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Warts

Warts are small generally harmless and usually painless growths on the skin. Warts can be disfiguring and embarrassing however and occasionally they will hurt or itch. The different types of warts include the following.

• Common warts: usually on the hands but can appear anywhere

• Flat warts: generally found on the face and back of the hands

• Genital warts: normally found on the external genitalia in the pubic area and in the area between the thighs but can appear inside the vagina and in the anal canal

• Plantar warts: found on the soles of the feet

Warts affect all age groups. Genital warts are quite contagious while common flat and plantar warts are much less likely to spread from person to person. All warts can spread from one part of the body to another. Some warts will disappear without treatment although it can take as long as six months to two years. Whether treated or not warts that disappear often reappear.

Signs and Symptoms

bulletCommon warts: usually begin as tiny smooth flesh-colored eruptions and grow into rough growths perhaps 1/4 inch across or in clusters
bulletFlat warts: small flesh-colored or pink growths with flat tops
bulletGenital warts: tiny eruptions that grow to resemble common warts
bulletPlantar warts: rough flattened callus-like growths often with tiny black dots in the center; frequently tender; can disrupt your posture resulting in leg or back pain

What Causes It?

Warts are caused by a common virus in humans the human papillomavirus (HPV). Your risk of getting warts is increased by direct contact with warts or the fluid in warts (notably genital warts) using communal facilities (such as locker rooms) skin trauma and diseases or drugs that weaken your immune system.

What to Expect at Your Provider's Office

Warts can generally be diagnosed by location and appearance. Your health care provider may want to cut into a wart to confirm that it is not a corn callus or other similar-appearing growth but rarely will your provider have to order laboratory tests. If you have genital warts your provider will want to check inside your anus and (in women) vagina.

Treatment Options

Treatment Plan

Treatment depends on the type severity and location of your wart. Be sure to see your provider if your wart is on your face or genitals. Drugs usually are used first when trying to get rid of a wart. Cryosurgery ("freezing" the wart to destroy tissue) may leave a slight scar. With electrosurgery lasers or cutting out the wart it is more likely that you will have a scar. Covering the area with waterproof tape can cure warts by preventing viral growth. Hot water soaks (113° water for 30 to 45 minutes 2 to 3 times a week for 6 to 8 weeks) may cure a plantar wart.

Drug Therapies

Prescription

bulletTrichloroacetic acid or cantharidin—for common warts
bulletTretinoin—such as Retin-A for flat warts especially on the face
bulletPodophyllin in tincture of benzoin—applied weekly by your provider for genital warts; possibly strong local reaction
bulletPodofilox—applied at home for genital warts
bulletInterferon alfa-n3—for recurring external genital warts

Over the Counter

bulletSalicylic acid (12% to 40%) with lactic acid—for common flat and plantar warts; soak in warm water and then dry before applying ointment or patch then keep dry

Complementary and Alternative Therapies

Nutritional and herbal support may enhance immune function and minimize recurrence of HPV the virus that causes warts.

Nutrition

Some changes you can make in your diet include the following.

bulletEliminate caffeine alcohol refined foods and sugar.
bulletAvoid saturated fats (animal protein and dairy products).
bulletIncrease whole grains fresh vegetables fruits legumes and essential fatty acids (nuts seeds and cold-water fish).
bulletVitamin C (1 000 to 1 500 mg three times per day) beta-carotene (100 000 IU per day) vitamin E (400 IU per day) and zinc (15 to 30 mg per day) support immune function and healing. Vitamin E may also be put directly on a wart to treat it.
bulletB complex (50 to 100 mg per day) helps reduce the effects of stress which can weaken your immune system.
bulletFolic acid (800 mcg per day) is recommended for genital warts.
bulletSelenium (200 mcg per day) supports immune function.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. of herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Combine tinctures of one part goldenseal (Hydrastis canadensis) with two parts each of the following herbs: lomatium (Lomatium dissectum) licorice root (Glycyrrhiza glabra) coneflower (Echinacea purpurea) osha (Ligusticum porteri) and thuja leaf (Thuja occidentalis). Take 30 drops twice a day. Do not take licorice if you have high blood pressure.

Topical applications are most effective for treating warts. Stop any topical application if irritation should develop in the surrounding skin. For plantar flat and common warts use the following applications.

bulletBanana peel patch. Cut a piece of banana peel and place it over the wart before going to bed. Tape in place.
bulletRaw garlic patch. Cover the wart and surrounding skin with a thin layer of castor oil or olive oil. Apply a thin slice of fresh garlic and tape in place.

To maximize benefit place two to four drops of tincture of thuja or greater celandine (Chelidonium majus) on the wart before covering with peel or garlic. This application may need to be repeated nightly for up to three weeks. The wart will turn black as it begins to die.

For external genital warts paint the warts with vitamin A or beta-carotene once or twice daily. Add 3 to 4 drops each of thuja echinacea and lomatium for best results.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Acupuncture

Acupuncture may be helpful in stimulating your immune system.

Special Considerations

Do not use podophyllin if you are pregnant.

Supporting Research

Barker LR et al eds. Principles of Ambulatory Medicine. 4th ed. Baltimore Md: Williams and Wilkins; 1995:1467–1469.

Berkow R Beers MH. The Merck Manual of Medical Information. Whitehouse Station NJ: Merck Research Laboratories; 1997:984–985.

Brodell RT. Infect Med. SCP Communications Inc.; 1996:13:56–60 66.

Dambro MR. Griffith's 5-Minute Clinical Consult–1999. Baltimore Md: Lippincott Williams and Wilkins; 1999:1166–1169.

Duke JA. The Green Pharmacy. Emmaus Pa: Rodale Press; 1997: 452–455.

Ewald GA McKenzie CR eds. Manual of Medical Therapeutics. 28th ed. Boston Mass: Little Brown and Company; 1995:20–21.

Lockie A Deddes N. The Complete Guide to Homeopathy. New York NY: DK Publishing Inc; 1995:187 189 227.

Ody P. The Complete Medicinal Herbal. New York NY: DK Publishing Inc; 1993:160–161.

Pray WS. Nonprescription Product Therapeutics. Baltimore Md: Lippincott Willliams & Wilkins in press.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Durango Colo: Kivaki Press; 1994:73.

Walker LP Brown EH. The Alternative Pharmacy. Paramus NJ: Prentice Hall Press; 1998:353–354.