aka Verruca Vulgaris

What causes warts?

Warts are caused by a virus from the HPV (human papilloma virus) family that has found its way through an insult in the skin.  Warts are contagious. 

How do you treat warts?

A variety of treatment modalities exists aimed at destruction of the wart locally and/or waking-up the immune system to fight off the wart virus at the site and beyond.  Liquid nitrogen is the most often used and effective treatment for warts.  Other options include: 40% salicylic acid, podophyllin, cantharidin, 5-fluorouricil + salicylic acid (WartPeel), and candida injections.

Is the over the counter freezing the same?

In office and over the counter freezing products are not created equal.  In office liquid nitrogen is negative 196 degrees Celsius.  Liquid nitrogen is much colder than your drug store brand freezing agent. 

What can you expect with Liquid Nitrogen?

Treating with liquid nitrogen produces a localized freezing of the warts and a small area of surrounding skin.  Freezing a small area of surround skin prevents formation of a ring wart (an annular wart from residual virus at the edges and destruction of virus in center). The freezing wears off within moments of the treatment, but the pain and burning sensation from it usually persist for 10-30 minutes and result in redness to the treated area.  The full effects of the freezing are not seen for 8 to 72 hours.  Patients can expect for the area to be tender for several days, especially if on the bottom of the foot.  Within 24 hours a clear or red-to-purple blister may appear, avoid popping or manipulating the blister as it is nature’s best Band-Aid.  The treated area will then scab over within the next 7-10 days.  The scab will eventually fall off, but the area will be pink for several weeks.

If your wound demonstrates signs and symptoms of infection such as FEVER, REDNESS, WARMTH, PAIN, or YELLOW DRAINAGE, please call our office.

What are the best at home treatments for warts?

Three to five days after your liquid nitrogen, start with a pumice stone (available at retail stores and pharmacies such as Walgreen’s, Safeway, Target, CVS, Sephora or Ulta) to use after bathing to help remove the potential dead skin (be as aggressive as you can tolerate). 

A good option in combination with liquid nitrogen and the pumice stone is 40% salicylic acid or WartPeel (5-Fluorouricil + salicylic acid).  After the blistering and peeling from the liquid nitrogen subsides in approximately one-week, apply 40% salicylic acid (Mediplast from Curad, Wart Stick, Compound W, Dr. Scholl’s) or WartPeel nightly.  During the first few days of application the skin around the wart may swell and become white.  This will slough off with continued applications and use of the pumice stone. 

How many treatments will I need?

Some patients are lucky and one treatment wakes up the immune system and the warts are gone, but in the majority of cases, patients need anywhere from 2-10 treatments spaced 2 to 4 weeks apart.