There is no single effective treatment for warts; management is
based on the age of the individual as well as the size, number, and
location of warts. Common warts, especially in children, do not
necessarily need to be treated, because they exhibit a high rate of
spontaneous remission. Without treatment, however, spread can occur.
Treatment involves the physical or chemical destruction of the
lesion. In physical destruction, liquid nitrogen, which is extremely
cold, is sprayed onto the wart or applied with a cotton-tipped swab.
Because freezing is painful, this form of treatment is not tolerated
well by young children. Warts can be anesthetized and then scraped
(curetted), burned (desiccated), lasered off, or surgically cut out
(excised).
A variety of chemicals are used to eradicate warts. Genital warts
respont to a topical resin, podophyllin, applied in strong
concentration at regular intervals by the doctor, or a prescription gel
(Condylox®) to be used at home. Cantharin, an extract from a blistering
beetle, is used alone or in combination with podophyllin to treat warts.
Over-the-counter preparations of salicylic acid are sometimes used.
Imiquimod cream (Aldara®) is approved as a prescription for enhancing
the immune response to warts, thus helping the body fight the human
papilloma virus.
A dilution of bleomycin, a medication used in chemotherapy, can be
effective when injected into warts that are resistant to other
treatments.
Despite numerous treatment modalities, warts sometimes require
repeated treatment because they are difficult to eradicate and commonly
recur.
