Warts: New Solutions to an Old Problem

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Warts are a common and annoying dermatological problem. Treatments for warts has evolved dramatically over the past few years. Some warts can be treated at home, and if that doesn’t work, dermatologist can offer more advanced treatments involving stronger drugs techniques and lasers.

Warts—of which there are some 60 different types—are one of the most common and annoying dermatological problems known to man (and woman). “Most adults have had a wart somewhere on their body at some time, and they affect up to 10% of children and young adults,” says Joshua Fox, MD, dermatologist and founder of Advanced Dermatology and The Center for Laser and Cosmetic Surgery.

Warts are typically noncancerous and will sometimes go away on their own within months or a couple of years. However, they can also be painful, especially if they grow on the sole of the foot. They can be easily irritated or made to bleed. They can also spread, to yourself or others, enlarge or multiply, and can be especially embarrassing if they appear on the face. The good news is that wart treatment has evolved dramatically over the past few years. “Some warts can be treated at home,” Dr. Fox notes. “If that doesn’t work, you can see a dermatologist for more advanced treatments involving stronger drugs techniques and lasers.”

Warts, caused by a viral infection in the top layer of the skin, are linked to the human papillomavirus (HPV). The virus is spread through contact with other people or surfaces (such as a towel or locker room floor) that are infected. People with open wounds or cracks on their skin, of those with weakened immune systems and children are more prone to getting the virus than others.

Three prevalent types of warts are:

· Common warts, most often appear on the fingers, around the nails and on the backs of the hands. They are raised and flesh tone, but may have black dots in them that look like little seeds. “These warts tend to appear in areas where the skin has been broken or traumatized,” Dr. Fox explains, “such as around bitten fingernails or hangnails.”

· Plantar warts, which grow on the soles or heels of the feet i.e. plantar surface. They tend to be white and flat (the pressure of walking on the foot flattens them so they don’t project out of the skin). Like common warts, they may have black dots in them; they also may grow in clusters.

· Flat warts, which are typically flatter, smaller and smoother in appearance than common warts and may grow in large numbers. In children, they’re most common on the face, whereas in adults they’re more common in areas that are shaved, such as the beard area in men and the legs in women.

Step-by-step Approach

Wart treatment typically starts at home with a nonprescription salicylic acid product, such as Compound W or Occlusol Salacid, which is applied to the wart on a once or twice daily basis (usually after soaking and paring the skin). “A recent review of wart treatments has found that salicylic acid is the most effective and safest treatment,” explains Dr. Fox. “These products soften the layers of skin so you can rub the dead surface of the wart off with a pumice stone or emery board.” The downside to this approach is that it requires patience and persistence, because it can take many treatments and many weeks to months to destroy the wart completely. “To make the salicylic acid even more effective, you can place duct tape over the wart after you treat it,” he advises. “When you remove the tape in the morning, you remove some of the wart tissue with it.” However the success rate is usually only about 50%.

Another over-the-counter treatment, which until recently was available only through dermatologists, is cryotherapy (such as Compound W Freeze Off or Dr. Scholl’s Freeze Away), which uses a very cold liquid to kill the virus in the skin and freeze off the wart. Again, the wart will need to be treated numerous times before it goes away. This technique is more likely to blister, discolor or scar.

If home treatments aren’t for you, don’t work or you don’t want to lessen the risk of scarring, and don’t have long to treat, the next step is to see a dermatologist, says Dr. Fox. “We can offer stronger medications, such as cantharidin, which is painted on the wart and causes a blister to form under it. Prescription retinoids (such as Retin-A or Avita) or imiquimod (Aldara) can be prescribed to be applied topically to warts; the former disrupts cell growth, while the latter boosts the body’s immune response to the HPV virus. For really resistant or large warts, an anti-cancer drug’s called bleomycin or 5FU can be injected into or applied to the wart to kill the virus. Alternatively, warts can be injected with interferon or Candida skin test antigen, both of which prompt strong immune system reactions that clear the HPV virus from the body—and the wart along with it. Some of these treatments are costly and potentially more dangerous than other treatments, so it’s important to talk with a dermatologist about their risks and benefits,” Dr. Fox explains. There are many other medical treatment options for warts.

Other surgical options include cryotherapy (freezing) electrosurgery (burning), curettage (cutting) excision and lasering (destroying the wart with an intense beam of light). “Certain lasers are a good option for warts on the face or groin because they don’t typically leave scars or wounds in the skin the way other treatments do,” he notes. However, laser therapy is expensive; for warts elsewhere on the body, it is usually only tried if warts have resisted other treatments.

Summing up, Dr. Fox notes that “Unlike in the past, warts aren’t something you have to live with. There are more treatment options than ever before that are effective—and there may even be a vaccine in the near future.

Bio: Joshua L. Fox, M.D., F.A.A.D.

Joshua L. Fox, M.D., is a leading authority in the field of dermatology with an expertise in skin cancer, cosmetic surgery, and laser procedures. As an official spokesperson for the American Academy of Dermatology and the American Society for Dermatologic Surgery, Dr. Fox has been an expert resource on dermatologic topics for numerous televisions networks, including ABC, CBS, CNN, NBC and Telemundo, talk shows, radio stations, newspapers and magazines. Dr. Fox has served on the board of the National Rosacea Foundation and has done clinical trials in both medical and laser therapy in rosacea. He has received multiple research and clinical awards, including recognition from Top Doctors, Who’s Who, Journal of Dermatologic Surgery and Oncology, Community Service Award from the American Society for Dermatologic Surgery, the prestigious Husic Award, as well as certificates of recognition for service from multiple hospitals and civic, educational and community organizations. Dr. Fox has authored and presented papers of his research on lasers, cosmetic procedures, stretch marks, scars, skin cancer, bug bites, photosensitivity and various rashes.

As founder and director of Advanced Dermatology and The Center for Laser and Cosmetic Surgery, Dr. Fox and associates have expanded the practice to one of the largest in dermatology, laser and cosmetic surgery, with more lasers than any hospital or dermatology practice on the eastern coast. Dr. Fox is a graduate of the New York University Medical Center of Skin and Cancer and has been on the advisory board of the Psoriasis Foundation and National Rosacea Foundation, among others. He has also been a fellow of many societies, including the International Academy of Cosmetic Surgery, International Academy of Cosmetic Dermatology and the Society for Investigative Dermatology. Dr. Fox is the founder of the AAD Melanoma/Skin Cancer Prevention Program in Queens, New York (since 1987). Dr. Fox has been Chief of Dermatology of several major teaching hospitals, including Mt. Sinai Hospital of Queens and Jamaica Medical Center, and is currently on the staff of ten NY area hospitals. Dr. Fox and Advanced Dermatology and The Center for Laser & Cosmetic Surgery have been used as a resource center educating dermatologists, laser surgeons and cosmetic surgeons and others about lasers, cancer and cosmetic surgery. http://www.advancedd.com.


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