FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

LASERS FOR WARTS MAY BE LIKE BAZOOKAS FOR SWATTING FLIES

Question: My girlfriend had a wart burned off her foot recently with a laser. It worked great. What makes a laser such a good treatment for warts?

Answer: Warts are a very common affliction. They are an infection caused by the human papilloma virus. The virus - by taking charge of the growth of the cells it has invaded - creates the rough, raised irregular skin characteristic of a wart.

The body's defense system often identifies the wart as an infection and gets rid of it within a year or two. Those who don't want to wait for the wart to "go away" or who fall in the unlucky 20 percent that don't have natural healing regardless of how long they wait, will need to have some type of treatment to destroy the wart-infected skin.

A laser produces very intense light that is made up of only one color. Sunlight, by contrast, is made up of light of many different colors. In technical jargon, this means that laser light is of a single wavelength. This is important because some wavelengths penetrate the skin with little difficulty, while others are absorbed by or reflected from it. By using a laser of the right wavelength a doctor can selectively kill wart-damaged skin. To better illustrate this point, let's look at two specific examples used to treat skin disorders - carbon dioxide lasers and argon lasers.

Carbon dioxide lasers create their light in the invisible infrared color. This particular wavelength of light is absorbed by water. In medical uses the laser strikes tissue, such as a wart, with such intensity that it almost instantly heats the water within the cell until it explodes in a cloud of steam and broken cell fragments. Since the laser light is aimed very precisely, the surrounding tissue receives much less damage than it would with other methods used to destroy skin cells. It is also hot enough to burn closed the ends of the small blood vessels that are present in the skin. In practical terms, you can think of the laser as boiling away the wart-infected cells without doing much damage to the healthy cells in the neighborhood.

Actually, the carbon dioxide laser is a fancy "high-tech" tool for removing warts that doesn't work any better than the less glamorous methods of freezing, burning, or cutting them out with a knife and scissors. There are other lasers, however, that are quite unique in the benefits they offer those with skin problems.

Argon lasers and tuned dye lasers can produce light in the blue-green color. This imparts some special advantages to their use, because these colors penetrate the skin fairly well but are absorbed by blood and blood-colored tissue. This makes it possible to treat the cosmetically disfiguring port-wine stains and other vascular lesions of the skin that could not be achieved in any other way. The argon laser is also very good at reducing the bulbous red nose that occurs in acne rosacea.

A laser is a very special tool that can be of some help in treating skin problems. Sometimes - as in the case of wart treatment - a laser is often used simply because it is new, not because it is necessarily better. In other diseases it has unique and desirable features that justify the expense of its use.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.