How to get rid of warts?

Wart anatomy

Warts are normally not harmful and frequently go away on their own with time, but they are unattractive, and some, like those on the bottoms of the feet, can hurt when you walk or exercise. Wart removal can be difficult, but fortunately, the least invasive procedures work best.

The epidermis, the top layer of skin, is where warts develop. The surface of a wart is typically elevated and rough. (Some may be flat and smooth, such as those on the face.) There may be dark spots in the core of a wart; these are its blood capillaries.

What are warts anyway?

Human papillomavirus infection causes abnormally rapid growth of skin cells, which results in warts (HPV). About 10 of the 150 HPV strains, including common, plantar, and flat warts, are responsible for cutaneous (skin) warts (see "Common types of skin warts," below). Anal warts and genital warts are caused by specific other strains. 

The HPV strains that produce skin warts have rarely been associated with cancer, although some sexually transmitted HPV types have been connected to genital and cervical malignancies.

We all constantly come into contact with HPV, such as when we shake hands or touch a doorknob, but only some of us get warts, which is difficult to understand. Particularly at risk are children and those with immune system disorders. So are persons who work with meat, fish, and poultry, among other professions, for reasons that aren't totally clear. The most plausible cause, though, is that some people simply have a higher wart occurrence rate than others.

Skin warts don't spread quickly. They can be transferred from person to person through direct touch, usually through skin breaches. It's also possible to theoretically acquire warts from surfaces like shower floors or locker room flooring, but there's no way to determine how frequently this happens. Wash your hands and everything that comes in contact with your warts, such as pumice stones or nail files, to prevent the transmission of warts from one part of the body to another.

A bacterial illness, like strep throat, can be identified, treated, and cleared up, however, a wart viral infection does not progress in the same way. Warts behave in a far less predictable way. dermatologist claims "Who knows where or when you acquired the wart virus, which lives in the top layer of skin? The infection might have been present for a long time. Then, for unknown reasons, it develops a wart. Additionally, the virus can still be found in the epidermis after the wart has disappeared."

Common types of skin warts
Type	Appearance	Characteristics
Common	Raised, rough surface, sometimes with dark specks; light-colored to gray-brown.	Found mostly on the hands, but may appear anywhere. Those under or around the fingernails and toenails can be hard to treat.
Plantar	Rough, spongy surface kept flat by walking; gray or brown with dark specks.	Found only on the soles of the feet. Clustered plantar warts are called mosaic warts.
Flat	Flat or slightly raised; smooth and pink. Smaller than other warts.	Found mostly on the face, hands, and shins. They're less common than other warts, but when they do appear, it's often in large numbers.

Treating warts

According to studies, two-thirds of warts and around half of the new warts disappear on their own after two years, thus "watchful waiting" is undoubtedly an option. To lessen the amount of virus shed into neighboring tissue and perhaps minimize the chance of recurrence, several doctors advise seeking prompt medical attention. You have a number of therapy alternatives if you'd rather not wait it out:

Salicylic acid

This is the main ingredient in aspirin, and it should usually be your first choice. According to one study, salicylic acid is the only topical treatment (treatment applied directly to the skin) that clearly outperforms a placebo. (The study, in the August 2011 issue of the British Journal of Dermatology, combined and reanalyzed data from a number of previous studies.) Salicylic acid costs little have minimal side effects and comes in various over-the-counter preparations, including liquids, gels, and patches. Concentrations range from 17% to 40% (stronger concentrations should be used only for warts on thicker skin). To treat a wart, soak it for 10 to 15 minutes (you can do this in the shower or bath), file away the dead warty skin with an emery board or pumice stone, and apply the salicylic acid. 

Do this once or twice a day for 12 weeks. Warts in thick skin, like the bottom of the foot, may respond best to a patch that stays in place for several days. Continuing treatment for a week or two after the wart goes away may help prevent a recurrence.

Freezing. 

In this treatment, also called cryotherapy, a clinician swabs or sprays liquid nitrogen onto the wart and a small surrounding area. The extreme cold (which may be as low as –321 F) burns the skin, causing pain, redness, and usually a blister. 

Getting rid of the wart this way usually takes three or four treatments, one every two to three weeks; any more than that probably won't help. After the skin has healed, apply salicylic acid to encourage more skin to peel off. Some individual trials have found salicylic acid and cryotherapy to be equally effective, with cure rates of 50% to 70%, but there is some evidence that cryotherapy is particularly effective for hand warts.

Duct tape. 

Although findings have been mixed, anecdotal evidence suggests that this low-risk, low-tech approach may be worth a try. In one study comparing duct tape with cryotherapy, subjects wore duct tape patches over their warts for six days. Then they removed the patches, soaked and filed warts, left them uncovered overnight, and reapplied the tape in the morning, leaving them in place for another six days. They followed this regimen for two months or until the wart disappeared. In this study, duct tape was about 45% more effective than cryotherapy. Two other studies found no benefit, but those studies used clear duct tape rather than the standard silver type, which is stickier and has a different kind of adhesive. Given this limited evidence, if you plan to try duct tape, it makes sense to use the silver kind. Why duct tape works aren't clear — it may deprive the wart of oxygen, or perhaps dead skin and viral particles are removed along with the tape. Some people apply salicylic acid before covering the wart with duct tape.

Other agents. 

Warts that don't respond to standard therapies may be treated with prescription drugs. The topical immunotherapy drug imiquimod (Aldara), a standard therapy for genital warts, can also be used to treat skin warts. Imiquimod is thought to work by causing an allergic response and irritation at the site of the wart. 

In an approach called intralesional immunotherapy, the wart is injected with a skin-test antigen (such as for mumps or Candida) in people who have demonstrated an immune response to the antigen. Other agents that may be used to treat recalcitrant warts are the chemotherapy drugs fluorouracil (5-FU), applied as a cream, and bleomycin, which is injected into the wart. All these treatments have side effects, and the evidence for their effectiveness is limited.

Zapping and cutting. 

The technical name for this treatment is electrodesiccation (or cautery) and curettage. Using local anesthesia, the clinician dries the wart with an electric needle and scrapes it away with a scoop-like instrument called a curette. This usually causes scarring (so does removing the wart with a scalpel, another option). It's usually reserved for warts that don't respond to other treatments and should generally be avoided on the soles of the feet.

warts removal treatment