WartsWarts are very common and caused by the Human Papilloma Virus (HPV). Generally they are not harmful, but most patients pursue treatment due to irritation, pain or simply because they can be unsightly. Commonly, warts favor the hands and fingers, but can be found on any part of the skin. Those found on the bottom of the feet are know as plantar warts and can be particularly difficult to treatment. Warts are contagious by direct contact so manipulating, picking at or biting these growths is discouraged. Genital warts are the most commonly sexually transmitted disease. The lifetime risk of sexually active persons may be as high as 50-80%. In most patients, genital warts tend to be transient and without adverse effect. However, in a small population it is closely linked to cervical, penile and anal cancers. Workup, treatment and close monitoring should be considered given this possibility. A wide variety of treatment options exist for warts. None are 100% effective and repeat treatments are common. Different patients respond differently to each treatment type. Over the counter medication is usually the first line therapy. The active ingredient is usually salicylic acid. Destruction is the most common therapy used by physicians. Liquid nitrogen can be used to freeze the area and produce a blister to destroy the wart. Cantharone, a beetle extract, can be used in small drops to produce a similar effect. These may be repeated every 2-3 weeks until improvement is noted. Another technique involves producing an inflammatory reaction around the wart. One method is the injection Candida antigen directly into the wart. The body responds to the antigen and in the process also attacks the wart. Multiple methods of treatment may be needed to resolve some difficult warts. Some warts are recalcitrant to all therapies and other warts involute on their own. (AAD phamphlet) |
