Warts Q&A

Warts are viruses which enter through the skin. Some people are more susceptible to warts for reasons that are not completely clear, but likely have to do with immune function and skin integrity. If you do nothing, the body’s immune system will eventually get rid of warts, but it may take months to years, and the warts may multiply/spread in the meantime.

Getting rid of warts is not always easy, and no single method works better than another for any particular patient. Treatments are segregated into destructive methods and those that stimulate the immune system.

Destructive methods

1. Some studies have shown that simply putting duct tape over the wart for a few days, then removing it and replacing it with a new piece (removing the tape physically removes the top layers of wart) is as effective as other treatments. If you choose to use this method, you should plan to do so for 4-8 weeks. I find this doesn’t work well on hands, which get wet often from washing, etc. or for sweaty feet (the tape won’t stick). This is clearly an easy, benign option.
2. Acid products literally “eat away” at the wart little by little to destroy the lesions. This can be effective at all body locations. Most of the products, including Occlussal HP, are 17% salicylic acid. For best results you will need to use this product daily for 4-6 weeks. After bathing, it helps to use an emery board to scrape off the top layers of the wart, and then apply the Occlusal to dry skin. Repeat this process once daily.
   If this is a plantar wart (so called because it occurs on the plantar or bottom of the foot), Mediplast is often helpful. It contains 40% salicylic acid and comes as a pad/plaster. The plastar should be cut to the size of the wart. If the plaster covers too much normal, healthy tissue, skin irritation may develop. The backing of the plaster is removed and the sticky surface is applied to the wart which can then be reinforced to your skin by adding tape. The plaster should be left in place for 48 hours and then removed. Following a shower/bath when the skin is soft, you should remove the top layers with an emery board/pumice stone/clean stiff toothbrush, and then reapply a new peice of plaster. This process should be repeated every 48 hours until the wart resolves (approximately 1-2 months).
3. Cryosurgery is the technical name for “freezing” warts. This procedure creates a frozen, dead top layer which often then falls off. It also helps to “make it too cold for the virus to live.” This may take multiple treatments at intervals of about 2 weeks, to get to the bottom layers of the wart. This can be done in the office, or at a specialist’s office.
4. Dermatologists have additional methods of destruction available in their offices, such as lasers.

Immune stimulators

1. Aldara cream should be applied to each lesion nightly for 4-8 weeks in order to stimulate the immune system locally and help destroy the warts. Aldara is a prescription medicine.
2. Some dermatologists also use other foreign materials such as beetle juice to stimulate a local reaction so the immune system starts to locally fight off the wart virus.
3. Tagamet is a prescription oral medicine which has been found to stimulate the immune system. It must be taken by mouth twice daily for several months for best results.