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By: Jason Cheyney, MPAS, PA-C

Good day all,

Warts are a problem faced by many individuals, it is one of the more common complaints I address in my clinical practice.  What is a wart for starters?  Well a wart is virus that is contracted from person to person.  There are several types of warts seen in the human population most have no long term medical complications but several are associated with increased cancer rates.  The most common wart is seen on the hands and feet.  I hear a lot of confusion about the Plantar wart.  Most people tend to think it is called a “planter” wart and that it is a type of wart unto itself.   The reason a wart is called a “plantar” not “planter” is due to anatomic location.  The bottom of the foot is called the plantar aspect of the foot.  This is probably one of the most common places to find a wart.  Why?  Well we spend most of our time on our feet so injury and micro trauma are common problems encountered with upright movement.  With this trauma if your skin comes in contact with the wart virus it is going to invade the area of trauma and set up shop.  I hear from numerous individuals how they had a splinter in their foot and now there is a wart in the same location.  The virus takes advantage of the vulnerable injured area of the foot and sneaks in under the skins immune system radar and sets up shop.  The wart virus sheds regularly and makes it easy for individuals to contact the virus through exposure in shower floors, community pools and other barefoot type multi-use areas.  Most contraction of warts probably occurs in the home with other family members.

Wart treatments are varied and difficult.  I try to encourage most individuals that have a wart, that is not problematic, to leave it alone and let the immune system take care of it.  Unfortunately, some warts are so unsightly or cause pain and discomfort and treatment it necessary.  The most common therapy encountered in the provider’s office is application of liquid nitrogen.  This is painful and not always successful requiring multiple treatments and possibly long-term scarring.  I use this technique daily but am always concerned about the scarring that develops.  I hate replacing a short term problem, a wart that will resolve with no evidence, with a long term reminder, a scar.  Surgery is another option with an even greater risk of scarring and the same view is shared on that.  I reserve surgery as the absolute last ditch effort.  There are a multitude of over the counter liquids and wart removers, most contain some percentage of salicylic acid that causes erosion of the warts.  I encourage a lot of patients to use these products and directed by the manufacturer due to the relative pain free approach.  These treatments are also non-scarring in most cases.  A less scientific approach is application of duct tape at night and removal in the morning.  A combination of duct tape and over the counter liquid wart remover works well.  I have heard a lot of folk remedies over my career and am not sure what to say about most.  I avoid recommending any treatments that haven’t been tested for safety.  There are several prescription topical medications approved for wart treatment and occasionally use those but the cost is substantially more than the over the counter treatments and don’t seem to be any more effective so are rarely prescribed by myself.

See Jason Cheyney, MPAS, PA-C in Myrtle Beach, San Antonio and Las Vegas.