Warts
What Causes Warts?
Warts are caused by the human papilloma virus. They will impregnate the skin and up to a year later a slow growing wart will develop. The appearance of the wart depends on the sight. On the soles of the feet they are called plantar warts. Elsewhere they can protrude from the skin. Scratching the warts then other areas can cause them to spread. This virus can be picked up from wet areas such as swimming pools etc. They tend to occur on the fingers, soles of feet (plantar wart) knees and elbows.
How Long do They Last ?
Warts will generally disappear within 2 years in 50% of people. Sometimes they can be stubborn. It is rare for them to reappear once they have gone.
Do They Cause Any Problems ?
The short answer is no. In some cases the plantar wart will be uncomfortable when walking on bare feet. Otherwise the main issue is cosmetic. The ordinary papilloma wart virus is different to the genital papilloma virus which is associated with cervical cancer. Sometimes they can be secondarily infected if they are scratched.
What About Treatment ?
As mentioned there is no need to treat warts as they will go away with time. There is no scarring once warts have gone. There are hundreds of treatments for warts, some of which are expensive with little or no evidence that they hasten elimination. Most treatments that have been found to have some effectiveness cause irritation of the skin around the wart. Eventually the wart virus will be eliminated by the immune response to this irritation. So if the wart is harmless, not particularly bothering the child then doing nothing is appropriate. The Hippocratic Oath translation is “First do no harm”. In other words “given an existing problem, it may be better to do nothing, than to risk causing more harm than good.” Never is this truer than for warts.
- Chemist treatments – will irritate, can be expensive and may take many weeks to months
- Cryotherapy – freezing warts is effective in the hands of a skilled dermatologist or practitioner who is used to using such treatment. It is painful for children, not guaranteed to work, and has the risk of causing scarring.
- Surgery – is not recommended as the warts will return and scarring can occur
- There are lots of other treatments which exist in folklore (banana skins is one) which really do not have any benefit.
For those children where the wart is either in an awkward place, such as a thumb or toe, and is aggravating there is some evidence that occlusive tape such as duct tape will hasten eradication. In addition this will prevent spread. The tape needs to be applied on the wart 24 hours per day. Some dermatologists use Cantherone which is effective. Again it causes a temporary blister but it is painless to apply and therefore better tolerated than freezing.
