Noah Sinclair
Warts are caused by the human papillomavirus (HPV) and can be challenging to treat. Periungual and subungual warts, which occur around and under the nails, are particularly difficult to treat due to their location. Various methods can be used to remove them, including over-the-counter or prescribed topical medications, cryotherapy (freezing the warts with liquid nitrogen), and surgical procedures. These treatments aim to eliminate symptoms, clear the appearance of warts, and prevent further spread, as there is currently no cure for warts.
| Characteristics | Values |
|---|---|
| Types of warts | Periungual warts, Subungual warts |
| Location | Periungual warts: around the finger or toenails; Subungual warts: underneath the fingernail |
| Appearance | Periungual warts: covered by the nail or create a raised/rounded shape around the nail; Subungual warts: the skin around the nail becomes raised and ridged |
| Treatment | Salicylic acid, Cryotherapy, Duct tape occlusion therapy, Imiquimod, Intralesional immunotherapy, Electrodesiccation and curettage, Topical medicine, Fluorouracil, Bleomycin |
| Preventative measures | Wash hands regularly, avoid biting or picking at nails, wear protective gloves when washing dishes, do not share personal items, disinfect nail clippers and similar equipment after each use, ensure salon workers change gloves between clients |
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What You'll Learn
- Salicylic acid: A popular over-the-counter medication that can destroy the HPV virus
- Cryotherapy: Liquid nitrogen is used to freeze off the warts, causing blistering and skin discolouration
- Preventing contagion: Warts are contagious, so it's important to wash hands, not share personal items, and disinfect equipment
- Duct tape: Mechanism is unclear, but may deprive the wart of oxygen or remove dead skin and viral particles
- Intralesional immunotherapy: An injection of a skin-test antigen causes an immune system attack on the wart
Salicylic acid: A popular over-the-counter medication that can destroy the HPV virus
Salicylic acid is a popular over-the-counter medication used to treat warts. It is a slow-acting chemical agent that is absorbed into the skin, causing the peeling of skin cells that contain the wart virus. Salicylic acid is one of the most studied treatments for warts, and it has been found to be effective in destroying the HPV virus, which is responsible for periungual warts. Periungual warts are a common type of wart that occurs under and around the nails and can be challenging to treat due to their location.
Salicylic acid is a good option for treating periungual warts because it can be applied topically, which is less invasive than other treatment methods such as cryotherapy or surgical removal. However, it may take up to 3 months of regular applications for the wart to be eliminated. During this time, it is important to practise good hygiene and take steps to prevent the spread of the virus, as warts are highly contagious even during treatment. This includes washing hands regularly, avoiding biting or picking at nails or cuticles, disinfecting nail equipment, and not sharing personal items such as towels or nail clippers.
While salicylic acid is available over the counter, it is recommended to consult a doctor before using it, as it can cause skin irritation. Additionally, a doctor can advise on the proper strength and application method for the medication. In some cases, a doctor may need to make an incision in the nail to access the wart, especially if it is a subungual wart located directly underneath the nail.
The success rate of salicylic acid in treating periungual warts is about 50 to 70%, which is similar to other treatment options such as cryotherapy. Cryotherapy involves freezing off the warts using liquid nitrogen and may require fewer treatments than salicylic acid. However, it can also cause blistering and skin discolouration. Other treatment options for periungual warts include topical medications such as cantharidin, which cuts off the blood supply to the wart and forms a blister, and intralesional immunotherapy, where the wart is injected with a skin-test antigen to trigger an immune response.
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Cryotherapy: Liquid nitrogen is used to freeze off the warts, causing blistering and skin discolouration
Cryotherapy is a common way to remove warts. It involves freezing off the targeted cells and tissues. Warts are noncancerous tumors that develop due to human papillomavirus (HPV) infections. There are several different types of warts, and various strains of HPV can cause them.
Liquid nitrogen is used to freeze off the warts, which can reach temperatures as low as --320 F. Doctors use either a cotton swab or a spray "cryogun" to apply the liquid nitrogen to the wart and some of the skin around it, pressing on the wart for a few seconds. This may feel like an ice cube touching the skin, but it won't last long.
As the skin gets warmer (thaws), it may feel hot or like it's burning. The skin may also hurt, turn red, or form a blister. Blistering and skin discolouration are common side effects of cryotherapy. In some cases, the liquid nitrogen might give you a headache, especially if the wart is on your forehead or temple.
Cryotherapy usually requires fewer treatments than salicylic acid, often only needing three to four treatments spaced 2 to 3 weeks apart. Success rates for salicylic acid and cryotherapy are about the same, with reported success rates in 50 to 70 percent of cases. Cryotherapy can also be used in combination with salicylic acid.
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Preventing contagion: Warts are contagious, so it's important to wash hands, not share personal items, and disinfect equipment
Warts are highly contagious and are caused by variations of the HPV virus. They can spread from person to person or from one part of the body to another. They are usually harmless and non-cancerous, and most people will have a wart at some point in their lives. While they often go away on their own, they can be bothersome and even lead to permanent nail damage if left untreated.
