If you’ve noticed bumps on your skin, you may be dealing with warts. Here at California Skin Institute we’ve helped many patients remove warts with very little discomfort. If you think you have warts, it’s a good idea to get them checked out by a dermatologist, because in some cases they may end up leading to a more serious skin condition.
In this installment we sit down with Nikki Satovsky Melet, a Certified Physician’s Assistant at CSI San Francisco – Laurel Heights and CSI San Francisco – Pacific Heights, to talk about some of the best treatments for warts.
Q: What are warts, and how common are they?
NSM: So basically, warts are skin neoplasms, or growths of skin cells. Sometimes a patient will have just one wart, but these can also appear in clusters. They’re usually about one centimeter in diameter, on average. But they can range from just two millimeters to two centimeters in size, or about an inch. Overall, they’re actually very common. We treat them all the time.
Q: What causes warts?
NSM: The culprit that causes warts is the human pappillomavirus, which you can pick up in a swimming pool or walking barefoot at the gym. There are many types of warts that we see, including plantar warts, flat warts, and genital warts.
Plantar warts appear on the feet. They’re rough bumps that have a grainy texture to them and may even bleed sometimes.
Flat warts are not as bumpy as plantar warts, but they’re still quite visible because of the discoloration. These most commonly appear on the face.
Genital warts usually manifest as small bumps on the genitals. They can look like skin tags in some cases or can resemble a cauliflower. These are usually caused by skin-to-skin contact.
And, of course, there is also the common wart that can appear almost anywhere on the body.
Q: How do you diagnose warts?
NSM: A visual inspection is usually enough. Here at CSI, we deal with skin conditions on a daily basis, so we can often identify warts just by looking at them. But in some cases we may need to do a biopsy, especially if a patient has previously undergone treatment with a primary care physician but the warts didn’t go away.
Q: How are warts treated?
NSM: So, there are several ways. The most common way for treating warts in adults is through cryotherapy. We freeze the wart with a liquid nitrogen spray, which destroys the cells.
With young patients, we’ll typically use a treatment like Cantharidin, because the liquid nitrogen spray can be a bit frightening for them. Cantharidin is derived from blistering beetles, which is fascinating to most children, and, therefore, the procedure is more fun. So we really try to make it a pleasant experience.
In some cases, patients also need to do some work at home, especially if the office procedure isn’t working as quickly as they would like. This involves applying keratolytic agents, like salicylic or lactic acid, to gradually remove the excess skin cells at home.
For genital warts, we also have a number of options, including electrocauterization and cryotherapy. It sounds much scarier than it really is.
Regardless, of the patient’s situation, we always discuss all the options beforehand, so that the patient can have input into the process and we can find the best solution for them.
Q: How long does it take for the wart to go away?
NSM: Good question. It depends on the wart size. We can perform treatments in increments of about two to four weeks. Depending on the wart size, it can take anywhere from one to six treatments.
Q: Are warts dangerous, if left untreated?
NSM: It depends on the wart and other risk factors. One of the potential issues is that if a genital wart is left untreated, it may eventually develop into squamous cell carcinoma. Also, skin cancer can be confused with warts sometimes. We’ve had patients come in who were being treated for warts by their primary health physician, and upon further examination it turned out to be skin cancer. So it’s a very good idea to get checked out by a dermatologist if you have any questionable bumps on your skin.
(Nikki Satovsky Melet received her Physician’s Assistant Master’s degree from the University of New England, and has been helping patients for 17 years. She enjoys working with patients from all walks of life, from infants to seniors. Nikki is part of the San Francisco Bay PA Association and works in many aspects of cosmetic and general dermatology.)