Dear Dr. Dave and Dr. Dee,
I have a wart on the back of my hand. Will this go away eventually, or is there something that I should take to get rid of it?
Dear Worry Wart,
Warts might disappear on their own, but it could take months, maybe years. Warts are skin infections caused by a common virus called HPV (human papillomavirus). Group Health Incorporated (www.ghi.com) estimates that three out of four people will develop a wart some time in their lives, usually on the hands or feet.
Because warts can spread, don't pick at your wart, and wash your hands after touching your wart. Also, keep your hands dry as warts thrive in moist environments. There are various ways to remove warts ranging from home remedies to having your doctor remove it. Below are some common treatments for warts.
1. Salicylic Acid: over-the-counter treatments contain salicylic acid. Treatment must be applied every day until the wart is gone, and could take weeks. In addition, the wart should be filed gently daily with an emery board to remove the dead surface of the wart.
2. Duct Tape: Another home remedy is to use duct tape every day until the wart is gone and this treatment could take weeks. A more complete description of duct tape treatment is provided below.
3. Physician Removal:
a. Freezing (Cryotherapy): your doctor may freeze the wart with liquid nitrogen. Treatment may be needed several times over several weeks.
b. Chemical - Cantharidin: your doctor can use to a chemical called cantharidin to remove the wart. The chemical will blister the wart, and the doctor will remove the dead skin of the wart at the next visit. If the wart is not gone, the doctor may apply another treatment of cantharidin.
c. Surgery: your doctor can surgically remove the wart. However, surgery can be painful and may leave a scar.
d. Laser Removal: if other treatments have been unsuccessful, then your doctor may remove the wart with laser surgery. Laser surgery is expensive, can be painful, and could leave a scar.
Even if the wart disappears with any of the above treatments, it may recur later.
DUCT TAPE FOR WART REMOVAL
A study by Dr. Dean Focht, reported in the Archives of Pediatrics and Adolescent Medicine (http://archpedi.ama-assn.org), found duct tape to be more effective than treatment with cryotherapy (liquid nitrogen used to freeze warts).
Dr. Anthony J. Mancini, pediatric dermatologist at Children's Memorial Hospital in Chicago uses duct-tape therapy for warts. In an interview with the American Academy of Dermatology consumer magazine, "Dermatology Insights," duct tape treatment was discussed by Dr. Mancini (www.aad.org):
WHY DUCT TAPE
Two theories were proposed as to why duct tape works:
1. Debrides (removes dead skin) from the wart, thereby gradually eliminating the wart virus that resides in the skin.
2. Occluding the wart with duct tape somehow gets the patient's immune system activated to attack the wart virus.
DUCT TAPE TREATMENT PROCESS
There are various ways to use duct tape on warts:
1. Patients apply the duct tape to the wart, keep it in place for six or so days, then remove it, soak the wart, and pare it down with a filing (emery) board.
2. Apply over-the-counter salicylic acid wart remover liquid to the wart before bedtime. After letting it air dry for a minute or so, apply the duct tape over the wart, completely covering the area. Remove the duct tape the following morning. Each time they remove the tape, they are debriding some of the wart tissue. Repeat the application each night, until there is no remaining wart tissue.
DOWNSIDES TO USING DUCT TAPE
1. The skin can become very macerated (red and soggy) under the duct tape. If this happens, then take a few nights to one week off of the treatment to let the area breathe and dry out, and then resume therapy.
As Dr. Mancini points out, duct tape treatment is a gradual process that takes time and commitment on the part of the patient. For more information see www.aad.org