A Family Doctor's Tale - WARTS, CORNS And CALLUSES

DOC I HAVE A WART,CORN OR CALLUS

WARTS, CORNS And CALLUSES was supposed to be in the blog after skin infections but I decided the Common Cold and Influenza are more common illnesses seen by family doctors and should be read first.


Warts are cauliflowered swellings present on the foot(plantar wart), hand(palmar) and even genitalia of the body(sexually transmitted). 
The cause is a viral infection called the human Papilloma virus which can spread from one person to another through direct contact provided there is a break in the skin exposed to the wart.

Sometimes they may disappear by themselves after several months. 
However in the worst cases they become bigger and can spread to the other parts of the body.

There are all sorts of treatments for warts:
1.Traditional: 
Vinegar and Chinese herbal medicine has been used to dissolve the wart. The cure rate is low.

2.Duct tape has been used over the wart to occlude it from air in the hope of it disappearing. Again the cure rate is low.


3.Western medicine include:

a.Salicylate acid in over the counter Duofilm, Compound W , Wartgone are applied over the wart for about ten to fourteen days giving rise to a white coat over the wart for several days before peeling off together with the wart. 
However the recurrence rate is quite high.

The medicine can also dissolve corns and calluses in the same way because the medicine removes thick skin. They may be called Collomack or Corn therapy. 
Again the recurrence rates are high because corns are caused by pressure points and calluses by friction.

b.Podophyllum resin cream has also being used on warts with good effect except again the recurrence rate is high.

c.Liquid nitrogen spray can also be bought in England and other countries to freeze the wart but often it did not work.

d. 5flourouracil ointment is an anticancer drug which when applied to the wart seems to be the best for the removal of the wart but act slowly. 
After a few months of application the wart usually disappeared. Only problem is that it is difficult to get in Singapore.


I had a patient from England who had tried salicylate lotion, liquid nitrogen and then tried the Fluorouracil ointment find his wart disappeared after a few weeks of constant application.

e. Silver nitrate pen used for stopping nosebleeds can also work in burning the wart. However it is a bit painful.

4. Surgery:
a.Surgical removal of the wart usually get rid of the wart but recurrence can occur unless the root is removed.
Even then the wart can grow again in the excised operation wound.

b.The best treatment in a family practice is electrical cautery removal of the wart. 
Not only does it remove the wart but it destroy the root of the wart preventing the virus to grow on dead tissue.

A patient with wart is given a local anesthetic at the cleansed wart site.
Once the wart site is numb (completely anesthetised) , the wart is burned using the cautery machine until the root of the wart is removed. The wound is cleansed and antibiotic cream is applied. Because of burning of the root area, the virus do not have a living tissue to regrow in. So the chances of the wart recurring is very low.

Corns and calluses are thickened usually caused by pressure points and friction.

Surgical removal of the corn and callus just removed the hard thickened skin which caused pain by pressing on the nerves in the skin temporarily. 
But if the pressure points and friction points are still there, recurrence of the corn and callus will happened. 
Prevention is by soaking the skin wound in warm water to soften the skin and antibiotic cream is applied to prevent infection of the skin.


Sport shoes are actually the best cure for corn and callus of the foot because the air cushion in shoes can prevent pressure and friction on the skin. 
The corn and callus will be less likely to recur.

Removal of warts, corns and calluses will temporarily remove the lesions but recurrence will occur unless the underlying cause like the virus, the pressure points and friction is removed totally.