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Those Pesky Warts

 

Warts are growths on the skin and mucous membrane caused by the Human Papilloma Virus. They are very difficult to culture on any culture medium, being almost purely human specific (That's right, those wart-like growths on frogs are not really warts at all).

The most difficult warts are those found on the bottom of the feet (plantar surface) called plantar warts, those around the fingernails, and flat warts which can be found virtually anywhere and frequently in large numbers (but their diameter is small and they are only barely elevated off the surface and are frequently misdiagnosed). Most people over time will become immune to the wart virus and be able to repress it so that they are neither contagious or show any visible signs of warts; nevertheless, as we are learning about many viruses that infect us, the wart virus is not truly gone, it is simply suppressed. Because of the difficulty of growing the war virus and studying it, we have yet to develop a wart vaccine and most wart treatments resolve around destroying the most obvious, painful, rapid growing, or infected ones in hoping new ones will not develop.

Of course, since it is a virus they are contagious and can be acquired through touching or even from skin contact in an area where the wart virus was recently deposited (such as a shower or a pool surface where the virus was left from someone with a plantar wart walking over the area).

Wart treatments are numerous and the over-the-counter wart treatments are usually valuable only in smaller types of warts and in those patients who are able to persist for a number of weeks in the daily treatments. Other treatments include freezing, electrical cautery, excising, lasering, caustic chemical applications, and injections of wart killing medications. Recently, a new topical cream that stimulates immunity has been approved, but it is mostly effective in genital warts (but that is a whole other story!).

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