How I learned to stop worrying and love the Human Papillomavirus

February 20, 2009 9:03 AM

Why does a healthy adult keep getting warts? How to prevent? How to cope?

I’m 24 years old, relatively healthy, and seem to be uniquely susceptible to warts. I also have tendencies towards obsessive-compulsive behavior, and lately, I’ve been showing symptoms of depression. I’d really appreciate some medical information and psychological counsel, as well as some personal anecdotes.

Right now, I have a very small wart on the bottom of my left big toe, and something that seems to be developing into a wart on my left thumb. Probably wouldn’t be a big deal for most people, but it’s affecting me pretty significantly, especially this last discovery with the thumb. I keep looking at it constantly and prodding it and seeing if there’s any new development.

In the past, I’ve had warts crop up here and there, which have thus far been eliminated (after a lot of stress and multiple different treatments were thrown at it), with the exception of my most current warts, obviously. Even the giant plantar wart that was three inches in diameter (pretty amazing, really) was eventually eliminated with cantharidin treatments my freshman year of college.

Still, these warts take their toll psychologically, and recently, I’ve been led to do some thinking. It strikes me as odd that a healthy adult, especially one with OCD tendencies, would keep getting warts like this. So my first question would be: is there anyone who, as adults, have or have had the same problem? My guess is that there are, but I’d like to hear about it.

Second, is it even worth stressing over warts like this? What are the real dangers of having warts? Also, should I now be keeping my thumb covered at all times? Because I more or less did that for my foot (although I have been going to bed barefoot) and yet here I am with another wart, on my thumb, of all places.

Which leads to the third question: is HPV pretty much everywhere? Because I was originally going to ask a question a while back on MeFi about how to kill/inactivate HPV on surfaces, like the floor, for instance, but I’m now led to believe the attempt would be futile and impractical. Am I right? Am I to worry about shedding on my instrument (a string instrument, so made of wood and covered with varnish)? (Viral shedding, not shredding.)

Fourth, anything else I should be aware of, from a medical standpoint? I’m wearing flip-flops in the shower, drying my feet (which I didn’t do before, figuring I was safe). I’m treating my toe with salicylic acid and waiting on the thumb. Anything to help my immune system?

Fifth, probably the most important. As I mentioned, this latest discovery of the possible wart on my thumb has gotten me pretty down. I guess it’s partly because I was more or less coming to terms with the one on my foot, which seemed like it was on its way out, and now I have this new thing on my thumb, which is worse, since I’m a musician and I work with my hands. And let’s not forget the fact of my dealing with OCD.

Now, I’m thinking these are the thoughts, conscious and subconscious, that are running through my head:

I shouldn’t be getting warts.
In a just world, this wouldn’t happen to me.
I did everything and it didn’t make a difference.
Nobody else seems to be getting warts. Especially not the cool kids, who seem so worry-free.
These warts are going to get worse.
These warts are going to multiply.
They’re going to get on my hands, my face, and my groinage area.
I’m going to turn into the treeman like that guy from Indonesia. (Probably unlikely.)
I’m going to contaminate the things around me, especially my instrument.
I won’t be able to do my job.
I’ll keep passing them on to myself.
I’ll pass them on to others.
I’m going to have to deal with this stress, with treatment and “quarantining” and just the general fact of having warts, for months to come. (I’m stressing over stress.)

Now, these are examples of distorted, irrational thinking. I think. I mean, some of them might have an ounce of truth to it, but it’s getting magnified and twisted beyond what’s reasonable. I haven’t gotten beyond Chapter 4 of David Burns’s The Feeling Good Handbook, so my final question: how do I deal with these thoughts? How do I learn to stop worrying and love the Human Papillomavirus? Any help would be welcome. Repeating “It’s not your fault” like Robin Williams might not hurt, either.

If you made it this far, congratulations. I’ve put hours into editing this, and because I have so many questions and now would just like some answers, I’m posting this as is. Thanks for any help with any of the questions in advance. IANAD disclosures for the medical questions would be appreciated.

Postscript:
I really don’t know if this thing on my thumb is a wart or not. I noticed some rough skin on the nail groove, next to the nail, and I pruned it with a nail clipper. It’s still a bit hard, so, I really don’t know. I wish I did.

