No one likes them, most people get at least one at some point in their lives. They are caused by a common virus that gets embedded in the epithelial tissue (i.e. skin and mucous membranes). The good news is that they will go away on their own if you leave them alone and give them enough time. The bad news is that it may take months to years for warts to self-resolve. Treatment for warts is generally not medically necessary but may be pursued because a person feels they are unsightly or because they are uncomfortable (especially on the bottom of feet–called plantar warts–or on other pressure points like the back of the legs).
There are multiple options for treating warts. First line therapy is something you can do at home with an over-the-counter product. Salicylic acid wart paint is available under several names (Compound W, Dr Scholl’s Clear Away, Duo Film, Mediplast, Occlusal, Trans-Ver-Sal and Wart Off), is easy to apply and is well tolerated. For best penetration, soak the wart in warm water for at least 5 minutes then file the top layer with a pumice stone or emery board (do not use the pumice stone or emery board for anything other than the wart since it can spread virus). Apply a thin layer of the wart paint to the wart and cover with a Band-Aid or piece of duct tape. Remove the covering in the morning. Repeat this process every night for a minimum of 6 weeks–most guidelines suggest 2-3 months. If you do not have time for soaking and wrapping, at a minimum, file the wart then apply wart paint.
If this home treatment is not effective or otherwise not tolerated, there is cryotherapy (liquid nitrogen) treatment available in our office. We do not perform electro surgery or laser treatment for warts in our office.
Cryotherapy involves spraying each wart with liquid nitrogen for 3-5 seconds x 3. Usually it takes multiple visits for repeat cryotherapy until resolution of a wart is achieved and each cryotherapy session needs to be separated by 3 weeks. This means that it often takes just as long, if not longer, from the start of treatment to the time of wart resolution for cryotherapy to be effective as it does for the home salicylic acid therapy, which is why we strongly recommend starting treatment at home first. Another reason to wait on cryotherapy is that it can be painful on the skin surrounding the wart and that infrequently there can be mild scarring. However, it is an option to keep in mind if the salicylic acid does not prove helpful.
If neither the salicylic acid nor the cryotherapy is effective, dermatologists have additional treatment options available. Keep in mind that the reason there are multiple treatment modalities is because there is not one particularly good way to get rid of warts. Treatment addresses the wart and not the underlying viral infection so occasionally warts will recur despite treatment.