What are the treatment options for warts?
The goals of treatment are to destroy the wart and get an immune system response to fight the virus. Treatment can take weeks or months. Warts often go away without treatment, especially in children. Warts in adults may take longer to disappear.
Although warts are harmless, any growth that bothers you, has changed, or you can’t get rid of should be evaluated by a dermatologist. Before warts are treated they can shed the HPV virus cells into the skin, allowing new warts to grow around the original warts. To avoid this, have your dermatologist treat new warts immediately. Even with treatment, warts tend to return or spread.
Treatment options depend on your age, health, and the type of wart you have. The first treatment options your dermatologist may recommend can be done at home. He or she will advise if these options would work for you. Never try to treat a wart if you have a weakened immune system, and never treat a wart on your foot if you have diabetes.
At-home treatments include:
- Non-prescription-strength salicylic acid is available as a patch, pad, ointment or liquid. Products like Compound W or Dr. Scholl’s Clear Away Wart Remover have a 17% salicylic acid solution. They’re used daily for a few weeks. Be sure to soak the wart in warm water, then file away dead skin with a disposable emery board (never reuse it to prevent spreading the virus) or pumice stone before applying the product. If your skin becomes irritated, use it less often.
- Liquid nitrogen products (Compound W Freeze Off or Dr. Scholl’s Freeze Away) can freeze the wart. It will fall off in about a week.
If at-home methods don’t work, see your dermatologist about these in-office treatments:
- Stronger salicylic acid (prescription-strength) works by removing one layer of the wart at a time. It’s often combined with cryotherapy.
- Cantharidin applied to the wart causes it to form a blister under the wart. In about a week it will die, and the dermatologist can clip it off.
- Cryotherapy freezes the wart so it will die and fall off in about a week. It is the most common way to remove warts but usually requires repeat treatments. It can cause pain, blistering, or darker spots in people who have dark skin.
- Electrosurgery uses liquid nitrogen to “burn” off common, filiform or foot warts.
- Curettage is used to scrape off (curetting) the wart with a sharp knife or small, spoon-shaped tool. Curettage and electrosurgery are often used in combination by first curetting the wart.
- Surgery involves cutting out the wart, but it may leave a small scar.
If your warts are hard-to-treat, the dermatologist may use these treatment methods:
- Laser removal may work for some warts that won’t go away or aren’t responding to any of the treatments listed above. The dead tissue sloughs off, but the process can cause pain and scarring.
- Chemical peels are used when there are many flat warts. A peeling medicine (very strong salicylic acid, tretinoin or glycolic acid) is applied at home every day. Side effects can include burning and stinging.
- Bleomycin is an anti-cancer medication that’s injected into each wart. Side effects include painful shots, or nail loss if injections are given in the fingers.
- Immunotherapy uses your immune system to fight warts. It’s used when other treatments haven’t worked. A chemical is applied to the warts, causing a mild allergic reaction. The immune system reacts, and attacks the warts so they go away. Another method is shots of interferon to boost the immune system, giving it the ability to fight the virus.
Can warts be prevented?
There are several things you can do to help prevent warts from developing:
- Avoid direct contact with warts, including your own. Wash your hands after treating a wart.
- Don’t scratch or pick at warts to avoid spreading the virus.
- Don't bite your fingernails because this can allow the HPV to infect your skin.
- Shave carefully in areas with warts; consider using an electric razor.
- Wear flip-flops in shower rooms, around swimming pools or hot tubs, and in gyms.
- Keep foot warts dry to prevent them from spreading.