As for why I’m not seeing a professional psychiatrist, it’s because I’m cheap, and due to my circumstances, geographic and otherwise, it’ll take forever to get an appointment, and it’ll be expensive, and by the time I get an appointment I might not be here.

My obsessions and compulsions arise mostly out of thoughts dealing with contagion. I didn't originally respond to the notion of actual germs, just the notion of general filth, passed on by touch (ad infinitum), but since moving, I've noticed that my thoughts started dealing with actual pathogens. Less so now, but it's become a factor.

Now that I’ve thought about it, I’ve pretty much gotten warts while I was away from home: away at college, away at a summer program, and now while I’m in Europe. So stress seems to be a big factor. Doesn’t make it easier, though.

posted by anonymous to health & fitness (21 comments total)

Wow, ok, um...warts. My brother used to get warts a lot. Several years ago, he had a huge one on his left thumb. He saw a doctor about it (plastic surgeon, actually), and she decided the best course of action was to cut the wart completely out, eliminating all of the (what, wart roots?) tissue underneath. Most of the skin on his thumb got cut out. I think it's now five years later...his thumb print still hasn't fully grown back, but he hasn't gotten another wart (anywhere) since. From what I've seen on my brother (and dad), the topical treatments don't work very well. They'll zap a wart, but not get rid of the underlying problem. I would suggest seeing a surgeon-type MD and pursuing a much more aggressive treatment.

However, when you make the call to see the surgeon-type MD, you really ought to look into seeing someone about your OCD. If you're the kind of person who's obsessing about a wart, you're probably going to be obsessing over having a giant hole in your thumb, too. As for how you deal with the warts, this isn't Salem. It's not the 1600s. Having a wart is not going to make other people think you're a bad person. You're not going to be burned at the stake for having a wart. It's entirely likely that no one other than the doctor you see will even notice that you have warts (and they're certainly not going care about them). Go see a professional about this.
posted by phunniemee at 9:16 AM on February 20

Warts aren't your problem.

Don't talk yourself out of therapy, see someone about your compulsions as soon as possible.
posted by fire&wings at 9:24 AM on February 20 [8 favorites has favorites]

Warts are caused by a virus. You never get rid of viruses. It's just like cold sores - once you get one, you have the potential to get cold sores for the rest of your life. It will never go away. The only thing you can do is control the "outbreak" with medication.
posted by phrakture at 9:29 AM on February 20

OK first of all, warts are not a moral or hygenic failing. I have been getting warts on my hands since I was 6 or 7. They are annoying and sort of ugly, true, but they are caused by a virus that lives dormant inside my body and therefore something outside my control. No amount of washing my hands or cleaning my bathroom will cause these warts to disappear or fail to come back because their re-occurance is a natural process. Let me repeat: There is nothing in your house that can cause warts - the cause of warts is a virus that lies dormant in like 95% of people.

I know the idea of being out of control is scary, and I hope your OCD is something that you will work on with a therapist. To be blunt, your excuses sound like the same sort of thing everyone says when they're afraid of getting their mental house in order.
posted by muddgirl at 9:29 AM on February 20 [2 favorites has favorites]

Papillomavirus
posted by Chocolate Pickle at 9:35 AM on February 20

Listen to Fire&Wings.
posted by LarryC at 9:37 AM on February 20

I had a wart problem from high school straight through my freshman year of college. I was a swimmer in high school, and as they were confined to my feet, I'm convinced that I got them from walking on pool decks all the time. I, too, had to go through cantharidin treatment to get rid of them. What finally saved me, though, was applying Aldara (imiquimod) for months after the last wart disappeared. It basically ramps up your immune system so that it's constantly fighting the virus in the area that you apply the cream.

Also, if you think you have one on your thumb now, go to a doctor tomorrow. Preferably a dermatologist. They can freeze it off and be done with it. The longer you wait, the harder it's going to be to get rid of.
posted by awesomebrad at 9:55 AM on February 20 [1 favorite has favorites]

Yup, I'll second that the OCD seems to be the major problem here, not the warts. You are doing the same thing that I do at times when I'm not taking care of myself mentally - in my case, I obsess and ruminate over my various moles (there are many) and worry about which will go cancerous next. It's miserable, but it's not really the moles that are the problem.

