Warts

Warts are caused by a virus infection, although we are not certain why some people get warts and others don’t. Even without treatment, most warts will go away in about 2 years, but, when they are on the hands, face or feet, they can be bothersome and embarrassing. Plantar warts can be especially uncomfortable. (The sole of the foot is also called the “plantar surface” of the foot, so warts on the sole of the foot are called “plantar warts”. They aren’t different from regular warts but occasionally are deeper into the surface of the foot due to constant pressure. There is no such thing as a “planter’s wart”.)

     For centuries, different things have been used to treat warts with different levels of success: milkweed sap, dandelion sap, garlic juice, nail polish and Elmer’s glue to name a few. Out of the many commercial products used to treat warts, the only ones that the FDA judges to be effective are salicylic acid in concentrations over 6 % or urea in concentrations over 30%.  They both get rid of the wart by dissolving the skin cells. They are available in liquids, gels, creams or soaked into pads. With higher concentrations, the effectiveness is greater, but the surrounding tissue can be irritated and injured. Treatment may have to be continued for up to 3 months on a regular basis to finally get rid of the wart.

     It is common to “freeze” warts in a caregiver’s office by applying liquid nitrogen. Parents and kids need to know that freezing hurts. Trying to do it “gently” usually results in the wart not being removed, but being too aggressive can harm the deep layers of skin and cause damage to the tissue underneath or permanent scaring. After freezing, the area hurts again as it re-warms and a blister usually develops in the area as it heals. The area can develop a superficial temporary scar. Sometimes a new “ring of warts” develops around the scar where the original wart was, but these usually resolve by themselves in a short time. There are wart-freezing products sold over the counter but they don’t seem to be as effective. This may be because they are not liquid nitrogen and don’t get as cold or it could be that the child simply won’t allow the parent at home to apply the painful procedure long enough.

   Another method used in caregiver’s offices is to apply canthrone (often called “bug juice” because it comes from a beetle). This doesn’t hurt at first, but hurts after the application. It is a very irritating chemical and needs to be washed off within three hours of application or it can cause a severe reaction. 

     There are reports that simply covering the wart with Scotch tape, duct tape, athletic tape or band-aids can cause them to go away, but we don’t know why. Even if the child and the parents decide to allow the wart to go away on it’s own, I’ve found covering the wart with a band-aid is helpful, especially with warts on the hands. It seems to be impossible not to pick at things on our hands (think of calluses and hangnails) and picking seems to encourage the warts to spread. Covering hand warts discourages picking and covering plantar warts on the feet puts a soft pad over them and makes them a little less uncomfortable.