Warts and Molluscum

We get calls about warts on a fairly regular basis. Warts are usually caused by a virus. These tricky little skin growths have evolved over time so that they have the ability to invade the body without triggering the immune system.

Dr. Grogan, a terrific local podiatrist tells his patients to imagine that their body is a castle that has guards, but somehow the wart has sneaked through the defense system and is already at the castle walls.

Plan A for getting rid of them is to gently remind the body that there is a wart and we want it gone. Make the body pay attention to this unwelcome guest by causing a bit of irritation to the area. Think of this process as an “Intruder Alert” signal to the body.

Warts have an easier time getting onto skin that is not intact. If your child has eczema or is a nail biter, they are more prone to warts. A person whose immune system has been going through a tough time, one illness after another, may also be a bit more prone to getting warts.

A wart is on the bottom of the foot is referred to as a Plantar wart. Because there is so much pressure from walking on it, those warts tend to be deeper and probably will do better with help from the specialists. Dr Grogan's office uses something call cantharidin (fun fact, this is a substance secreted by blister beetles.) It may take 4 or 5 applications; most kids tolerate the treatments pretty well.

For warts on other parts of the body, Dr. Cheung my ‘go to” dermatologist, prefers the 40% salicylic acid patches (Mediplast.) These are used for any age. Cut the patch to the size of the wart and cover the area with duct tape.

Do the application after a shower or bath. Even if you skip a daily bath,the patch should be changed every 24 hours or so. When you remove the patch, it is quite normal for part of the wart to peel off. You can also use an emery board to gently debride the area in between patch changes.

Go ahead and make an appointment for the dermatologist to take a look at things and evaluate treatment options, but it is fully possible that if you make an appointment a month in advance, the home treatment will take care of it and then you can just cancel the appointment (of course give a 48 hour warning.)
Dr Schwanke is also happy to see a wart here in the office to help with a treatment plan.

If you do end up at the dermatologist, they will base the treatment on the age of the patient. For older kids, Dr. Cheung finds that freezing them off with cryotherapy is the most effective treatment. Most warts require multiple visits, spaced about a month or two apart.

If you are seeing clusters of warts, another possibility is a fairly common wart related skin disease called Molluscum (muh-luhs-kum) contagiosum (kən-tā-jē-ō-səm). Just like common warts, this is caused by a virus and can easily spread from person to person.

People can get molluscum by sharing towels and clothing. Wrestlers and gymnasts may get it from touching infected mats. Skin-to-skin contact also spreads the virus. Often the only sign of molluscum is pink or flesh-colored bumps on the skin. These bumps can appear anywhere on the skin.(usually not on the palms of the hands or the soles of the feet.) Most people get about 10 to 20 bumps on their skin. If a person has a weakened immune system, they may have way more than that.

Bumps on the skin can be the only sign that a person has molluscum contagiosum. These bumps often appear about 7 weeks after being exposed to the virus that causes molluscum. Sometimes, the bumps do not appear for many months. When the bumps appear on the skin, they often:

• Begin as small, firm, dome-shaped growths.
• Have a surface that feels smooth, waxy, or pearly.
• Are flesh-colored or pink.
• Have a dimple in the center. The dimple may be filled with a thick, white substance that is cheesy or waxy.
• Are painless, but some bumps itch.
• Turn red as the person’s immune system fights the virus.
• Appear on other areas of the body after a person scratches or picks the bumps. Scratching or picking can spread the virus.

This condition usually goes away by itself within a year, but I would probably give the same advice as I do for warts; go ahead and make that non-urgent dermatology appointment. If it isn’t clearing up on it’s own within a month or two, it is worth seeing what treatment options are available to you. Unfortunately folks can get this more than once. Having a prior case does not seem to give immunity.There are lots of internet 'cures' for this including coating the body with silver....., but they are likely a waste of time and money.

Warts are viral - shoes, socks and anyplace where bare feet have been in contact with should get sprayed or wiped down with Lysol. It is best not to share baths with siblings if they have warts or molluscum. Swimming in a pool is fine because of the chemicals.

There are loads of other the counter suggestions out there. Most are harmless but probably ineffective. Keep in mind that the goal is to irritate the wart enough that the body’s immune system is stimulated to come in and help get the job done. I will equate the natural remedies such as tea tree oil to using a watering can to fight a fire. The OTC wart patches are your fire extinguishers. The dermatologists and podiatrists have the fully equipped fire trucks!

Any lesion, wart or otherwise, on the body that isn’t gone within a month or two is worth an evaluation by a specialist. Dr. Cheung cautions that although it is very rare, some warts can turn into skin cancers, so get them checked out. Early intervention can make all the difference.