FIGHTING THE WART WAR

Jeffrey Sassmannshausen, MD

I am always surprised when patients expect their warts to go away with one treatment. I explain that I am a medical doctor, not a miracle doctor, and treating a wart is not that easy. It frequently requires multiple treatments to get those pesky growths to go away.

Warts are caused by the human papillomavirus or HPV. There are over 70 types of HPV though only a few will infect the skin. The visible wart that is on the hand or the bottom of the foot is actually a thick overgrowth of skin that the virus has caused in order to protect itself. The reason the warts will grow and spread is that our bodies may not recognize the virus as an invader, but it will ignore the infectious agent and allow it to spread. It is not uncommon for this to run in families, where mom or dad will explain that they had many warts when they were young, and now I am treating their son or daughter. In nearly all cases of warts, the immune system will eventually begin to attack the virus and it will go away. This may take a year or a decade, but it will happen.

There is no magical cure for warts. Yes, I have heard that rubbing a banana peel on the wart, or rubbing it with a penny and then throwing it away will make the wart disappear overnight. I wish I could employ the many grandmas and aunts that could pray over the wart and make it shrink. The fact is that most warts will go away, eventually, on their own. Unfortunately, this may not happen for decades.

There are many ways to treat warts in the office. Some methods kill the cells the virus is living in. The tried-and-true treatment is freezing the wart with liquid nitrogen. Yes, it hurts, but it will eventually kill the virus. Cantharidin is another treatment option that comes from the blister beetle. For years, it was applied directly to the wart and would cause a blister. Currently, it is unavailable because a company has applied for its use in a pen applicator. This may make its use cost-prohibitive. I have also used injections of a chemotherapy agent called bleomycin. This too is very uncomfortable. Lasers can also be used but they are expensive to operate and don’t work any better than liquid nitrogen. The medication Tagamet was touted as an agent that cleared warts. Studies later showed that it really didn’t work and that the warts were just going away. Many topical creams may help, but it is likely that they only offer minimal help. Using acids on the wart, like Compound W, will eventually eat away at the wart. It is important to pare (file) the wart daily with a pumice stone or emery board when using this approach.

My favorite treatment for multiple warts is using a protein called Candin. This is a part of the cell wall of the yeast Candida. When it is injected into a wart, the body’s immune response is activated and will eventually begin to attack the HPV virus.

When seeking treatment for warts, remember that there is no silver bullet to clear them with one treatment. So, be ready and patient for treatments to take a while, and probably hurt some.