The Orlando Sentinel

They’re embarrassing, sometimes painful, and conjure up images of nannies named McPhee.

If you’ve ever had warts, those black-dotted barnacles that sprout from skin or mucous membranes, you probably know they come not from smooching frogs but from a toad of a germ, the human papilloma virus (HPV). It enters the body through moist or compromised skin through direct or indirect contact, and the virus remains present and contagious (newer warts contain more HPV than older ones) until the wart clears up.

Although warts are medically benign, for some they can inflict emotional harm – even if more than half of warts disappear within two years without intervention. For those who don’t want to wait, an arsenal of treatment options have emerged in recent years.

“There is no silver bullet for warts,” says Joshua L. Fox, a dermatologist and founder of Advanced Dermatology and the Center for Laser and Cosmetic Surgery in New York. But with modern treatments, he says, “we are able to eliminate the warts” and that helps “prevent the spread from family member to family member and friend to friend.”

A round of “benign neglect” is what dermatologist Randall Coverman prescribes in most cases. If standing pat isn’t your style, he says over-the-counter wart liquids and patches that contain salicylic acid “do keep them from getting larger.” If after several weeks there is no change, a dermatologist can try freezing warts with liquid nitrogen, the gold standard for warts.

However, Coverman doesn’t advocate it for kids – who along with teens are most commonly plagued by warts. Freezing can cause scarring and discoloration, and for kids, can be painful.

Cantharidin – an extract from the blister beetle – presents another option. Doctors mix the extract with other chemicals, slather it on the wart and cover the area with a bandage. After a time, the concoction blisters off the wart, which can cause discomfort.

If cost isn’t an issue, Coverman calls imiquimod cream (sold under the brand name Aldara) “a great treatment.” It boosts the immune reaction to warts and helps the body battle HPV.

Stubborn warts might require more invasive options. One infrequently used treatment involves injecting the diluted chemotherapy drug bleomycin into the wart, which kills the virus. Coverman says the drug works, but “no more so than other things,” adding the injections can be painful.

When all else fails, wart-sufferers can try laser surgery, expensive and potentially scarring, or minor surgery to excise or destroy the wart, both painful and presenting a scarring risk.

Which is why, although treatment can manage warts, Coverman tries to quell patients’ desire for aggressive treatment by sharing his daughter’s story.

“Every finger of her hands had a wart on it,” he says. “It took her three or four years, but they all spontaneously resolved. No scars.”

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(c) 2006, The Orlando Sentinel (Fla.).

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Distributed by Knight Ridder/Tribune Information Services.

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ARCHIVE ILLUSTRATION on KRT Direct (from KRT Illustration Bank, 202-383-6064): warts+illus

AP-NY-05-26-06 0612EDT