Classic Warts and Molluscan Skin Warts
What causes warts?
Warts are caused by a virus that invades the skin cells and causes the skin cells to grow abnormally.
These are usually quite obvious. They occur mostly on the hands and feet. They appear as raised, skin-colored bumps with a rough surface, and if you look close enough, you can see the surface is made up of dozens of tiny finger-like projections. They vary in size from the tip of a pencil to as big as a dime. They almost look like a crater that is filled in with rough, calloused skin. They may first appear as a tiny bump on normal skin, with a tiny black center that looks like there is something stuck under the skin. You may not even know this is a wart until the wart tissue grows out of the skin, giving it the appearance described above.
Treating classic warts
Here is a home treatment you may try before consulting your doctor:
- Salicylic acid – this is a very mild acid available at drug stores. It comes as a liquid or band-aide. Soak the wart in warm water for five minutes, then apply twice a day. You can file away any excess wart tissue that you are able. The acid slowly breaks down the skin around the wart, causing it to blister. Eventually you can gently pick at the edge of the wart and remove it after the acid has weakened the skin enough. It may take several weeks of treatment before you see any effect. If you stick with it long enough, this treatment usually works, although it can take months.
- Duct tape – apply a wart-sized piece of duct tape to the wart. Keep it on for one week, then soak it and peel off the tape. Rub the wart with emory board or pumice stone, then re-apply a new piece of tape for another week. If the tape comes off sooner, just put a new piece on. Repeat as long as necessary. It is not known if this method is better or faster than over-the-counter wart acid.
At the doctor’s office:
- Liquid nitrogen freezing – this is a very effective treatment, for those who can tolerate pain well. This liquid is applied with a cotton swab for 1 to 2 minutes. One misconception many people have about freezing warts is that they think the wart is immediately frozen or burned off. This isn’t true.It has the same effect on the skin surrounding the wart as described for the acid above. It also has an added effect of stunning the wart virus for about two weeks, so growth of the wart slows or stops. Several days after freezing, you may be able to gently pick the wart off if the skin around it has weakened enough. It sometimes takes 2 or 3 treatments before the wart is ready to be removed, and treatments are generally given every 1 to 2 weeks. Some large plantar warts (warts on the bottom of the feet) take up to 6 treatments. This treatment has the advantage over the above acid in that it gets rid of the wart faster.
- Stronger acids – there are a variety of acids similar to salicylic acid, but stronger, that your doctor can apply every several days. This may work faster than salicylic acid, is painless (as compared to liquid nitrogen), but may not work as well as liquid nitrogen.
- Most warts will eventually go away on their own without treatment after 2 to 3 years. The virus is contracted usually from the environment or prolonged, repeated close physical contact with the warts of another person.
Dr. Bob notes:
One of my kids had a plantar wart on his foot. We didn’t even consider freezing it – he is just not into pain. We used salicylic acid twice daily as above. We were very religious about it. After about two months, we could finally pick it off. There was a little left over that needed a few more weeks of acid. A year later, another wart appeared near the same spot. We did the acid again, but got tired of doing it after a month or so, and stopped. We forgot about the wart, and then were very surprised when we looked at it a couple months later. It was gone. No trace at all.
Molluscum contagiosum warts
These are another type of wart caused by a different virus from the classic wart. They have a different appearance and usually occur on the chest, abdomen, upper thighs, and occasionally the face. They are skin-colored bumps, can vary in size from the tip of a ballpoint pen to about half the size of the eraser end of a pencil, are smooth surfaced, often have a dimple in the center, and usually occur in clusters. They can itch. They are more contagious than classic warts, and are transmitted by repeated close physical contact with the warts. These often do not require any treatment, and will go away on their own usually within 1 year. They are more difficult to treat because there can be several dozen at any time. If treatment is desired due to significant irritation, itching, or undesirable cosmetic nuisance, then the same treatment options are used as for classic warts. One additional treatment available for molluscum is a dermatologist can scoop out the core of these warts.