Wart Removal

Treatment options for non-genital warts include freezing, topicals & surgery.

Why why you might want your warts removed?

  • They have been present a long time
  • They have resisted home treatment
  • They are unsightly
  • Concern about spreading them
  • You just don’t like them!

Cantharadin is probably the most effective treatment other than surgery.

Freezing Warts

Cryotherapy is the most common clinic treatment.

Methods available through The Wart Clinic also include Medical-Grade topical treatment, Electrocautery, and Surgery.

Freezing warts at home may be attempted at home using over the counter products but they are nowhere near as effective as Freezing using liquid nitrogen in a GP clinic¹. Freezing using over the counter products will freeze at temperatures of up to -70°C whereas liquid nitrogen freezes at -176°C.

Cryotherapy involves freezing the wart with a 2mm margin of normal skin included in the treated area so as to kill the virus in and around the wart. A thick wart may be pared down before freezing. Cryotherapy is reasonably effective. However, more than one session is usually required to clear the wart. Treatment is performed at 2 to 3 week intervals.

The greater the freeze time, the more effective the treatment but with a greater risk of pain and blistering.

Side effects can include lightening or darkening of the skin in the treated area which may persist.

How about kids? Children will definitely not appreciate a deep freeze and may hate doctors for years to come! A light freeze may be performed but is probably not going to be effective. Whether you want the wart treated or not depends on the age of your child, their tolerance to potential pain and their attitude to the wart.

What specific treatments are available at The Wart Clinic?

Treatment options at The Clinic include:

  • Medical-Grade Topical treatment.
  • Surgery using curettage or cautery – though success is not guaranteed with recurrences occuring in up to 30% ²

Treating warts is challenging and recurrence rates may be high despite the best of endeavours.

What causes Common warts?

HPV type 2

HPV type 2

Nongenital Warts most often occur on the hands and feet but may also occur on other parts of the body. Warts on the soles of the feet and also known as verrucae.

Warts are caused by the ‘human papilloma virus’ (HPV). HPV is better known for types 16 & 18 that may cause cervical cancer, and types 4 & 11 that may cause genital warts. HPV vaccine given to Queensland kids at school in year 8 covers these HPV types. However, Nongenital Warts are usually caused other HPV types 1,2,4, 60 & 63.

The virus enters the skin through tiny breaks in the skin surface, and moistness and maceration of the skin on the feet probably make infection with the wart virus easier. They are caught by direct contact, or indirect contact with virally-infected skin scales found on surfaces such as the tiles around a swimming pool, or public changing rooms. It is not clear why some people get infected and others do not. The time between exposure to the virus and a wart developing (the incubation period) is thought to be 1-6 months.

Treating a wart yourself

home-wart-treatmentsMost warts go eventually on their own. A study in kids showed that two thirds went within two years without treatment – so you can be waiting a long time.

A reasonable start is with one of the many commercial preparations that contain salicylic acid, a chemical that helps remove the hard outer layer of the wart. Wart off ® paint is an example. Treatment should be used every night.

  1. Soak the wart in warm water for at least 5 minutes. This will soften the wart and help the salicylic acid to penetrate the skin.
  2. Before applying, if the wart is thick and scaly, the wart should be pared down or filed with sandpaper or an emery board.
  3. Mask the area around the wart by Painting around it with Nail Varnish
  4. Apply a very small amount of Wart-Off on the top of the wart only, using the applicator. Avoid contact with surrounding skin
  5. Allow the Wart-Off paint to dry, then cover the wart with material so it does not breath. Use either a waterproof enclosed bandaid or you can use micropore® tape.
  6. Wash hands thoroughly after applying Wart-Off.
  7. Remove the bandaid or tape the following morning
  8. Repeat once daily for 12 weeks or until the wart has completely cleared.

Remember the point of the exercise is to get rid of the wart without causing you or your child any pain. Some warts are already tender, in which case you won’t be able to file down the wart at all. Kids are unlikely to put up with much of this treatment and the best you can then hope for is to put on the salicylic acid every couple of days. Some warts are really tender and you won’t be able to go anywhere near your child with a file.

Formaldehyde preparations. Mosaic warts (see above) in particular may respond to a gel containing formaldehyde. If you have large numbers of small plantar warts, it may be worth soaking the whole affected area for 10 minutes at night in a weak formaldehyde solution.

How can I help stop the wart virus spreading?

  • For a verruca, wear comfortable shoes that do not press on it.
  • Do not share your shoes or socks with anyone else. Special pads to relieve pressure on plantar warts can be bought at a chemist.
  • Keep your feet clean and dry, and change your socks daily. Do not go barefoot in public places. Plantar warts should be covered with waterproof plasters or rubber ‘verruca socks’ if you go swimming. · Do not pick at your plantar warts. When you pare your wart down, dispose of the dead skin carefully. The sand paper or emery board will also have living wart virus on it, and so do not use it for any other purpose, or you may spread the virus.
  • When paring or filing down warts, take care not to damage the surrounding skin, as doing so might result in the warts spreading. · If you have children, check their feet periodically for viral warts.

Medical-grade Topical Therapy

Cantharadin plus is offered by a limited number of dermatologists. This requires a referral. The mixture also contains other substances such as podophyillin that help to destroy the wart. The liquid is applied to the wart by the doctor. The liquid then dries and is covered a plastic adhesive tape. You then leave the clinic. After 4 hours – or time otherwise agreed – you remove the tape and wash the wart with soap and water . A blister forms within 24 hours and this is likely to be uncomfortable for a day or two. The local reaction can sometimes be more severe.

The treatment may need to be repeated. A particularly large wart may be treated with a combination of Cantharadin plus followed by surgical scraping (curettage) under local anaesthetic the following day. Cantharadin may on occasion be useful in the treatment of molluscum contagiosum.