Warts

What they are:

Warts are benign growths caused by the human papillomavirus. They can present anywhere on the skin, but the hands, feet, knees, face, and genitals are the most common. There are more than 100 different kinds of warts.

Treatment:

Warts are very difficult to treat. No one treatment is uniformly effective, so your doctor may suggest the least expensive, easiest treatment at first. Multiple treatments are usually necessary.

There is no cure for the wart virus, so this means that warts can return at the same site or appear in a new spot. 

Some treatments include:

Benign neglect:
65 percent of warts disappear spontaneously within two years. Although without treatment, patients risk warts that may enlarge or spread. 

Topical agents:
Salicylic acid, available over-the-counter, can be 70-80% effective.

Cantharidin, dibutyl squaric acid, trichloroaceitc acid, podophyllin, or amniolevulinic acid, are administered by trained personnel in the doctor’s office. Or prescription medications like imiquimod or cidofovir, can be applied by patients at home. 

Intralesional injections: 
Persistent warts that don’t respond to topical agents may require intralesional injections. Candida, Trichophyton, Belomycin, and Interferon-alfa have all be used with varying degrees of success. 

Photodynamic therapy: 
Certain warts respond to photodynamic therapy, which involves the patient being injected with photoreactive chemicals. The patient is then exposed to light strong enough to activate the chemicals, which causes them to destroy the targeted abnormal cells. This treatment can also be used to treat basal and squamous cell carcinomas, actinic keratosis, psoriasis, acne, and wrinkle rejuvenation. 

Systemic agents:
Systemic medications are prescription drugs that work throughout the body. Systemic medications are used when other treatments are not responsive, or the patient cannot take topical medications or UV light therapy. Systemic agents are also used to treat severe psoriasis, psoriatic arthritis, acne, and other dermatological diseases. 

Cryotherapy:
For common warts in adults and older children, cryotherapy, or freezing, is a common treatment. It is not painful, but may cause dark spots in people who have dark skin. Sometimes this procedure needs to be repeated more than once to be completely effective. 

Electrosurgery and curettage:
Electrosurgery, or burning, is a good treatment for common warts, filiform warts, and foot warts. Curettage involves scraping off the wart with a sharp knife or small, spoon-shaped tool. These two procedures are often used together. The dermatologist may remove the wart by scraping it off before or after electrosurgery. 

Excision:
The doctor may cut out the wart in rare situations.