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Dr Phil: You and your warts

But I don't have warts

Dr PhilPerhaps not yet, but one in ten of us will have at least one wart at some time during our lives.

Is this a recent development?

Not at all. Warts were categorized into four types as far back as the first century AD, and wart therapists used to wander the streets of Rome sucking them out and, if that failed, biting them off.
 

Oh, yuck. Who gets them these days?

It's hard to say. Some people are just prone to them and if you've had one, you're three times more likely than a wart-virgin to have another. Also, some occupations seem to encourage warts e.g. fishmongering, poultry processing and butchering.
 

So stuffing a turkey gives you warts?

Not exactly. Warts are infections with different varieties of the Human Papilloma Virus or HPV. This hardy bug can survive in temperatures as low as 25°C and has been found alive and well on warm, wet surfaces such as the sides of Tooting Lido. The virus gets into the body through cracks in the skin and can just hang round doing nothing for months or years without you realising it's there. Then one day, it decides to multiply and out pops the wart.
 

What would happen if I just left it alone?

About a fifth vanish in 3 months, a third are gone by 6 months and half by 2 years. If you're unlucky, it may last for 5 years or so. If you have a good immune system, it will eventually see off the wart, and only those whose body defences are weakened (e.g. with cancer or AIDS) suffer incurable warts. Once the wart has gone, your immune system will resist infection with that particular strain for about 4 years, but alas will not protect you against infection from other strains.
 

How many strains are there?

More than 120.
 

All causing knobbly fingers?

No. Warts come in a wide variety of appearances and body sites. The common knobble on the fingers and back of hand is down to HPV types 1-4, usually HPV2. This also causes the flattened wart, or verruca. It's flat because pressure from the foot makes it grow in rather than out, and this can be a bit painful. The filiform wart is an unsightly brush like protuberance, usually on the face, and the plane wart is small, flat and harder to spot. Periungual warts occur in the nail margins of people who suck their fingers until the skin cracks, and can distort the nail. Mosaic warts cause pretty patterns on the feet and are very hard to treat and anogenital wart viruses are sexually transmitted. Some cause unsightly warts, particularly HPV types 6 and 11, and some can cause cervical cancer, particularly types 6 and 18.
 

Can't you vaccinate against them?

Yes. The government has just introduced a vaccination programme for schoolgirls using Cervarix, which protects against the cervical cancer causing viruses only. If you want protection against genital warts too (which are much more common than cervical cancer), you have to pay privately for another vaccine, Gardasil (which is what I've done for my daughter). Both vaccines work best before any sexual exposure, which is why they're given early. Once you've had sex, it's very likely you'll be exposed to HPV, which makes vaccination much less effective.
 

Don't condoms stop transmission?

Condoms are great for stopping infections like gonorrhoea and Chlamydia but wart virus is spread by skin to skin contact and condoms are only about 50% effective at blocking HPV.
 

If I get warts, should I treat them or leave them be?

That's a tough call. Genital warts are itchy, unsightly and infectious so it's worth getting these treated although it can be a messy, protracted, uncomfortable business. They can be frozen off but it's more common to use a paint or cream that you'll need to get on prescription (and you may not be able to use if you're pregnant). It's worth getting a check up for other sexually transmitted infections too, because they tend to go round in gangs.

Warts away from your privates nearly always go away on their own but over the counter treatments are available that can speed the process up (although you can't use them on your face). Wart paints, ointments and gels contain either salicylic acid to break down keratin or lactic acid to disrupt the wart's acid balance. Treatment requires a daily 10-minute warm water pre-soak, drying, smoothing the wart with a pumice stone and applying the lotion. After 12 weeks of daily treatment, 80% of warts will go but, as you can imagine, very few sufferers stay the course. You can try strapping your warts for 2 months with duct tape, as described elsewhere on this site.
 

Can't a doctor just scrape it off?

Warts can be surgically scraped or cut off, although this method has largely been replaced by cryotherapy with liquid nitrogen at -196°C. It's sprayed or dabbed on with a cotton bud, and up to six treatments a fortnight apart will see off most hand warts. GPs used to do this but most don't consider it to be part of the NHS. However, freezing aerosols are now available from pharmacies. Whatever you do, don't try to scrape warts off yourself with a knife or a cheese grater. It could all end up as an embarrassing visit to casualty.
 

