As of Wednesday, November 13, 2013
DEAR DOCTOR K: What is the best way to get rid of warts?
DEAR READER: Getting rid of warts can be a challenge. Fortunately, the more effective treatments are the simplest.
Warts occur when skin cells grow faster than normal because they are infected with the human papillomavirus (HPV). (I’ve put an illustration of wart anatomy on my website, AskDoctorK.com.)
Warts aren’t highly contagious, but they can spread from person to person by direct contact, mainly through breaks in the skin. Warts on one part of the body can also spread to other areas.
Warts are generally harmless and often disappear on their own over time. As I write this column, I’m watching a wart on my foot get smaller with no treatment and hoping it will just disappear. So “watchful waiting” is definitely an option for new warts.
On the other hand, some warts disappear only to later reappear. Even when warts disappear completely, there still is some virus left in the skin cells. Treating a wart can help lower the risk of recurrence.
If you’d prefer not to wait it out, there are two treatment options you can try yourself:
— Salicylic acid, the main ingredient in aspirin, is a good first choice. It costs little, has minimal side effects and comes in various over-the-counter preparations, including liquids, gels and patches. Soak the wart for 10 to 15 minutes, file away the dead warty skin with an emery board or pumice stone, and apply the salicylic acid. Do this once or twice a day for 12 weeks.
— Duct tape. This low-risk, low-tech approach may sound suspect, but it’s worth a try. Wear a patch of duct tape over your wart for six days. Remove the patch, soak and file the wart, and leave it uncovered overnight. Reapply the tape in the morning and leave it in place for another six days. Repeat for two months or until the wart disappears. Use silver duct tape, which is stickier and has a particular kind of adhesive. (I’m repeating the advice that my skin specialist colleagues give patients. Personally, I wouldn’t have the patience for this.)
There are various treatments that doctors can give you in the office:
— With freezing (cryotherapy), a clinician swabs or sprays liquid nitrogen onto the wart. The extreme cold burns the skin, causing pain, redness and usually a blister. Getting rid of the wart can take three or four treatments, although it’s sometimes successful with just one.
— Various other solutions that “kill” warts can be applied by the doctor. They all have strange names: imiquimod, cantharidin, tretinoin, 5-fluorouracil. Don’t try to pronounce them — that’s one of the things you pay your doctor to do.
Warts that don’t respond to standard therapies may need treatment with prescription drugs or with a “zapping and cutting” procedure done under local anesthesia.
Warts are an annoyance. I’ve had a dermatologist freeze several I’ve gotten over the years. The one I’m watching now started to shrink pretty quickly on its own. Maybe it knew what was coming.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.