Warts are noncancerous skin growths caused by the human papillomavirus (HPV). Skin warts can spread to other individuals by direct contact with infected skin or with objects and surfaces on which the virus is present.
Warts on the hands or soles of the feet often go away on their own in due time. In fact, research shows that about half of all warts heal within 12 months without any treatment. However, pain or the warts’ unsightly appearance sometimes leads people to seek medical treatment for warts.
When warts fail to respond to over-the-counter therapies such as salicylic acid or freezing products, a dermatologist can offer a number of other treatment options.
If you choose the standard cryotherapy wart removal, your dermatologist will apply liquid nitrogen to the wart after first removing any dead skin. Once the wart freezes and the skin tissue begins to thaw, the doctor may apply liquid nitrogen a second time.
You may need more than one cyrotherapy treatment session before the wart falls off, especially if it’s a large wart. In some cases, a wart may return, or you may have a scar or skin discoloration after the area heals.
Chemical Peeling Agents
If a combination of prescription-strength salicylic acid and cryotherapy fails to kill a wart, your dermatologist may treat the wart with chemical peeling agents that contain tretinoin and glycolic acid. The doctor shaves the surface of the wart before applying the medication, so you may feel a stinging and burning sensation.
Sometimes dermatologists use medicines that contain bichloracetic or trichloroacetic acid. Although these chemicals are found in over-the-counter products for treating warts, the chemicals can destroy healthy tissue as well as wart tissue.
Improper application can lead to side effects that may include swelling and severe pain in the skin around the treated area. Therefore, it’s better to have a dermatologist apply the medicine. You may also need several treatments before the wart disappears.
Bleomycin is a medication doctors generally use to treat thyroid cancer, bone cancer, skin cancer, and malignant melanoma. But if you have a severe case of warts, and other treatment options have failed, your dermatologist may recommend treatment with bleomycin-an antibiotic that kills the virus that causes warts to form.
The doctor will inject bleomycin directly into the wart, which will cause a blister to develop. The medicine-diluted in a saline solution-can cause the fingers where warts are treated to feel cold. You may also experience pain or a burning sensation at the injection site. In some cases, nail damage can occur.
The wart will turn black and either fall off within a few weeks or be removed by your dermatologist via scalpel. Patients sometimes require only a single treatment, but you may need to return for more injections before the wart is gone.
Intralesional Antigen Immunotherapy
Some dermatologists recommend immunotherapy for treatment of plantar warts and warts on the hands that fail to respond to other treatment methods. Your doctor will inject a test antigen, such as Candida albicans, into the wart to create an immune response. The goal is to help your body overcome the viral infection that caused the wart.
Injecting Candida antigen is an off-label use of the antigen not approved by the Food and Drug Administration (FDA) for the treatment of warts. However, intralesional immunotherapy appears to be a safe treatment option for warts, particularly for multiple warts on the hands and fingers. Side effects that occur usually are mild, but it normally takes more than one treatment to get rid of a wart entirely.
Although laser surgery for warts usually is performed in a dermatologist’s office under local anesthesia, you will experience pain for a few days afterward. Warts fall off after the infected tissue dies.
Doctors normally recommend laser surgery only after other treatment options have failed. Recovery time varies depending on how many warts are treated and the skin areas where they are located.
If you have warts that are spreading or not responding to self-care or over-the-counter treatments, the doctors at Asheboro Dermatology & Skin Surgery Center can treat warts that are painful. Even if you aren’t sure that a skin growth is a wart, the health care professionals on staff will be happy to take a look.