If I've got genital warts, when can I have sex again?

Most people are told to wait until the warts have been successfully treated, and then use condoms for the following three months. However, this isn't a perfect science. Most of us have been exposed to wart virus at some time but only a few of us get warts, and even after treatment the virus doesn't go away but sits under the skin. Condoms are always worth wearing, preferably on your head, but there isn't a foolproof way of stopping the spread of genital warts other than avoiding all skin-to-skin contact, which is why some sexual health specialists advocate vaccinating boys, as well as girls, against HPV.
 

What about complementary treatments?

Hypnosis has been shown to hasten the disappearance of warts and reduce their recurrence rate, probably by some strange affect on the immune system. Folk remedies remain very popular, especially for hand warts. There are four types of charm. (1) Wasting the wart is rubbed with something that is then discarded. As it decays, so does the wart (allegedly). (2) Incantations you can make up your own or get someone else in to incant for you. (3) Specifics the wart is rubbed with the flavor of the month remedy (Kate Winslet's tears, a widow's wedding ring, early morning spit, etc). And (4) transference the wart is rubbed with something left for someone else to find. The finder then keeps the warts as well.
 

How charming

 
Dr Phil Hammond is a medical doctor, comedian and commentator on health issues. http://drphilhammond.com

Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last updated: Friday, August 13th 2010


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Comments on this article

Posted by Optional on 20/07/2017 at 09:42

Hi dr, please give me some advice. I've had warts for nearly 7 years now, I regularly get them freezed but the still keep coming back, I am in a long term relationship.

Posted by Optional on 19/03/2016 at 09:51

I have white pin head sized growth on my right nipple. It gets itchy sometimes. Should I be worried?

Posted by tiny on 11/12/2015 at 10:15

i have genital warts, what can i use to treat them?

Posted by mel on 14/05/2015 at 01:59

so ,i have not been active sexually in a very long time,but meet someone, he has cauiflower growths ,located in his pubic area,andinner thigh, they are large clusters,he says he has always had them,am I in danger,I have never had any STD,need help scared..

Posted by Optional on 30/10/2014 at 09:47

Hello doctor, I have had genital warts for quite a time talk 2yrs but was using podofilyn as instructed by my doctor. it seems to go but comes back, and now its in the opening of my penis but started on the shaft. Could there be tablets one can swallow in order to get rid of it. Coz it's now scaring me. Please I need help. Thanks.

Posted by Optional on 08/10/2013 at 12:19

I have had warts on my face for so long and as i grow,they seem to grow and multiply! Please help me. There is no sign of them disappearing naturaly!

Posted by matt on 21/05/2013 at 09:13

I have a small wart in my bellybutton..how do I get rid of it?The doctor said it was too dangerous to remove it..any help appreciated..

Posted by Anonymous on 01/08/2012 at 06:14

I went to a nearby clinic and was told i have genital warts and i got treatment for it a "silver nitrate applicators"but im not sure how to use it can you guys help?

Posted by Optional on 05/03/2012 at 06:01

I went to medical check up just now at women's specialist and the doc said I infected with genital warts around the vulva. I got the injection just now. will I get infection of cervical cancer? Doc suggested me to get HPV vaccine, is this vaccine still effective to me, since I got HPV.

Posted by sophia d on 30/06/2011 at 08:50

i m still tryin to come to term with my warts.......

Posted by Confused on 24/05/2011 at 06:15

I was diagnosied with hpv in 2007.I get big csyic they take forever to come to a white head.do I have acne or wartz I have them on the outer part on my vigina.

Posted by Optional on 23/11/2010 at 09:37

How do I remove the pink wart atachet to the inside of the tip of my penis?

Posted by Optional on 23/10/2010 at 08:00

How do they get rid of the ones that are on the cervix or the vaginal wall?

Posted by Optional on 05/10/2010 at 07:31

I have been to the doctors about some little flat warts on the top of my feet is there any treatment to get rid of them. Mrs Neve

Posted by Optional on 29/09/2010 at 03:42

i have warts on my neck. they are like little flaps of skin.would i be able to get rid of them like they were ordinary warts?

Posted by Optional on 15/07/2010 at 10:19

i was told i had genital wartsin 2002 i had them treated rite away and have not had any back but im worried as ive met a new partner and am scared he will get them from me please advise me since not having them back does that mean im clear of them now ??

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