In superstition, as well as in folk and fairy tales, you can always tell who is the witch because typically she’s got green skin, wrinkles and a large wart on her nose.

Although missing the wart, the most memorably played witch of all time was Margaret Hamilton as the green-skinned Wicked Witch of the West in the 1939 film “The Wizard of Oz.”

This was based on “The Wonderful Wizard of Oz,” the first of L. Frank Baum’s 14 Oz books. Baum was a 19th- and 20th-century actor, playwright and newspaper journalist/owner. He was also an active supporter of women’s suffrage. In the Oz books, he explored a utopian world in which all of the leaders were women.

Historically, and more tragically, warts have had sinister implications. Early on, it was believed that a child got warts from handling a toad or washing in water that had been used to boil eggs.

By the 17th century, however, warts became associated with evil, as evidenced in the Salem Witch Trials in 1692 and 1693. There, warts were seen as one of many devil’s marks, and having a wart was justification enough to be one of the 20 people, mostly women, murdered in the name of justice on the whim of some young girls.

Popular culture aside, warts are not peculiar to women. In fact, almost everyone will have at least one wart at some time in their lives.

What is a wart?

A wart is one of many skin lesions. Others include moles, scars, birthmarks, skin tags and natural blemishes, not to mention cancerous lesions like melanoma.

A wart is an infection in the outer layer of your skin, the epidermis, by one of about 150 members of the human papillomavirus family. HPV gets in through a tiny scratch in your skin and causes a rapid growth of cells in the epidermis.

HPV is everywhere in your daily life. You can get it from skin contact like shaking hands or from objects like doorknobs, keyboards or locker room equipment — or any other place you may touch that has been touched by someone with warts. One thing is clear, however: You don’t get them from toads or water used to boil eggs.

Warts can appear anywhere on your body, but they are most common on your hands. Others may appear on your feet or genitals. Genital HPV is a somewhat complex subject beyond the scope of this column.

What should you do?

Warts are not dangerous, and usually not painful, but they are contagious through touching. And so your responsibility is mainly to avoid letting your warts be in touch with other people directly or indirectly with things that others may touch.

For yourself, the good news is that the best treatment for warts is no treatment at all. Most warts will go away on their own, although it may take some time. About a third of warts disappear in 10 weeks or less. Most of the other two-thirds will go away within two years. If you have warts that persist beyond two years, then they’re less likely to disappear untreated, and it’s possible that your immune system is compromised in some way.

How to treat warts

That said, of course, warts are unsightly, and you may wish to do something actively to get rid of them.

Why, you may say, don’t you just have it cut out? And the answer is that frequently they just grow back.

It’s always OK to consult your doctor. And please see your doctor before trying the following if you have diabetes, are pregnant or have immune system problems. Also consult your doctor if you are not sure it’s really a wart that you have.

The treatments for warts are mainly self-treatments, but they are time-consuming, not particularly pleasant and not always effective. Any treatment you use is likely to irritate the healthy skin around the wart. If they were easy, then everyone would get rid of their warts immediately. The thought is that these treatments irritate the area enough to kick your immune system into gear to attack the virus.

Salicylic acid

The most common approach is to use over-the-counter products in which salicylic acid is the main ingredient. This is a treatment that needs to be done every day for about 12 weeks. You start by soaking the wart for in warm water to soften the skin. Then use a pumice stone or emery board to rub off the top of the wart just before applying the salicylic acid.

This is about 80 percent effective. And by the way: Don’t let anyone else use the emery board or pumice!

Duct tape

Another approach is to use duct tape repeatedly for about two months. Again, soak the area in warm water and scrape off the top of the wart before applying the tape. Leave the tape in place for about six days.

This is about 70 percent effective.

Freezing

A third way, somewhat more drastic, involves freezing the wart, cryotherapy. This is done with an over-the-counter spray that uses liquid nitrogen. It’s done four times, each separated by about four weeks from the previous treatment. The spray will likely cause blistering and burning in the area especially when being applied. Cryotherapy has not been shown to be any more effective that salicylic acid, and if it hasn’t worked in three months, then it’s likely not to work at all.

By the way: Don’t try to do this with ice cubes; they’re nowhere near cold enough. Ice cubes are exactly 32 degrees, while liquid nitrogen is about minus 321 degrees.

Other thoughts

Some suggest a plethora of natural remedies. These include using castor oil, vitamin E oil, vitamin C paste, aloe vera, crushed garlic, banana peel, a vinegar compress or fresh basil leaf. While these are untested and would likely take as much time as the approaches I described above, they are probably less unpleasant.

One thing not to do is to scratch or pick at the wart. The probable effect of doing that is to increase the likelihood of transmitting it to someone else and to spread it on your own body.

We live with HPV

There are about 20 million of us living with HPV, and another 6 million or so are infected every year. However, not all HPV infections result in warts. In fact, about 90 percent of us who are infected don’t know we have HPV, as our immune system is able to control the infection and clear it within a couple of years.

The best defense is awareness and personal hygiene. Wash your hands regularly, try to avoid contact with objects and facilities that are used by others, and keep your own warts from infecting others.

I emphasize hand washing rather than the so-called hand sanitizers. Research at Pennsylvania State University has shown that while HPV is susceptible to certain nasty disinfectants, it is resistant to the alcohol-based disinfectants in hand sanitizers, which do nothing to prevent the spread of HPV. 

¢¢¢

Bob Keller maintains a holistic practice in Newburyport. He offers medical massage therapy for pain relief and advice on muscular balance and diet, as well as psychological counseling, dream work and spiritual direction. His new book, “Making Sense of Medicine: Medical Matters Made Simple,” is available now. He can be reached at 978-465-5111 or bob@myokineast.com.

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