Re: the warts. I've struggled with a veritable PLAGUE of warts on my hands at various times during my life. They show up when I'm stressed beyond belief for a long period of time. They first showed up when I was in junior high school - not fun! I seriously had so many that I could not adequately treat them with over-the-counter solutions or hide them - at one point, small warts on almost every finger.

It was embarrassing. I was humiliated.

And yet - no one else (other than my mom) noticed them. Even in junior high, when children are especially cruel. And eventually, they went away of their own accord. All of them. Occasionally one or two will pop up when I'm stressed and the virus surfaces, but they subside again.

You say you've noticed a connection between stress and warts. Quit giving yourself reasons not to address the OCD and get some help with that.
posted by Knicke at 10:15 AM on February 20

The kind of thoughts that I would suggest repeating include:
-I do not take getting warts as a reflection of my worth.
-Lots of people have problems with warts
-I'm going to be super patient and chill about my warts because I know I'm doing everything I can

The last one because, as people have said, warts are stubborn you may never get rid of them. But you need to decide that they aren't going to ruin you. You are stronger than a wart.

To commiserate, it took me months to get rid of my warts on my feet and it did get to me. I got painful treatments at a clinic for way too long. What helped was keeping it covered and depriving it of oxegen as well as applying topical treatment at home in between clinic treatments.
posted by Gor-ella at 10:19 AM on February 20

Aldara helped me and yet they've popped back up on another toe nearby; it's hard to come to terms with them (and yes, they are really, really, annoying), but better to deal with getting as much of them cut out as you can (if they're deep, they're just going to keep coming back). Why not concentrate on fixing the ones you currently have instead of worrying about recurrence? If they go away when the dermo removes them but then come up elsewhere, you'll just deal with those, too. One step at a time. It's hard to concentrate on what MIGHT happen in the future if you instead focus on fixing the current problem.

(I have OCD-like tendencies myself, I know it's hard to talk yourself out of worrying about them, but if it's becoming a big problem, maybe the therapy referrals suggested above will help).
posted by bitter-girl.com at 10:23 AM on February 20

If you already have a wart on your foot, wearing flip-flops won't help. Indeed, it'll mean your foot is making contact with an increasingly infected surface on a regular basis.

FWIW, pretty much everyone who's ever been to a public pool has had plantar warts. It's no big deal, really.

Have a doctor freeze them off. Worked for me.
posted by Sys Rq at 11:02 AM on February 20

Warning: this is gross/graphic. But you're all reading about warts anyway, you must like being grossed out. It has a happy ending tho, so here goes:

When I was younger I developed a whole colony of plantar warts on my big toe, nasty things. Totally covered the bottom of it, and they were slowly spreading down onto my foot. They were distorting the prints of my toes - disturbing. Of course I never showed anyone my feet, never let anyone borrow my shoes and always wore socks no matter what - so embarrassing. I tried to remove them with the cyclic soaking/shaving/acid treatments, which kind of hurt and it bled (there's still flesh mixed in there, after all). But it was taking forever, so hard to tell if I was making any progress, so I gave up. This happened over about 3 years.

One day I offhandedly asked the doctor about it and they said "oh! we'll just freeze them out, it'll only take a few minutes". They took a cotton swab dipped in liquid nitrogen and pressed it into the warts, freezing them all out one by one. It hurt, but not super bad (just like a pinching feeling). The bottom of my toe turned black with the dead skin, which eventually all fell off and healed up, and there's not even any scarring. Even though it was one (thorough) treatment, that got rid of all of them and I never experienced any resurgence of plantar warts ever again.

I Nth the freezing treatment, those creams and acids are so time consuming and stressful.
posted by lizbunny at 11:06 AM on February 20

I've had a long history of warts. Through elementary and middle school I would get small warts in different places. The largest batch were on my knees, specifically the right knee. Eventually one got to a pill size (still close to the skin and almost unnoticeable, but we knew they would just keep growing.) So my parents herded me to the doctor's office. "They'll just rub some cream on them, and they'll disappear! That's what they did for our coworker's daughter!" they coaxed. I was doubtful.

