By Dr Katie (GP)

 

Ahhh… warts! The bane of many school kid’s, and their parents’ existence.  When I was in high school I had warts on the underside of my feet, Plantar warts.  They used to drive me nuts and it felt like I tried everything to get rid of them.  The budding doctor in me even tried to surgically remove them at the kitchen table using ice for a numbing agent and an old scalpel of my Mother’s from her university days (I definitely do NOT recommend trying that one at home!)  I survived the experience thankfully, but frustratingly, so did my Plantar warts.  Then one day they just weren’t there anymore, and I have not suffered with one since.  So what are they, how do we get them, and most importantly how can we get rid of them?

Warts are little lumps on the skin which are caused by a viral infection.  The offending family of viruses is the Human Papilloma Virus (HPV) family, and there are many types of HPV that can cause warts.  Wart often have different names depending on where they are or what they look like.

 

The most common types of warts are:

• Common warts – the type of warts seen most frequently and often found on hands or knees, though can be found anywhere on the body
• Plantar Warts – most often seen on the soles of the feet
• Plane Warts – flat, smooth warts often found on the lower legs or face often in lines
• Filiform warts – small, long warts that grow out from the skin usually on the eyelids or lips
• Genital warts – occurring on the genitals and caused by a specific type of HPV.

It is thought that up to 1 in 5 children will experience warts throughout their childhood.  They are commonly spread directly through skin to skin contact, though may also be caught from walking around barefoot at public swimming pools or showers.  It may take many months after the original infection occurs before the warts become evident on the skin.  It is also important for your child not to scratch or pick at their warts as they can easily spread them from place to place on themselves.

 

So what can be done to get rid of warts?  I’m sure most of us can think of at least one old wives tale we have heard of to treat them… Banana skins anyone?  But what are the options that  might actually work?

One option is to do nothing at all.  The viruses that cause warts do a pretty good job at hiding from our immune system, but eventually the immune system figures it out and clears the virus from the body.  Up to 90% of untreated warts will disappear on their own within the space of about 2 years.  There is no harm in just waiting for this to occur, particularly if your child is not bothered by them.

 

If, however your child finds them uncomfortable or embarrassing, then there are some things you can try to help stimulate the immune system to recognise and fight the virus more quickly:

1. Simple occlusion (ie covering them up) can be quite effective.  Use a strong occlusive tape, like duct tape (is there anything it can’t do?) and tape over the warts.  Leave the tape in place for 24hrs a day and replace it when it starts to pull away or look a little worse for wear.  This process is easily tolerated by even young kids but can take several weeks or months to work.
2. Wart paints or ointments are readily available over the counter at the chemist.  These can be quite effective if used correctly but can take months of nightly use before they can have an effect.  It is important to protect the surrounding skin from irritation, I suggest painting it with a little clear nail polish first, then prepare the wart by soaking it then filing the top layers of skin off with a nail file or pumice stone.  You can then apply the wart paint and cover the wart with duct tape or a plaster.  This needs to be repeated nightly until it disappears.

If these options fail, it may be worth a visit to your GP to discuss other options.  In older kids we can often try freezing the warts using liquid nitrogen which works best if the top layers of skin are pared back prior.  This can be temporarily painful however so not suitable for everyone.

Surgical removal of the warts is not usually an option as it is invasive and often not curative (that is, they come back!).

All of these potential treatments aim to work by causing inflammation and stimulating your own immune system to recognise the wart virus and fight it off.  Thus sometimes you only need to treat one or two of the warts to kick off the process which will cause them all to disappear.  When they finally do disappear, it can occur quite suddenly.  Some warts however, may be particularly recalcitrant and may not respond to any of the methods of treatment above, and sometimes our only option is to wait it out.  Sometimes a referral to a dermatologist is necessary.

So what should I do if I think my child has warts? 

The first step if you are unsure whether your child has warts is to visit your friendly GP to confirm the diagnosis and have a discussion about which form of treatment, if any, may suit you and your child.

It is especially important to visit you GP if your child has a very sudden or extensive outbreak of multiple warts as very occasionally this may signal a problem with your child’s immune system.

 

So that’s it folks, a quick rundown of a most frustrating condition.  Stay tuned for my next post.