Oh the childhood tales…which always warn of the touch of a toad causing warty growths all over your fingers. Yet, as much as a tomboy as I was in my youth, I put this theory to its test many times, and lo and behold I remained bump free.
So if our amphibian friends do not cause the flesh-colored, cauliflower like lesions, then what does? It’s actually a strain of the HPV virus that is spread from other infected individuals or contaminated surfaces. It favors certain body locations like the hands, feet, face, and genitals. Young age, nail biting, open skin conditions like eczema or psoriasis, and hands frequently in water can be risk factors for catching the virus. Once it plants its seed, HPV blooms, and may cause skin growth of a few millimeters or centimeters. Two-thirds of warts will spontaneously disappear over 1-2 years.
Nonetheless, warts can be quite persistent and/or spread to multiple areas on the body. It is unknown how long the virus can survive dormant underneath the skin. Although warts typically are not hazardous, they can be quite a nuisance and cosmetically unattractive.
Use of OTC treatments requires patience, as successful eradication entails multiple treatments over many months. The most popular OTC medicaments utilize the ingredient Salicylic Acid, to break down and eat away at warty tissue. This is helpful, but in many instances, it may only keep warts from blossoming rather than fully destroying them. Salicylic acid treatment effectiveness is also dependent on the strength of the main ingredient, which varies among product in the 17-40% range. The Wart Stick, a 40% Salicylic Acid treatment, is one of my favorites. It is easy to apply and on the high strength range.
An OTC version of freezing is also available in the form of a butane spray can. Brands like Freeze-Off or Freeze-Away, promote spraying the warts with a really cold liquid that reaches temperatures of 50-70 below zero, compared to the office-version of 320 below zero with liquid nitrogen. Butane sprays may cause warts to be red, peel, tender, or blister. Yet again, several treatments would be needed to gain any traction. A combination therapy of freezing and a topical would be a better regimen to fight this pesky virus.
Other shelf options include homeopathic derivatives which may display variable results dependent on patient. However, Terrasil Ointment, includes a popular remedy called Thuja Occidentalis. It’s applied twice a day to the wart and is targeted to induce your body fighting off the virus.
There are several prescription topical treatments for warts, but unfortunately, the success rate of treatment with topicals is low. Options like Virasal contain a salicylic acid component with an antiviral compound. Imiquimod is an older, yet popular medication, which was originally used as a chemotherapeutic agent for skin cancers and pre-cancers. Historically, it has been used off-label for warts and shows mild effectiveness, if any at all. Veregen is a topical treatment made from green tea, which ignites the skin’s immune system in antiviral defense. However, it is approved for use on genital warts, so it is off label for other areas. Yet, when it works, it tends to work quite well. The issue with the latter two medications is price point, in that, even with health insurance these medications may cost $150 or more out-of-pocket.
The most effective treatments are in-office procedures, such as application of a liquid blistering agent called Canthacur, liquid nitrogen destruction (again 320 below zero) or cauterization and curettage (burn & scrape method). The initial two may cause blistering, which lifts a layer of warty tissue away from the base every time the procedure is done, until the root is reached and destroyed. This is utilized over 3-6 treatments, once a month, and success rates are greater with liquid nitrogen modality. All techniques may cause redness, tenderness, irritation, pain, and the cauterization will cause a large burnt sore.