Friday 6 December 2019

Warts disappear without treatment

My son has a verruca on his foot for over a year now. We have tried all kinds of remedies and none seem to work. He has also recently developed warts on his hands. These look terrible. Have you any advice about how we can get rid of them?

Warts are painless cauliflower-like lumps on the skin, which are very common - they are thought to occur in four to five pc of children and adolescents. They can appear on any part of the body, but are mostly found on the hands and feet.

Warts are not dangerous but can be unsightly, so many people invest a lot of time and money trying to treat them. When a wart occurs on the foot, it can press inward, and as a result, appears flat. Warts on the feet are called verrucae.

All warts are caused by the Human Papillomavirus (HPV). This virus leads to a reaction in the skin that causes keratin (the hard protein layer of the skin) to grow too much. Most people develop warts before the age of 20, but they can occur in adults also.

Warts are contagious, and transmission more likely occurs if the skin is wet or in contact with rough surfaces, so areas such as pools and communal showers can be a source of infection. You can also transfer warts to other parts of the body by scratching, or biting them.

It is not necessary to treat warts. Without treatment, about 30pc of warts will be gone within 10 weeks and most will be gone between one and two years. However, warts in older people may last longer. Those who have a weakened immune system, such as people with HIV, or those who have had cancer treatment or a transplant, have a higher chance of developing warts. Fifty pc of those who have had a kidney transplant develop warts in five years.

Parents are often more upset by warts than children, and as some treatments can cause discomfort, I would typically advise to leave the wart alone as it will eventually go away. However, this is not a popular choice.

There are three main forms of treatment. The first port of call is the pharmacy where a number of over-the-counter remedies are available. Most of these contain salicylic or lactic acid, which needs to be applied daily to the wart for several months. There are a number of factors to consider when using this treatment. Acid works best if the wart is soaked in water and softened for a few minutes first. The dead skin should be removed from the wart using a nail file each day before reapplying acid.

It is important to avoid placing the acid on normal skin as it can cause a local burn. Applying Vaseline around the wart before applying the acid can help with this. If the skin around the wart becomes inflamed, stop treatment for a few days to allow the skin to heal.

Acid treatment should not be used on the face and should only be used on doctor's advice in those with diabetes or other circulation disorders. Placing a plaster over the wart after applying the acid can speed up treatment. Studies suggest that 80pc of warts are cleared in three months using salicylic acid.

The second form of treatment is freezing (cryotherapy). There are some over-the-counter freezing treatments, but these are not as effective as clinic-based treatment.

Cryotherapy is available in many doctors' surgeries and is covered by the medical card and most insurance policies. The wart is frozen using liquid nitrogen. This causes a small area of frostbite in the wart, which then dies and falls off.

It usually takes several cryotherapy treatments to treat a wart effectively. Each treatment occurs a number of weeks apart.

Initial studies suggested that cryotherapy is as effective as salicylic acid, but recent evidence suggests it is slightly better and may provide quicker results.

Combining the use of acid with intermittent cryotherapy may be more effective than using either alone. With both treatments, it is essential to remove dead skin before applying a new treatment.

The third form of treatment is simple, cheap and easy to do. It involves using duct tape. One study with this tape showed that 70pc of warts had resolved within two months. The tape should be applied to the wart and left for six days if it falls off. During this time, a new piece should be applied. After six days, the wart should be soaked, rubbed with a nail file, and left uncovered overnight to have tape reapplied next day.

Follow up studies didn't show such great results, but it is certainly a method worth trying.

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