Warts are very common. There are many types of warts. They can occur at any age, but they are especially frequent in children and young people. Technically, they are caused by a virus, and exposure to the virus can occur practically anywhere (e.g. shoes, counter tops, sports equipment, doors, wood, you name it). However, exposure to the virus that causes warts doesn’t mean an individual will acquire the virus in their skin. Other factors such as age, stage of immune development, skin type and genetics also play a role. When infected, the skin where the wart is visible is only part of the area involved because the wart virus can be microscopically located in other adjacent areas. All of these factors make treatment of warts challenging. To further complicate matters, the wart virus is usually eliminated from the body by the body’s own immune defenses over time without any direct treatment. Therefore, it’s not always possible to know for sure what
caused the wart to disappear. This lends itself to the belief that whatever was last used to address/treat the wart resulted in the cure (e.g. Clorox, Vick’s vapor rub, “talking the wart off” etc.). No one single treatment can guarantee a “cure” for a given wart, so persistence is often required. Ultimately, one’s own immune response does by far the most in attacking and defeating warts. Our job as providers is to treat the wart(s) with tactics that “attract” one’s own immune response to the area of the wart. In short, anything that keeps the wart(s) “inflamed” and/or “agitated” helps attract the immune response, so these techniques are employed to maximize the final cure. There are a litany of wart treatments. Here are some of the most common ones.

Liquid Nitrogen Treatment (LN2) – This technique is sometimes called “freezing” or “burning”. Liquid Nitrogen is around 320 degrees BELOW ZERO. It damages everything it touches. It works by doing some local destruction to the wart(s) and by causing inflammation that attracts the immune system to the area. It can blister and cause some really “icky” spots. It is also quite painful.

Cantharone – Cantharone is a blistering agent produced by the “blister beetle” and is frequently used in dermatology. It is mixed as a brown, sticky application and left on for a certain amount of time (typically 2-4 hours) before washing off with soap and water. It doesn’t hurt to apply, but it produces blisters, which can be painful and/or large.

Salicylic acid Preparations – These agents are used for home wart therapy and can be very effective if used properly and consistently. Some of the name brands are Compound W and Duofilm, but there are others which may be just as effective. These products are sold over the counter. Most are inexpensive. Because the treatment of warts can be difficult, regardless of the therapy utilized, use of Salicylic acid agents requires patience. This type of home therapy can be used as a single form of therapy. However, oftentimes, your provider will have you use Salicylic acid therapy at home following LN2 or Cantharone. Specifically, you would wait about a week for the inflammation from LN2 (or Cantharone) to settle down. Then, you begin using salicylic acid nightly for 3-4 weeks. If the wart(s) persist after that, you may need to see your provider again.

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