So we get to the doctor's office. And go to the little room and wait. The doctor walks in--and brings five separate tool sets with him. One is similar to the kit you might use to burn designs into wood (burning). One is a large steel tank like you might fill a balloon out of (freezing). There were also several other things I don't remember. Turns out the warts would be burned off, arts-and-crafts style. My father later told me I looked like a frightened deer, ready to chew off his own leg to escape the situation.

Seven shots and ~1.5 hours later, a significant portion of the front of my knee has been burned away. Three distinct holes. He gauzes it up--and, to my horror, the gauze heals into the wounds. Several times. Really got fun when the anaesthetic wore off. It takes weeks to heal, since the human knee is constantly flexing and rubbing up against EVERYTHING, ALL the time. That's been ten or so years now, and parts of my knee still get odd sensations from time to time (when you touch it, it feels like your fingertip extends into the knee--not painful, but very unsettling.) No scars, though. And no noticeable warts since (which is to say, none anywhere I can see.)
posted by Phyltre at 11:51 AM on February 20

I got a small plantar wart on my left foot about the time my first daughter was born. I treated it off and on with OTC stuff for about a year, to no effect, except it kept getting bigger. So after a while, I go to my GP. She treats it with liquid nitrogen for a while ( 6 or so treatments with 2 week wait between). Meanwhile, 2 other smaller warts had appeared on the same foot....finally, she sends me to a dermatologist, who treats it with super-duper compressed liquid nitrogen (or something---not just the q-tip dipped in the styrofoam cup of liquid nitrogen, anyway). So....my daughter's 3 1/2 now, and I had my final wart treatment this past summer.
posted by leahwrenn at 2:15 PM on February 20

I used to always get warts, I would have to go to the doctor every 3 months or so to get the new ones frozen off. They would be on my fingers and toes. This went on for 3-4 years.

One day, all the warts on my foot started shrinking. Over a 2 week period, they all disappeared. I've never had one since.

If you have the warts frozen enough times, eventually you may develop an immunity and they'll go away. So keep at it and hopefully that day will come!
posted by dave99 at 3:04 PM on February 20

To answer one of your fears:

They’re going to get on my hands, my face, and my groinage area.

I don't believe you can transmit them to your groinage area. That's what Alice, Columbia University's Health Q&A Service says:

However, the strains of HPV that cause warts on your hands or feet are not the same strains that cause genital warts — so genital contact with a wart on your (or someone else's) hand won't cause genital warts.

Also, phrakture said:
Warts are caused by a virus. You never get rid of viruses. It's just like cold sores - once you get one, you have the potential to get cold sores for the rest of your life. It will never go away. The only thing you can do is control the "outbreak" with medication.

It doesn't appear to me that that's always true. I found this on the ASHA's (American Social Health Association) STD website:

Recent studies from the Albert Einstein College of Medicine and from the University of Washington suggest that HPV may eventually be cleared, or rooted out altogether, in most people with well-functioning immune systems. However, in at least some cases the virus apparently does remain in the body infefinitely [sic], able to produce symptoms if the immune system weakens.

This was under the section titled: "6. Myth: If I have genital warts or dysplasia, I will have recurrences for the rest of my life." While they were talking specifically about genital HPV, it seems possible that this is true for other strains of HPV as well. Cold sores are caused by HSV, which I believe lays dormant in nerve ganglia and is not thought to be clearable. But I don't think it's accurate to generalize from HSV's persistence to all viruses.
posted by funkiwan at 4:15 PM on February 20

I think it's a good step that you've started to identify the thoughts that are arising related to the situation. Since you mention the Burns stuff, below I took a crack at some CBT-like responses to them.

The point here is not to just try to brainwash yourself with some alternate line of thinking, but to look at both the original thought and the response and honestly consider which one is more convincing to you. If the response is not convincing, then it's not going to be helpful and you have to keep working with it.

I'd suggest spending a certain amount of time, maybe 10-15 minutes per day, actually going through this process yourself, in writing. You will tell yourself stuff like, "It's stupid, it won't help, it's not necessary because I can just do it in my head, I can see what the responses will be already," and so on; just respond to that by going, "OK, but I'm going to do it anyway." It's amazing what a huge difference something that seems so simple can make.


