To Your Good Health: Can the HPV Vaccine be Used to Treat Warts?

  • Keith Roach

Friday, April 27, 2018

Dear Dr. Roach: My dermatologist suggested that I get the HPV vaccine, as it will help my body fight warts of various kinds. I’ve had plantar warts and warts on my fingers and hands. They go away with treatment, but seem to come back in a different spot over time. I am a 62-year-old male in good health otherwise. Is getting the vaccine a good idea? Thank you. — K.L.

Answer: The HPV vaccine was approved for use in women to prevent cervical cancer, which is caused by certain high-risk types of human papillomavirus. Other types of this same virus are responsible for cutaneous warts, the kind on the plantar surface (sole) of your foot, or on your hands and fingers.

Several recent case reports and one small series have shown that difficult-to-treat warts occasionally have gone away completely after people were vaccinated with the HPV vaccine, such as Gardasil. It is thought that the vaccine stimulates the immune system so that the body can fight off the infection. This is a bit surprising, since it had been thought that giving the vaccine after exposure would not be effective.

On the other hand, the success seen so far is encouraging, and hopefully there will be a trial to look at this problem — which is a real one, since some warts are very hard to get rid of.

For right now, discuss the upsides and the downsides with your physician. On the upside, some people who failed treatment with salicylic acid, duct tape, liquid nitrogen, imiquimod (a cream used to stimulate the immune system), laser treatment, oral Tagamet (cimetidine), 5-FU (a type of chemotherapy) and glutaraldehyde (a powerful medicine used for resistant warts) had complete success with the vaccine.

On the downside, the vaccine is expensive, and the three doses are not covered by insurance for people over 26. Local reactions to the vaccine, such as a sore arm, are common. Fainting is the most common serious reaction.

Dear Dr. Roach: I have gout in my big toes. Does uric acid cause gout? Also, I read that gout is caused by red meat and seafood. Is only shellfish considered seafood, or any fish, such as haddock and salmon? — D.E.B.

Answer: Gout is a disease associated with uric acid crystals (strictly speaking, it’s monosodium urate, the sodium salt of uric acid). They are deposited in soft tissues, joints or bones. It often is seen in its acute phase, commonly in the first joint of the big toe, where it is exquisitely painful, red and swollen.

However, some people can have a chronic form of gout, with uric acid crystals visible in the soft tissue, often in cool areas of the body, such as the ears and hands. These depositions are called “tophi,” and the condition is called “tophaceous gout.”

A diet high in purines (a chemical that gets broken down into uric acid) can precipitate a gout attack in people who are genetically predisposed. There are many foods that have high amounts of purines. I recommend the discussion about this from the Mayo Clinic (at https://tinyurl.com/gout-foods).

Some meats are much more likely to cause problems, including organ meats (liver, sweetbreads), some seafood (scallops and haddock are bad, salmon is not), and alcohol (beer is worse than wine). Too much protein of any kind needs to be avoided. People with recurrent gout (or with very high blood levels) should be on medication to prevent problems.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or at 628 Virginia Dr., Orlando, FL 32803.