Warts, caused by the HPV, are classified into different types according to the site of involvement and clinical appearance of the growths. The treatment of warts involves both medical and surgical methods. Some of the treatments can be carried out by the patient at home, while others are performed at the clinic by the treating physician or dermatologist.
How to Get Rid of Warts: Should Warts be Left Alone?
As most warts are self-limiting and resolve by themselves in a few months to years, potentially scarring aggressive treatments are best avoided, especially on the face and in young children. Spontaneous resolution of warts occurs within two years in most cases.
The following factors are to be considered while deciding whether to tackle the warts in an aggressive manner:
- Types of warts. Disfiguring warts on exposed parts are to be treated early for cosmetic reasons. Non-scarring methods of treatment are preferred on the face and neck, though. Steps should be taken to get rid of the painful plantar warts as early as possible, for obvious reasons.
- Genital warts. Certain types of HPV causing warts in the genital parts in both sexes have been found to cause cancer in later life, especially in the uterine cervix in females. As these are transmitted through sexual and other intimate contacts, the anogenital warts should be treated without much delay.
- Pregnancy. Certain medications like podophyllin should not be used pregnancy as these may cause fetal abnormalities.
- Profession. Cooks, waiters, hair dressers, beauty salon workers and healthcare professionals should get their Palmar warts treated as soon as they appear so as to avoid transmission to their customers.
- Warts on the beard area in males. Warts on the beard area in males get re-inoculated while shaving and can be a chronic problem in males. These should be removed at the earliest to reduce chances of recurrences.
How to Get Rid of Warts
Most warts can be treated at home with a little diligent and persistent effort. Hard, recurrent and extensive warts need be treated in a clinical setting.
- Home Based Treatment. The advantage of home based treatment by the patient is that these are comparatively cheaper and cause little or no pain. Disadvantage is that, if not dealt with properly, recurrence is common.
- Small warts. 10% salicylic acid-lactic acid in collodion is applied to the warts and paired off every three to four days till complete resolution.
- Large warts. 40% salicylic acid plaster is applied for three to four days, the macerated wart is scraped off till it becomes soft, then the salicylic acid-lactic acid solution, along with 5-flurouracil is applied to the warts for another three to four days. Pairing is repeated till bleeding points appear. Depending upon the depth, it may take anywhere between two to eight weeks to clear the warts. This type of graded pairing is particularly useful to get rid of the plantar warts. Larger and extensive warts call for pairing by an experienced dermatologist.
- Imiquimod cream: Thick warts-paired down after SA + LA solution, then apply imiquimod 3 times a week. External genital warts respond well to treatment with topical imiquimod, compared to other types of warts.
- Treatment at the Clinic. These are comparatively costlier and include painful procedures. These include cryotherapy, electrosurgery and laser surgery. Recurrence rates after cryosurgery (freezing the warts with liquid nitrogen) are high as it only destroys the infected area but does not kill the HPV. Electrocautery is more effective than other methods, but potential for scarring is also greater than others. Any procedures causing permanent scarring should be avoided as far as possible on the soles, palms and on the face.
There are some reports of plane warts responding to suggestion therapy and hypnotherapy, these require further clinical validation. Patients should be aware that the incidence of recurrence is high even after effective treatment of the warts. Early removal of warts is the only way to reduce the chances of future recurrences.
References:
- Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Sixth Ed, 2009
- Viral Infections, in IADVL Textbook of Dermatology, 3rd Ed, 2008
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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