What is the treatment for warts?

The majority of warts clear up without any treatment. How long it takes for them to clear up varies considerably from person to person. They tend to clear up faster among young children. Some warts may take several years to clear up. Less commonly, warts may clear up without treatment within weeks.

Some treatments may cause the skin around the wart to become irritated, others may cause pain, and even blistering. The type of treatment depends on where the wart is located and how many of them there are:

• Salicylic acid - most creams, gels, paints and medicated plasters that you can get at a pharmacy without a prescription contain salicylic acid. Studies indicate that salicylic acid treatment usually gets rid of most warts within three months. It is important to protect the skin before applying treatment. This is because salicylic acid may destroy healthy skin. Petroleum jelly or a corn plaster may be used to protect the skin around the wart.
  
  Before applying the medication soak the wart in water for about five minutes. Rub dead tissue off the surface of the wart each week using a pumice stone or emery board. Make sure you do not share it with anybody else. In most cases treatment is applied daily for about three months. If the skin becomes sore, stop the treatment.
  
  Medications containing salicylic acid should not be used on the face. Patients with poor circulation should not use medications that have salicylic acid without checking with their doctor.  

• Duct tape - some people use duct tape in order to get rid of warts. They should never be used for warts on the face. Duct tape is placed over the wart and left there for about six days, and then removed. The wart is then soaked in warm water for about five minutes after which the dead tissue is gently rubbed off using an emery board or pumice stone. It is important that the emery board or pumice stone is not used by anybody else. The wart is then left uncovered overnight and a new piece of duct tape is placed the next day.


• Cryotherapy - very cold liquid, possibly nitrogen, is sprayed on to the wart, freezing it and destroying the cells. A blister develops, which eventually turns into a scab and falls off a week or so later. This treatment has to be done by a healthcare professional and may require a local anesthetic. If the wart is large several treatments may be required over a number of weeks. Cryotherapy has a lower risk of skin irritation compared to medications containing salicylic acid or the use of duct tape. Pharmacies sell dimethyl-ether/propane spray which the patient can use himself/herself - this should not be used on the face.


• Surgery - this is less common for warts. Warts treated with surgery often come back. Surgery has a higher risk of scarring. However, sometimes a doctor may recommend surgery, which will generally be performed under local or general anesthetic. Surgery may be recommended if other treatments have not worked. If the wart is very big it will be cut out. Smaller warts may be scraped off using a curette.


• Laser treatment - a precise laser beam is used to destroy the wart. Laser treatment is usually recommended for warts that are hard to treat.


• Electrocautery - an electric current is used to burn off the wart.


• Photodynamic therapy - the wart cells absorb a chemical. This chemical is activated by light - usually laser light - and destroys the wart cells.


• Chemical treatments - these are available on prescription. They may include formaldehyde, glutaraldehyde and podophyllin. They must be applied only on the wart, and not on the surrounding skin.


• Cantharidin - this is a substance which is extracted from the blister beetle. The doctor will apply it onto the warts. Usually this extract is mixed with other chemicals, applied onto the skin and covered with a bandage. It is painless; however the resulting blister may be uncomfortable. The blister lifts the wart off the skin so that the doctor can them remove the dead part of the wart.


• Antigen shots - the human body's immune system does not realize that a wart is there. However, if you stimulate the immune system locally, some activated immune cells in the area will recognize the abnormality - the wart - and take care of it. The advantage of using antigen shots is that it leaves no scarring; the body's own immune system gets rid of the wart.

Doctors may sometimes treat pregnant patients, or they may decide to wait until after the pregnancy is over.

If warts have not responded to standard treatments a GP (general practitioner, primary care physician) may refer the patient to a dermatologist (skin specialist). The dermatologist may use some of the treatments below:

• Immunotherapy - the aim here is to get the patient's immune system to destroy the warts.


• Bleomycin (Blenoxane) - this is injected into the wart and kills the virus. Bleomycin is also used for treating some types of cancer.


• Retinoids - these disrupt the wart's skin cell growth. Retinoids are derived from vitamin A.


• Antibiotics are not effective for treating warts. Antibiotics are used for bacterial infection, not viral infections. Warts are caused by a virus.


• A common flower that helps wipe out garden insects has also shown promise in eradicating stubborn warts.

Common warts may be difficult to eliminate completely or permanently, especially those located around and under the fingernails and toenails. Many people who are susceptible to warts will regularly have them, even after successful treatment. Experts say that sometimes more than one treatment approach is needed for better management of warts.