedure.
    I suspect that I alerted my immune system to the virus and my own body has protected me from other exposures my entire life.

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  7. Rob

    I hate plantar warts! What worked amazingly well for me after struggling for two years trying to treat a stubborn plantar wart was duct tape covering the wart 24/7 to suffocate it, epsoms salt soaks daily to soften up the head and finaly after a week or two of that salicylic acid pads (Dr. scholl’s corn pads for example). In less than a month it was gone, hasn’t come back and there is no sign of a scar whatsoever.

    I created a blogger page to document the treatments I had tried. It has before and after photos and much more detail on this three pronged method.

    Give it a read through to help! http://stubbornwart.blogspot.com/

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