“Thirty eight… and seven.”

“Nice.”

Such was the interaction between one of my older brothers and me when he would return for a visit from college.  I was eight years old and my brother always wanted to know how many warts I was up to and how many scars I had on my head; I had a tendency to have more than the usual number of both.

We’ll leave the scar issue alone, but what about warts?  Mine dotted my hands, knees and forearms.  Happily, at around age eleven, when I began to actually care about these mild disfigurements, they started to magically disappear. Finally, I was left with four rather large warts: three on the hands and one on my knee.  These persisted stubbornly for another year and showed no sign of leaving despite my various attempts at home surgery.

Then someone told me that I needed to cut a raw potato in half and rub it on the warts and then bury the potato.  I had some skepticism… especially about the need to bury the potato.  But, hey, if I was going to do this, I might as well do it right.  Grabbing a spud out of the five pound bag of potatoes, I halved it, rubbed it on each wart and buried it in the garden.  I can’t say I really expected much.  But in the next three weeks all four of those large warts that had been stubbornly present for four years disappeared.  And now I want you to buy some of my Dr. Smith’s Magic Potato Wart-Be-Gone. Ok, I’m just kidding about that last sentence.

The point is this: warts are fickle, weird things.  They are caused by a virus, the human papillomavirus (HPV). There are over a hundred different strains of HPV known and they cause common warts, flat warts, genital warts and plantar warts (on the bottom of the feet).  They are spread either by direct skin to skin contact or indirectly when a wart touches a surface and then the virus is picked up when someone else touches that surface afterwards.

That contagiousness is one of the reasons that up to 10-20% of school age children may have warts at any given time.  And they can be anything from one tiny wart to my thirty eight (or more) to large mats of warty tissue called mosaic warts.  They can occur at any age, but peak in the middle teens.  At some point, if you’re fortunate, your immune system kicks in and knocks out the warts.  But sometimes this seems to take forever, and since it’s caused by a virus, a person may get more and more of them.

So, what do you do about them?  There is a saying in medicine: when there are lots of different treatments for a problem that means none of them works extremely well (or everyone would just use the one extremely effective treatment).  Warts have lots and lots of treatments, starting with just ignoring them.  About 65% of warts go away on their own within two years.  But, as we’ve said, some begin to spread and grow and refuse to disappear quietly.  For these there is salicylic acid, a somewhat effective non-prescription treatment. There are numerous acid applications including blister beetle juice.  My go-to treatment is the application of liquid nitrogen.  Occasionally a single application is sufficient, but more often a few applications at three week intervals is needed.  Even more aggressive measures such as surgical excision or laser can be used, but this sometimes replaces a temporary wart with a permanent scar.  One other measure that deserves mention is the injection of a small amount of a material into the wart which triggers an immune response against the wart.

The list of alternative treatments is both endless, and somewhat humorous.  It includes adhesiotherapy (that would be applying duct tape to the warts daily), raw garlic, hypnosis, tea tree oil, propolis resin, hyperthermia (immersion in 113 degree water for 30-45 minutes 3 times weekly), cimetidine, and the list goes on.  Because warts will sometimes spontaneously go away at the urging of our immune system, many approaches that trigger an immune response may aid in the disappearance of warts.  That is probably even why the potato treatment may have helped my warts.

So if these rough little bumps start showing up on your epidermis, don’t blame frogs and toads; it’s those nasty microscopic viruses.  And if you don’t want to ignore them, you’ve got lots of options.  If you’re a little desperate, you might even start with a potato… and you may want to start treatment before you get to a count of thirty eight.