DEAR DOCTOR, My eight-year-old daughter has some wart-like swellings around the eyes, but I do not know what could’ve caused them. She hasn’t reported any pain from them and I am told they will go away on their own. Is this true? If not, how should I treat them? SHAMILAH DEAR SHAMILAH, Warts are painless, slightly itchy hard swellings, which can occur anywhere on body. It can be single or multiple. Warts are caused by human papillomavirus (HPV). Infection can enter the body via a cut or abrasion on the skin and is detected only after the wart appears. As such, warts do not cause any problem, are benign, hence, can be left untreated. Rarely, a wart may become malignant, where it becomes urgent to treat it. Mostly they disappear on their own, though it may take months to years. Diagnosis of a wart is made by physical examination and biopsy. Here, a small piece of wart is removed and examined under the microscope, where typical changes of wart are visible, which confirms the diagnosis. If one wishes to treat a wart local applications of salicylic acid are available in form of ointments or peel offs. Trichloroacetic acid applied once or twice a week for three to four weeks is also useful. Removing small warts by just cutting them or pulling them by self, seems tempting. But it is painful, can leave a scar and chances of recurrence are high. Warts are also removed by cryotherapy, i.e. by liquid nitrogen. It may need more than one session and three to four weeks after therapy, warts may fall off. But it is painful and usually not used for young kids. Simple excision surgically or removal by laser are other treatment options available. However, there are home remedies as well for treatment of warts. Application of diluted apple cider vinegar, local application of banana peels or orange peels, application of crushed garlic cloves tied in a bandage, use of aloe vera locally, are such remedies. These substances have variable anti-inflammatory properties that help stop the local immune and inflammatory response, and have variable anti-viral properties that help to check the virus and its multiplication. But use of these substances is not backed by scientific research and effectiveness is more anecdotal. Local application of crushed tablets of vitamin C or E can also be tried. Zinc and vitamin C are immunity boosting. Giving your child tablets of vitamin C and zinc daily for some days may also help her. Dr. Rachna Pande, Specialist in internal medicine rachna212002@yahoo.co.uk
