Verruca Vulgaris (Warts)
Warts are a common viral (human papilloma virus) infection of the skin. There are over 70 types of wart viruses. Most individuals will have a wart experience during their lifetime. The virus affects the surface layer of the skin epidermis and causes a thickening of this layer, which forms a benign growth. We have no specific treatment that kills the virus. There are multiple treatments for warts, none of which are always effective. Treatments either irritate or kill the surface cells. Your doctor will use the treatment he/she feels is least painful and most effective. Warts will often go away spontaneously, although, they may last for several years. Sometimes the best treatment is No Treatment . Remember there are no guarantees when it comes to treating warts. Sometimes the warts will grow and sometimes they will clear in the center and recur at the margin of the treatment site (doughnut recurrence).
There are several methods of treatment for warts. Your doctor will help you decide which is best for you and will instruct you further. Treatment methods include:
- Occlusal/Duofilm (17% Salicylic Acid liquid): Apply this in the morning and /or the evening (as instructed) to wart and let dry. Do not apply to normal skin. Before re-application, soak the treated area with warm soapy water and rub off the dead or excess skin. If more than a little irritation occurs, stop for a few days.
- Liquid Nitrogen: This treatment freezes the wart with a cold liquid. A blister may form and may contain blood. If the blister is bothersome, you may take the following steps: clean the blister with alcohol and nick the blister top with a clean needle. Gently press out the fluid and/or blood with a clean tissue. DO NOT keep the area covered with a Band-Aid but continue to keep it clean with a mixture of half hydrogen peroxide and half water. It may take 3-4 weeks for complete healing.
- Cantharone: This is a strong medicine, which will cause blisters. Leave it on for 4-6 hours or until the next morning as directed by your physician. Then, thoroughly and gently wash off the dry medicine. If the area hurts before you are to remove the medicine, you may go ahead and remove the tape and medicine. If the tape and dry medicine are difficult to remove, soak the treated area in warm soapy water for ten minutes. If a blister forms, gently make a small nick with a needle and press out the fluid with a tissue. You may have pain for several days after the medicine is removed. You may take Tylenol or soak the treated area in cool water to relieve the pain.
- 40% Salicylic Acid Plaster (Mediplast): This is an over-the-counter medicine. The pharmacy may need to order it for you if they do not have it in stock. Trim a piece of the plaster to fit the exact size of the wart and apply to wart surface. Use strong tape to secure it. It is important to only cover the wart surface, since contact of the plaster to normal skin may result in pain. Change the plaster every 3-5 days . Remove the tape and old plaster, soak the area in warm soapy water, and then rub the treated area using a washcloth to remove dead surface skin. Reapply plaster as long as the wart is still visible.
- Curette Excision: Leave the wound alone. Apply Polysporin or Bacitracin ointment to the wound. If your wart was on the bottom of the foot and pain develops, you may nick a hole in the crust and release the fluid. If the lesion was removed on the hands, do not do vigorous work requiring use of your hands. If a red streak develops from the surgery site, call the clinic.
- Podophyllin: This medication is applied in the office. It should be left in place for 4-6 hours, then washed off thoroughly with mild soap and water.
- TCA (trichloroacetic acid): This is a mild acid which acts as a peeling agent. It is applied in the office only and may cause a mild burning sensation after it is applied. The burning sensation disappears quickly when the medicine is removed with an alcohol swab. You may notice mild irritation or peeling of skin for a few days after treatment.