Don't try to give authentication to your wild imaginations and folk stories

I have a very interesting story to tell. The story of wild imaginations of ill-informed and misinformed people. And how they try to authenticate their imaginations.

Recently I attended a get together party in one of my relatives place. I was with six of my cousins. One of my cousins got warts on her neck. Another one asked her how she got them.

The one who had the warts replied, "I got fever two months back. The doctor told me the bacteria that caused the fever reached my skin and caused them".

"What?!", I was about to exclaim when another of my cousins interjected and said, " I too got some warts some five years back. My doctor told me it is because of the fungus I ate along with copra". I was about to scream when a third one said, " I got mine from the apples I ate. The doctor asked me not to eat them".

"I got them when a pigeon dropped its poop on me", the last one added her version.

I was literally about to faint after listening to all the shocking stories my cousins were cooking up with wild imaginations and repeating folk stories and were trying to authenticate them by adding, "The doctor told me so".

"Wait a minute, ladies", I finally interrupted their creative illusions by coming out of the distress my cousins caused me, "As far as my knowledge goes Warts are caused by human papilloma virus and the doctors never say the things you said - so stop speaking this nonsense." Now it is their turn to go pale. They all fell silent immediately.

Then my lecture on warts began...

Yes, the infection with the human papilloma virus, which is quite common- especially the filiform ones- in this part of the world, stimulates the top layers of the skin to grow excessively and lead to the appearance of warts. There are different types of warts.

Common warts– the most common strain and these warts occur all over the body except the feet and genitals. They are often seen in older children and adults. They are tall cylindrical protrusions of skin which if big enough are noticeable. .

Digitate warts – usually appear on the scalp or near the hair line. They are rough and finger shaped.

Filiform warts– these are long and narrow and usually seen on the eyelids, face, neck or lips.

Flat warts– these mostly appear on the face, neck, legs and knees. They are common in young children where they often appear on the face. They are as small as pinheads and can occur in their hundreds.

Perlungual warts– commonly occur around the fingernails. They are also rough but irregular and elevated. They can extend under the nails causing pain and discomfort and can also occur in clusters.

Plantar's warts– usually found on the soles of the feet and easily recognized by the black dots (capilliaries) beneath the surface. They can become very painful with the pressure of walking or standing.

Each of these warts has a distinctive appearance.

A filiform wart - it can have a size of 1-3 mm.

Warts are highly contagious. If you already have warts, you can prevent them from spreading by not picking at them. In addition, keep hands as dry as possible -- warts are harder to control in moist environments. You should never brush, comb, or shave areas where warts are present as this can cause the virus to spread. Wash hands thoroughly after touching any warts. Touching the warts is enough to become infected. The person can contribute to the spread of the warts from the original area to another area (otherwise lesion free) by touch. If there is a breakdown in the skin, then the risk of becoming infected with the HPV is even higher. Sharing your clothing with a person who has warts increases the risk of yourself becoming infected, especially if those clothes have touched the infected area. Sharing your towels with a person who has warts poses an increased risk for infection. Sharing skin care products also poses a risk for infection. The HPV can be found on different surfaces, including shower floors or the surrounding surface of a pool. It is recommended to avoid sharing shoes with a person who has been infected with HPV

Risk factors that can favor the infection with HPV: Breach in the skin – cut or abrasion, weak immune system, prolonged exposure to HPV, carrier of the HPV, warm and moist skin.

HPV vaccine prevents infection and the resultant warts.

The virus is relatively hardy and immune to many common disinfectants. Exposure to 90% ethanol for at least 1 minute, 2% glutaraldehyde, 30% Savlon, and/or 1% sodium hypochlorite can disinfect the pathogen. The virus is resistant to drying and heat, but killed by 100 °C (212 °F) and ultraviolet radiation.

Treatment for warts: These are the common treatments for warts...

Topical irritants (active substance has a keratolytic effect) will help get rid of them. Like Salicylic acid application (the active substances contained in this treatment will help the immune system to fight off the infection, Trichloroacetic acid, and 5-fluorouracil.

Cryotherapy : Liquid nitrogen is used to freeze the fleshy growths. After the actual procedure, blisters may appear in the treated area. Patients are recommended to wear bandages in the treated area and remove the dead skin after a week. Several sessions of freezing are required for a wart to completely disappear. The sessions are repeated every two to four weeks; depending on the size, number and location of the filiform warts, there will be four to six therapy sessions. There are patients who develop a severe local reaction to cryotherapy, so the freezing process is performed in a gradual manner. Potential side-effects of cryotherapy include: Pain, tendon injury, superficial nerve injury, skin discoloration, scars, re-occurrence.

Cantharidin: Similar to cryotherapy. Causes the skin to blister. The blister dries up and the dead tissue is then removed

Minor surgery: The procedure is performed using a scalpel or an electric needle. Local anesthetic is applied before the surgery. Immediate removal, no second procedure is necessary. The skin might be scarred in the affected are. Electrosurgery involves two procedures, meaning curettage and cautery. The base of the wart is burned by using diathermy or cautery. After the surgery, it takes almost two weeks for the wound to heal. Wart recurrence is expected

Laser removal: Recommended for warts that are difficult to remove through other methods. The procedure involves a pulse dye laser or carbon dioxide (CO2) laser. Pulse dye lasers (wavelength 582 nm) work by selective absorption by blood cells (specifically haemoglobin). CO2 lasers work by selective absorption by water molecules. Pulse dye lasers are less destructive and more likely to heal without scarring. CO2 laser works by vaporizing and destroying tissue and skin. Higher costs and risk of scarring make peopel to avoid this type of treatment.

Other choices of treatment include: Occlusion (the blockage or closing of a blood vessel or hollow organ) with plaster or duct tape, applications of cytotoxic agents that kill wart cells, systemic retinoids ( a group of compounds having effects in the body like those of vitamin A) – these are only recommended for extensive warts.