To prevent the spread of warts, it is important to practice good hygiene and take precautions when visiting nail salons. Here are some measures to prevent contagion:
Wash your hands regularly: Handwashing helps remove the virus from your skin and reduces the risk of spreading it to others. Wash your hands frequently, especially after treating a wart or touching someone with a wart.
Avoid sharing personal items: Do not share items such as towels, razors, nail clippers, nail files, or other personal care items. HPV can be challenging to kill with disinfectants, and shared items can be a source of transmission. Ensure everyone in your household has their own set of personal items to minimize the risk of spreading warts.
Disinfect equipment: Always disinfect nail-cutting equipment, including clippers and cuticle sticks, after each use. If you visit a nail salon, ensure the technician uses new or properly disinfected tools for each client. Disposable tools, such as nail files and buffers, should be discarded after each use.
Protect your skin: Avoid biting your nails, picking your cuticles, or touching warts. Keep your skin clean and dry, and cover any cuts or scrapes to prevent the HPV virus from entering through broken skin. If you need to shave, avoid shaving before a salon visit as it can increase the risk of breaking the skin.
Wear protective gloves: When your hands are in water for extended periods, such as when washing dishes, wear protective gloves. This prevents direct contact between your skin and water, reducing the risk of transmitting the virus.
By following these precautions, you can help prevent the spread of warts and protect yourself and others from contagion.
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Duct tape: Mechanism is unclear, but may deprive the wart of oxygen or remove dead skin and viral particles
Duct tape occlusion is a low-cost, safe, and popular method of wart removal. It involves covering the wart with a small piece of duct tape for an extended period, usually about five days. The tape is then removed, and the wart is scrubbed and soaked in warm water. An emery board, pumice stone, or sandpaper can be used to slough off the top layer of the wart. The process is repeated until the wart is gone, which can take several weeks.
The exact mechanism by which duct tape removes warts is unclear. One theory suggests that the tape deprives the skin cells of oxygen, causing them to die. Another possibility is that the process of applying and removing the duct tape helps remove dead skin cells and viral particles, reducing the bulk and visibility of the wart.
While duct tape is a widely used home remedy for wart removal, studies on its effectiveness have produced mixed results. Some research indicates that duct tape is no more effective than a placebo. Additionally, the duct tape method can be challenging to maintain, as the tape must be frequently reapplied and kept on the wart for several weeks.
It's important to note that duct tape wart removal may cause skin irritation, especially in individuals with sensitive skin or conditions like eczema or psoriasis. In such cases, removing the duct tape can be painful and may even lead to contact dermatitis. Therefore, it is advisable to consult a healthcare professional before attempting any wart removal treatment, including the use of duct tape.
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Intralesional immunotherapy: An injection of a skin-test antigen causes an immune system attack on the wart
Warts are common viral infections caused by the human papillomavirus (HPV). While warts can often resolve on their own, treatments exist to eliminate symptoms and clear their appearance. One such treatment is intralesional immunotherapy, which has been shown to be effective in treating warts in challenging areas such as the subungual and periungual region, palms, volar surface of the fingers, and plantar surface of the feet.
Intralesional immunotherapy involves injecting a skin-test antigen into the wart, causing an immune system attack on the wart. The Mycobacterium w vaccine (MWV) is one such antigen that has been studied for its efficacy and safety in treating warts. In a double-blind randomized clinical trial, 67% of patients who received the MWV showed complete resolution of their warts, compared to 59% in the imiquimod group. The study also found a significant decline in the mean viral loads of HPV-6 and HPV-11 in the MWV group.
Another study by Marjid et al. (2013) examined the use of intralesional immunotherapy with the Candida Albicans antigen in resistant or recurrent warts. The treatment was found to be effective in achieving resolution of the warts. Other skin-test antigens that have been studied for intralesional immunotherapy include mumps, measles, rubella, and trichophyton.
Intralesional immunotherapy offers a promising approach to treating warts, especially in difficult-to-treat areas. However, it is important to note that there is currently no Food and Drug Administration (FDA)-approved treatment for intralesional therapies, and more research is needed to determine the most effective approach.
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Frequently asked questions
Periungual warts are caused by the human papillomavirus (HPV) and often form around the finger or toenails. To prevent them, you should avoid biting or picking at the fingernails or cuticles, wash your hands regularly, and wear protective gloves when your hands are in water for extended periods.
There are various treatment options available, including salicylic acid, cryotherapy (liquid nitrogen), and injections of antigens like mumps or Candida. Doctors may also prescribe topical medications such as cantharidin, which cuts off the blood supply to the wart and forms a blister.
Salicylic acid is a commonly used over-the-counter medication for wart removal. It is slowly absorbed into the skin, causing the peeling of skin cells that contain the wart virus. It is important to consult a doctor before using this treatment, as it may cause skin irritation.
Cryotherapy involves using liquid nitrogen to freeze off warts. It may require three to four treatments, spaced two to three weeks apart. This treatment can cause blistering or skin discolouration and may be painful.
Some people find success with duct tape, which may deprive the wart of oxygen or remove dead skin and viral particles. However, there is limited understanding of its effectiveness. Maintaining good hygiene and disinfecting nail equipment can also help prevent the spread of warts.
