Have you ever gotten a pedicure? Have you ever swum in a public pool? How about walked barefoot through a locker-room? If you answered yes to any of these questions, you might be at risk for the development of warts. Those stubborn unattractive little bumps are very common, with reports stating that at least 30 million individuals in the U.S. have experienced the condition. They can appear on any part of the skin, but they frequently occur on the palms of the hands and soles of the feet. Although warts are caused by the human papilloma virus (notorious for causing cervical cancer), the genetic type often found in the plantar and palmar warts tends to be benign. Some patients may complain of discomfort at the wart site, while others will remain asymptomatic. Fortunately, there are numerous treatment options for warts, many of which are now available over-the-counter. So, how are warts formed; and what are the associated risk factors that people should know in order to avoid these unsightly nubs?
The human papilloma virus is found within the skin cells that make up the wart itself. It can be transmitted via skin to skin contact of the infected site or it can be acquired when someone touches an object that was contaminated by someone with a wart. Moreover, the virus is even more contagious if the skin happens to be macerated (softened or “pruned”) or contains abrasions and lacerations. Warts can have a variable clinical appearance; some are grainy and nodular whereas others consist of a smooth surface. The diagnosis is mostly clinical and it is based on the physical examination findings. In cases in which the causation remains unclear, dermatologists can take a skin sample for further analysis. There are a multitude of therapeutic options, which include: A) salicylic acid, a weak acid that exfoliates the affected skin; B) liquid nitrogen, works by freezing the infected area, which is subsequently physically removed; C) cantharidin, a chemical compound that causes blistering; D) trichloroacetic acid, an agent that can destroy the protein components within cells; E) tretinoin cream, disrupts cell growth; F) intralesional immunotherapy, in which warts are injected with a special substance that stimulates the immune system; and G) shave and excision of the infected skin.
It’s important to note that patients who are immunocompromised (e.g. those with cancer or HIV) have a higher risk of developing warts. Some warts disappear and never come back, while others can become a recurring problem, even if properly removed. As a result, it’s always best to focus on prevention. Adhering to the following recommendations will ensure that you maintain healthy looking skin: 1) do not touch warts on other people; 2) be careful not to spread warts within your own body by contaminating normal skin sites; 3) wear slippers at all times when using public showers or walking on a pool deck; and 4) if you are getting pedicures at a salon, make sure that they abide by regulatory disinfecting practices. Nonetheless, if you do get a wart, remember to be patient with the treatment: it generally takes several weeks for the lesions to fully vanish…but vanish they will.