Warts on hands and feet - what helps against them?

Unhappy, Emma* holds out her right hand to her mum. Two small, jagged lumps are emblazoned on her index finger on her otherwise flawless skin. «They're so ugly,» complains the 9-year-old, «I want them gone!» Her mum reacts promptly: «We'll have to apply a wart remedy straight away or have them removed by a doctor.»
«A typical reaction of many parents,» says Thomas Steffen, Head of Medical Services Basel-Stadt. «Very few are relaxed when it comes to warts.» Yet warts in childhood are relatively normal - and unproblematic. «You could almost say they are part of childhood,» says Steffen. «After all, a third to half of all children get them at least once during their school years.» As a rule, the skin growths on children disappear by themselves after a while. In adulthood, however, warts appear much less frequently. There are several reasons for this.

What causes warts?

«Representatives of the human papillomavirus, HPV for short, are almost always responsible for the development of warts,» explains cantonal doctor Steffen. «There are over one hundred different types». However, not every contact with a wart virus necessarily leads to the formation of warts: «The state of the body's defences plays an important role here, which may or may not eliminate the intruder,» Steffen continues. « Unlike adults, children do not yet have a fully developed immune system, which first has to learn how to deal with the invader properly.»
Children therefore often develop warts until the organism has successfully developed the appropriate antibodies. «This also explains why warts usually disappear all by themselves,» says Steffen.

A souvenir from the swimming pool and gym?

In addition, the typical social behaviour of children plays an important role in the high prevalence of warts in this age group. «Children usually have a lot of skin contactwhen playing with other children,» says Steffen. «They touch each other, romp around together, splash around physically close in the swimming pool.» This promotes infection, as wart viruses spread through contact or smear infection.

«Infection can occur through direct skin contact, walking barefoot or touching door handles.»

Thomas Steffen, Head of Medical Services Basel-Stadt.

This means that the pathogens are passed on through touch or a chain of touches. «Infection can occur through direct skin contact with the wart, but can also be passed on indirectly by walking barefoot on infected floors or touching infected objects, door handles, etc.,» explains Steffen.
The smallest injuries such as abrasions and tiny skin tears, which are also more common in physically active children, make it easier for the virus to penetrate the top layer of skin. «Swimming pools in particular are classic centres of infection,» adds Steffen. «This is because wart viruses find ideal living conditions in warm, humid climates; the skin is barely covered and offers less protection when swollen by water.» Where the virus penetrates, it tries to multiply locally, to which the body reacts with the increased formation of horny cells.

There are these different types of warts:

Depending on which type of virus causes the infection and where the virus penetrates the skin locally, different types of warts can develop. Three types of warts are typical in children. Around 70 per cent of all warts in children are common warts, known in technical jargon as vulgar warts.
These skin growths are pinhead to pea-sized, skin-coloured or slightly brownish and resemble a tiny cauliflower due to their fissured surface. «Vulgar warts can occur anywhere on the body,» says Steffen. «However, they are most common on the hands and feet and, somewhat less frequently, on the face.»
So-called plantar warts, on the other hand, are only found on the underside of the feet. Due to the pressure of the body weight, they are not spherical or raised, but grow inwards into the tissue like a thorn and can therefore cause unpleasant stabbing pain when walking and especially during sport.

The third type of wart commonly found in children is molluscum contagiosum. «Strictly speaking, these are not really warts at all, but a type of smallpox,» explains the preventive physician. "This is because they are not caused by an HP virus, like most other warts, but by the molluscum contagiosum virus, a harmless representative of the smallpox viruses. Molluscum contagiosum warts are bright red nodules with a dent in the centre - hence the name.
They are filled with a pulpy secretion that is highly infectious. They often occur in groups, especially in the torso area, on the arms and thighs. However, they can also be easily transmitted to other parts of the body through self-infection.

How do warts heal?

Warts usually heal spontaneously in children within a few months to a maximum of two years. «Treatment that causes pain or may leave scars should therefore be treated with caution,» emphasises Steffen. «If the wart doesn't bother you, waiting is often the best strategy.»
However, if there is a high level of suffering because the child is being teased because of the wart or is experiencing pain, you can try to accelerate the healing process with targeted measures. There are a number of medical therapies available for this as well as a bewildering number of household remedies and ritual actions, some of which may seem a little strange.
Some recommendations range from applying fresh snail slime to brushing with your own urine to conjuring up the wart under a full moon. Curiously, spontaneous healings actually occur time and again. This is primarily attributed to a placebo effect. Thus, the belief in the effectiveness can actually activate the self-healing powers. Suggestion often works surprisingly well, especially with children.

Wart plasters and tinctures help to combat the virus.

When treating warts, conventional medicine focuses on removing the virus-producing cells located in the horny layer of the wart. "This makes it easier for the immune system to fight the source of the virus," explains the Basel cantonal doctor. Various methods can be used for this purpose: The most common form is wart plasters or wart tinctures based on lactic acid or salicylic acid.
They are applied daily to the wart and soften the horny layer containing the virus, which can then be gradually removed. However, you have to be patient until you see results. «It can take several weeks or even months for the wart to disappear,» says Steffen.

This will help you get rid of the warts sooner:

Wart freezing, technically known as cyrotherapy, promises faster results. The doctor applies a strong refrigerant, usually liquid nitrogen, to the wart and destroys the skin cells in the top layer of the skin, including viruses, at localised temperatures of up to minus 190 degrees. This treatment is painful, which is why sensitive patients or children are usually recommended a local anaesthetic. One application is often sufficient, but sometimes it has to be repeated.
There are also over-the-counter icing sprays for use at home. These are significantly less aggressive, but also less effective and also slightly painful. The duration and chances of success are similar to those of acid therapy. In particularly severe cases, warts can also be removed surgically.
In alternative medicine, warts are treated holistically. «I primarily use herbal solutions from the field of phytotherapy such as celandine tincture, homeopathic thuja dilution or a spagyric wart drop mixture,» says Johannes Brülisauer, naturopath and board member of the Swiss Association of Naturopaths (NVS).
These herbal medicines are applied to the wart and also ingested. «This stimulates the self-healing powers particularly intensively, so that the wart disappears after a week to three months at the latest,» explains the naturopath.

Warts can appear repeatedly and in the same place.

Homeopathic globules and tinctures are also said to have a supportive effect. Thuja, Causticum, Ferrum picrinicum and Acidum nitricum are particularly recommended against warts. The latest hit and advertised in internet forums is armour tape. The tape is wrapped tightly around the wart, left on for several days and then the keratinised tissue is gently removed. However, the same applies here as for all other methods:The wart can come back. Sometimes even in exactly the same place.
* Name changed

How to protect your children from warts

A functioning immune system and the skin barrier generally prevent warts from forming. As children usually do not yet have a fully developed immune system, they cannot be completely prevented - but the possibility of infection can be reduced somewhat:

• Always wear bathing shoes in the swimming pool and sauna.

• If possible, do not walk barefoot in the gym and cloakroom, but keep your socks on.

• Always clean your hands well with soap and dry them.

• If possible, do not use towels, socks, shoes and gloves together.

• Good skin care with oily ointments and moisturising bath products prevents cracked, chapped skin, which is easier for the virus to penetrate.

• If possible, cover existing warts with clothing or tape them up to prevent the virus from spreading.

• Do not scratch or rub the wart and wash your hands with soap after touching it.

• Bleeding warts are highly infectious, so be especially careful when using files etc.

• Incidentally, children with warts are also allowed to attend public facilities such as schools or kindergartens without restriction.

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