skin disorders
Warts
Treatment of Warts
Topical chemicals Freezing Burning or cutting Other therapies Many warts, particularly common warts, disappear on their own within a year or two. Because warts rarely leave a scar when they heal spontaneously, they do not need to be treated unless they cause pain or psychologic distress. Genital warts are treated to prevent spread to a sex partner (see Treatment ). All types of warts may return after removal. Plantar warts are the most difficult to cure. Warts can be removed in several ways. Some of these treatments are more effective for certain types of warts. Topical chemicals are applied directly to the wart. They come in various forms, such as creams, gels, lotions, or solutions. Some chemicals can be applied by the person, but others must be applied by a doctor. Most of these chemicals can burn normal skin, so when they are applied at home, directions must be followed carefully. Chemicals usually require multiple applications over several weeks to months. Before applying chemicals to the wart, the wart can first be soaked in hot water to make it easier for the chemicals to penetrate it. The wart is scraped either at home or in the office to remove dead tissue before each treatment. Examples of chemicals used to treat warts includesalicylic acid, trichloroacetic acid, 5-fluorouracil,cantharidin,tretinoin,imiquimod,podofiloxsolution,sinecatechins, andpodophyllumresin. Some of these chemicals work by causing the skin around the wart to exfoliate (peel) or by destroying the wart itself, causing it to loosen and fall off. Others work by stimulating the body's immune system to fight the virus that caused the wart. Warts may be frozen with various commercial freezing probes. However, liquid nitrogen sprayed on or applied with a cotton swab is more effective. Freezing is safe when it is done by a trained health care professional. The area usually does not need to be numbed, but freezing with no numbing may be too painful for children to tolerate. Cryotherapy is often used for plantar warts, filiform warts, and periungual warts. Multiple treatments at monthly intervals are often required, especially for large warts. A laser can be used to burn off warts. Like with freezing, multiple treatments usually are required (see Using Lasers to Treat Skin Problems ). A wart may be removed by scraping and burning it with an electric needle (a procedure called curettage and electrodesiccation). A wart can also be removed surgically either by shaving it off with a razor or using a scalpel blade to cut it out. These methods are effective but are more painful and usually leave a scar. An anesthetic is injected for some of these procedures. An antigen made with the yeastCandidacan be injected directly into warts, particularly warts that are difficult to treat. This antigen comes from the yeast. When injected into a wart, it causes an immune response that fights against the virus. The Human Papillomavirus (HPV) Vaccine that protects against 9 strains of HPV may be helpful for children who have warts that are difficult to treat. Warts may also be treated with the topical antiviral medicationcidofovir. 