Eliot Mostow

Wart Treatment

Warts are caused by the human papilloma virus (HPV) and are contagious. They are spread by skin to skin contact to yourself and others.

There are several ways we can effectively treat warts, including cryosurgery (freezing), laser therapy, prescription medications (imiquimod) and over-the-counter medications.


 

Warts are caused by the human papilloma virus (HPV) and are contagious. They are spread by skin to skin contact to yourself and others. There are several ways to effectively treat warts.

Common Treatments for Warts:

Cryosurgery

Liquid nitrogen is used to freeze the wart. Liquid Nitrogen in a medical office is colder (-196ºC) and much more effective than over-the counter freezing methods. Refreezing is often necessary every 2-3 weeks until the wart resolves. It feels very cold and may sting. Often, a blister with either clear fluid or blood can occur. Gently clean the area with soap and water and cover with a bandage. Wait 2-3 days after this treatment to resume topical home therapy.
 

Laser therapy: Pulsed Dye Laser

A quick pulse of localized heat is applied directly to the wart. Treatment is necessary every 2-3 weeks until resolved. Between laser treatments continue use of topical treatments. It feels much like a rubber band snapping against your skin and will cause a small bruise in that area.
 

Over-the-counter (OTC) wart preparations such as: Duofilm, Occlusol, Clear Away

Paint on the wart each day and cover with a bandage or duct tape (duct tape should only be applied to warts of the hands and feet) avoiding the surrounding skin. Each day remove the covering and gently rub with an emery board, pumice stone, or callus file (Keep these just for this purpose, do not use anywhere else or share with anyone) before reapplying medication and bandage or duct tape. If your skin becomes very irritated, stop treatment for 2-3 days.
 

Imiquimod cream + OTC preparation, such as: Duofilm, Occlusol, or Clear Away

Each day alternate application of imiquimod (Aldara cream) and OTC product with a bandage or duct tape (duct tape is to be used on the hands or feet only). Apply just a thin amount avoiding the surrounding skin. The small packets of Aldara will last longer if you poke a small hole instead of tearing the top of the packet. Disregard the Aldara package instructions and use as we instruct. Expect mild redness and irritation. If significant irritation results, stop treatment and call our office for treatment options. 

Less Common Treatments for Warts

  • Laser therapy:  CO2 Laser - Penetrates deeper to actually vaporize the wart. Follow up visit in 1 month to see if wart is resolved, there is a risk of recurrence. This laser treatment is used less often because of increased discomfort and longer healing time; you will leave here with a hole in that area.
  • Immunotherapy: injection of Candida skin antigen - Candida skin test antigen is injected directly into the wart. This results in the body fighting the wart from the inside out. You may require more than one treatment.
  • Photodynamic therapy:  Pulsed Dye Laser + aminolevulinic acid (Levulan). The acid is applied directly to the wart 1 – 24 hours before treatment with the pulsed dye laser increasing sensitivity to light in that area improving penetration of the laser.
  • Oral medication:  Cimetidine (Tagamet), taken daily by mouth, may help increase the body’s ability to fight warts.  Data on its success rate is not clear, but we do add this for some selected cases.
  • Contact sensitization:  A series of applications of Squaric Acid are applied to the skin to create an allergic contact reaction to this chemical. As a result, the body’s immune system will be tricked into fighting the virus when applied directly to the wart.
  • Retinoids: Tazarotene (Tazorac) cream or gel, a prescribed topical retinoid medication, can be applied daily or every other day in conjunction with an OTC medication. If significant irritation develops, apply every third day or stop treatment and contact our office.
  • Anticancer / Antimetabolite drugs:  5-fluorouracil (Efudex), a topical chemotherapy drug, applied directly to the wart can stimulate the immune system to fight off the virus.

© 2012 Akron Dermatology. Last updated February 10, 2012.

 

 

This information is for general educational uses only. It may not apply to you and your personal medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional.

Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

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