I shouldn’t be getting warts.
In a just world, this wouldn’t happen to me.
("should" statement)
It would be nice if this were the case, but the reality is that's not what's actually happening. If you consider the whole spectrum of negative circumstances a human could encounter, you have a quite minor and easily dealt with problem. It's this layering of thoughts about how things "should" be that is making it seem huge. Actually it's good to notice this thinking pattern and learn how to deal with it, because you can make yourself miserable over any kind of circumstance with this kind of thinking, but once you learn to deal with it you can also deal with it in any circumstance. So in a way this is a huge opportunity.

Nobody else seems to be getting warts. Especially not the cool kids, who seem so worry-free.
(mind-reading/"should" statement)
You don't really know for sure what other people's conditions are; you only know what they tell you. In general all human beings, including the ones that appear "worry-free", have different kinds of problems they have to deal with. In fact, there are probably people to whom you appear as a "worry-free cool kid"; assuming you don't go around talking about this problem, no one else is probably aware of it.

These warts are going to get worse. (and the next few)
These are all "fortune-telling" statements. You can't really predict the future with certainty either way, but there's really no basis for this kind of grim outlook. Probably the safest type of prediction is that things in the future will continue pretty much the way they have in the past. It sounds like you've been dealing with this for a while, and right now you have one minor wart and one thing that may not even be a wart. So on what basis can you go from that to these dire predictions about how things are going to get catastrophically worse? These predictions don't match the evidence you have so far about how the situation unfolds. (And furthermore, if one of these catastrophic outcomes did take place, you would be able to find a way to deal with that as well.)

I’m going to have to deal with this stress, with treatment and “quarantining” and just the general fact of having warts, for months to come.
This doesn't have to be true, because you're not so much dealing with a problem with warts as with a problem with your thoughts. You could completely drop the stress about this issue in this very moment (although this may sound like an exaggeration, it's not) just by changing the way you think about it. And if you use this situation as an opportunity to learn how to do that, it could make your whole life a lot easier.
posted by dixie flatline at 4:47 PM on February 20

As has been mentioned above, freezing with liquid nitrogen (by a doctor) is an excellent way to deal with these things. I had one on my thumb that was destroyed in this way. It had been there for years.

Took all of 5 minutes. Only hurt a little bit (seriously, about the same as a very minor burn). Healed up within a couple days and has never been a problem since.
posted by Riemann at 5:30 PM on February 20

From one cheap worrier to another, this OTC Dr. Scholl's wart cryotherapy kit worked for me. Two treatments at the doctor did nothing, but once I used the kit they were gone for good. I haven't had a wart in years.

In my case, I beat myself up because I knew exactly when, where and how I got it: I shook hands with a girl who had warts--only after convincing myself to go ahead and not to be such a hypochondriac ninny about it. Agh! Oh well, for all intents and purposes, it's gone. It probably helped that I strengthened my immune system through daily exercise and vitamins (among other things, a multivitamin, an extra B complex, and C). These lifestyle improvements also helped lower my stress and boosted my mood enormously.

If none of the psychological advice helps, you can always make yourself feel better by repeating this: At least I don't have [insert gross infectious disease of your choice here]." Life could be much worse!
posted by aquafortis at 8:25 PM on February 20

I've had up to 5 or 6 warts on various parts of my body at a time. When I was younger, I would go to the doctor and have them burned off. However, last year, after dealing with a particularly painful plantar wart for almost two years, I looked up some alternative treatments.

The most interesting and effective (not to mention pain-free) method of wart removal in my opinion, is imagery. So, every night as I would be going to sleep I would imagine the plantar wart being dug out of my foot. Within a week, it started to dry up. Within 2 weeks, it was completely gone.

Thinking that it was maybe a coincidence, I tried it on a wart on a pinky finger that had been there for a year. Well, within a week, it was gone.

There is actually some interesting evidence for this on google, if you are so inclined.

YMMV, but the more graphic the imagery, the more effective it will be.
posted by DeltaForce at 9:02 AM on February 21

I should not be having mold allergies, and yet despite my self image as a hardy outdoorsy tomboy, I do.
It's not a moral failing. It something that modern medicine can deal with. Like warts.
See a derm and a shrink.
posted by Lesser Shrew at 10:08 PM on February 21