Warts

All warts are caused by specific types of viruses that have an attraction for skin.  They can grow on just about any part of the body.  Their appearance depends on their location.  Warts are slightly contagious and may spread from one part of the body to another or from one person to another.  We do not understand why some people seem to be resistant to developing warts while others grow warts very easily.

Warts often resolve spontaneously without any treatment, especially in children.  While the majority of warts can be successfully treated, some warts are extremely difficult to eradicate (especially those around the fingernails and on the bottom of the foot). Sometimes new warts will form while existing ones are being destroyed.  At other times, untreated warts will disappear when other warts are treated.  Warts may also return after an apparent cure.  Do not be alarmed as this is very common.  These can be treated more vigorously with a different method. Occasionally a wart may actually be a skin cancer so you should have all warts checked if they do not resolve within a month or two.

How are warts treated?

Laser treatment using the NdYAG laser is the most effective treatment for warts, even those on the palms and soles. One to three or more treatments may be necessary to fully eradicate the wart.  Because the treatment is painful, local anesthetic is usually injected beneath the wart just before the laser treatment.

Liquid nitrogen is often very effective, especially for tiny warts on the hands or face. Treatment will often need to be repeated several times, about every 2-3 weeks.  

Retin-A cream (prescription required) is effective in treating some cases of warts especially those on the face.

Aldara cream (prescription required) can be helpful in treating flat warts or genital warts.

Salicylic acid plasters (example: Compound W) are available without a prescription.  Scrape off the dead tissue daily with an emery board, pumice stone or file.  Soak the wart in warm water for 10 minutes, then apply the plaster.  Use a piece only slightly larger than the wart so that the surrounding skin is not irritated.  Place adhesive tape over it to ensure that it sticks.  Continue treating until the wart is gone, which may take weeks to months.

Cantharidin, an extract of a blister beetle, may be applied to the wart by the physician.  Leave the tape on for 24 hours (or 48 hours if the wart is on the palms, soles or around the nail).  However, if burning occurs before this time, remove the tape and wash off the medicine.  The goal of therapy is to cause blister formation.  Treatment may have to be repeated.