Ugh…is that a Wart? Notes from a San Francisco Bay Area Dermatologist

What’s the deal with warts?  How did I get them and how do I get rid of them?

Questions that I often hear as a dermatologist about one of the most common skin nuisances.

To help keep from catching them or spreading them to others or to other places on your own skin, its important to know the basics.

Common warts seen on the hands and fingers are caused by certain strains of the human papillomavirus (HPV).   These strains are different from the ones that cause potentially serious diseases like cancer of the cervix.  In fact, different strains of HPV even cause different kinds of warts like plantar warts on the feet or smaller, flat warts seen on the face and legs.  With common warts, the virus causes rapid growth of cells on the outer layer of the skin resulting in flesh colored bumps with small black dots in them, which are actually clotted blood vessels.  Warts can eventually go away on their own (sometimes over a 2 year period), but to keep them from spreading, most people try to remove them with over the counter measures or with their doctor.  Warts are harmless, but people find them embarrassing and cosmetically annoying.

Like most viruses, warts spread through person to person contact or by person to object contact (like if you touch something a person with a wart has touched).  A wart may not actually develop until 2 to 6 months after exposure.  Depending on your immune system, you may be exposed to the virus, yet never develop a wart or you may have them as a kid and never develop them again as an adult.  I often joke with my patients that having a wart as adult is a sign of youth, as they are seen most often in children and young adults.  If you already have warts, keep in mind that they can spread through breaks in your skin, so don’t bite your nails or pick around your cuticles, especially after touching the wart!

At home treatments usually include salicylic acid medications or patches, which help peel away the affected layers of skin.  These work best if you can file down the top layers, then apply the medication.  I will often give patients a scalpel to help pare down the skin before using the patches to treat the wart in between visits.  Another at home treatment some patients try is duct tape.  They cover the wart for six days then remove the tape and file down the skin, then repeat the process until the wart dies.  While there is no real scientific evidence that duct tape works, some people give it a whirl.

At a doctor or dermatologist’s office, they may try freezing the wart with liquid nitrogen, which can be uncomfortable.  It causes a blister and the dead cells slough off after it has healed.  Injections of an antigen to stimulate your body’s natural immune process or laser may also be used for more stubborn warts.

If you have a wart, do not pick at it, bite it or shave over it as it may generate new warts nearby.  Do not use any accessory, like a nail file, on the wart and then on other areas.  Make sure to always wash your hands in general and especially after touching any wart.  Keep your hands as dry as possible - warts like a moist environment.  Wear footwear in public places like showers and locker rooms.

And most importantly, don’t despair.  Warts can be stubborn and some may seem like they are not responding to treatment or are taking a long time to go away.  Be persistent and consistent with treatment to get results.

Tags: bay area dermatologist, hpv, san francisco dermatologist, wart

This entry was posted on Wednesday, June 16th, 2010 at 12:59 am and is filed under Skin Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.