Health NW: Dealing with warts

<center>Kathryn B. Brown, FNP</center>

Common warts are indeed common. The viruses that cause warts can be transmitted by touching a surface or by person-to-person contact. They can last for weeks or for years. Some go away quickly with treatment; some are resistant.

If you are imagining a large, spiky wart on a witch's chin, that is a filiform wart. Flat warts are small with flat tops and are found on the face, legs or arms. The most common type is the common wart, which is a dome-shaped bump, often found on the hands. Plantar warts are found on the soles of the feet and may be mistaken for corns or calluses. They are most likely to be painful when located on a weight-bearing part of the foot.

You can tell if a skin lesion is a wart or not by looking very closely at it. You may need a magnifying glass to see whether or not the normal skin lines cross the surface of the lesion. If it is a wart, you will not be able to see normal skin lines.

Another clue is that some warts have tiny black dots in the center, which are tiny blood vessels. Warts can range in color from pink to brown, and they may be the same color as the skin around them.

The decision to treat or not to treat warts depends on many factors. More than half of all warts will disappear without treatment within two years. For young children, the treatment can be too traumatic and it may be better to leave them alone, especially if there are just a few small warts that are not causing any discomfort.

Warts that are embarrassing, painful or spreading should be treated. Small warts on the body (not the face) can be treated at home with over-the-counter wart treatments such as salicylic acid. This comes in liquid form as well as patches that are placed over the wart. Salicylic acid is not painful, and it is inexpensive.

To prepare the skin before home treatment, first soak in warm water to soften the skin around the wart. Then, gently rub the surface of the wart with an emery board or sand paper to remove the dead skin on top of the wart. Throw away the emery board after use since reusing it could transmit the wart virus to others.

If you have used home treatment faithfully for at least two months and the warts are not going away, it is time to see a health care professional to confirm the diagnosis and suggest another method of treatment. Other possible treatment options include: freezing the warts with liquid nitrogen, applying an acid or other chemical at regular intervals or surgical removal.

If you are not certain that a skin lesion is a wart, do not use salicylic acid to treat it until you have had the diagnosis confirmed. This is especially important if you are planning to treat a lesion on the bottom of your foot. Calluses and corns are firm, thickened skin on the feet caused by pressure and friction. If you treat a corn or a callus with salicylic acid, it can cause scarring and pain in the future.

Warts in the genital area require very different treatment and should be managed by a health care provider who is familiar with the problem. Public health departments are a good source of information about genital warts and other sexually transmitted infections.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to

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