Dermatologists routinely diagnose and remove warts. Warts are caused by infection with the Human Papillomavirus (HPV), which stimulates the rapid growth of skin cells. While many warts, especially in children, may resolve spontaneously as the body’s immune system fights the virus, this process can take months or years. Dermatologists offer effective, clinical solutions for growths that are persistent, problematic, or resistant to over-the-counter (OTC) treatments.
Identifying When Professional Removal is Necessary
Patients should seek professional help when a wart becomes painful, particularly if it is a plantar wart located on a weight-bearing area like the sole of the foot. Pressure from walking can force these warts inward, creating the feeling of stepping on a stone, which may alter gait and lead to joint or muscle strain. Warts that show signs of change, such as bleeding, rapid growth, or an alteration in color or texture, also warrant immediate evaluation. These changes could indicate a more aggressive viral strain or, rarely, mimic serious skin conditions like skin cancer.
A professional diagnosis is also important when the growth is located on sensitive areas, such as the face, near the eyes, or on the genitals. These delicate areas require specialized treatment to minimize the risk of scarring or complications. If a wart has been consistently treated with home remedies, such as salicylic acid products, for several weeks or months without improvement, it is categorized as refractory and requires stronger clinical intervention. Individuals with weakened immune systems or underlying health conditions like diabetes should always consult a specialist before attempting at-home removal.
Clinical Methods for Wart Removal
Dermatologists employ several distinct in-office procedures designed to destroy wart tissue and stimulate an immune response against the HPV virus. One common method is cryotherapy, which involves applying liquid nitrogen to the wart to freeze and destroy the infected cells. The extreme cold causes cell damage and blistering, and the dead tissue eventually falls off. Multiple treatments every few weeks are often necessary for complete clearance, achieving a clearance rate of approximately 50% to 70% for common warts after three to four sessions.
Another destructive technique is electrosurgery, which uses a high-frequency electrical current to burn and cauterize the wart tissue. This is often performed with curettage, where a sharp, spoon-shaped instrument scrapes away the destroyed tissue. Electrosurgery is reserved for more persistent lesions and requires a local anesthetic to manage discomfort. Surgical excision, though less common, involves cutting out the entire wart under local anesthesia, typically used for very large, solitary, or highly resistant warts.
Beyond physical destruction, dermatologists utilize prescription topical treatments and immune-boosting therapies. Cantharidin is a chemical applied in the office that causes a blister to form beneath the wart, lifting it off the skin over about a week. Immunotherapies like Imiquimod cream stimulate the body’s local immune system to attack the HPV virus, rather than physically destroying the tissue. Stronger prescription-strength acids, such as Trichloroacetic Acid (TCA), may also be applied directly to the wart to chemically burn off the infected tissue layers.
Managing Post-Treatment and Preventing Recurrence
After professional removal, the treated area often forms a blister, scab, or wound, which is a normal part of the healing process that takes between one and four weeks to resolve. Patients must protect the area by keeping it clean and avoiding picking or scratching, which can delay healing and risk spreading the virus. Allowing the wound to heal fully before exposing it to friction or sweat minimizes complications.
Wart recurrence is a common challenge, as the HPV virus can remain dormant in the deeper layers of the skin even after the visible growth is removed. To reduce the risk of the wart returning, patients should focus on maintaining a strong immune system through adequate sleep, a balanced diet, and stress management. Simple hygiene practices are also highly effective:
- Frequent handwashing.
- Avoiding walking barefoot in public.
- Not sharing personal items like towels or razors.
Follow-up appointments are often scheduled to monitor the treatment site, ensuring the virus has been fully cleared and addressing any signs of early recurrence.