Periungual warts are a common skin condition around fingernails and toenails. These growths are caused by the human papillomavirus (HPV), specifically types 2 and 4, which is highly contagious and thrives in warm, moist environments. Their location makes them challenging to treat, as they can grow under the nail plate and distort nail growth. Periungual warts can be bothersome and may cause discomfort.
At-Home Treatment Methods
Salicylic acid is a common at-home treatment for periungual warts. This keratolytic agent works by slowly destroying virus-infected skin cells and can be found in various forms, including gels, liquids, or patches. Apply the salicylic acid product directly to the wart once or twice daily for at least two to three months, ensuring consistency.
Duct tape occlusion therapy is another method for wart removal. This involves covering the wart with duct tape for four to seven days. After removal, clean the area and gently file away dead skin. Reapply tape after 12 hours, repeating for four to six weeks. Combining duct tape with salicylic acid can enhance results.
Over-the-counter freezing kits (cryotherapy) are also available for home use. These kits involve applying a cold gas to the wart to destroy affected cells. While some kits claim to remove warts within 10-14 days with a single application, multiple treatments are often necessary, especially for thicker warts.
When to Consult a Doctor
Consult a doctor if periungual warts persist despite consistent at-home treatment for several months. Warts that are painful, growing rapidly, or interfere with daily activities warrant a doctor’s visit. If a wart bleeds and does not stop with light pressure, or if it changes color or appearance, seek medical evaluation.
Also consult a doctor if there are signs of infection, such as redness, swelling, or pus around the wart. Individuals with underlying health conditions like diabetes or a compromised immune system need professional guidance, as these conditions can complicate wart treatment and healing.
Medical Treatment Options
For more stubborn periungual warts, medical professionals offer a range of treatments. Stronger, prescription-strength salicylic acid preparations are applied, which are more potent than over-the-counter options. These work by peeling away layers of skin and stimulating an immune response against the virus.
Cryotherapy performed by a doctor involves applying liquid nitrogen to freeze the wart, destroying the tissue. This procedure can be painful, may cause blistering, and often requires multiple sessions for complete removal. Laser therapy, such as pulsed dye laser, targets the blood supply within the wart and can denature the viral DNA, making it effective for warts located in nail folds or under the nail.
Surgical removal, including methods like curettage (scraping) or electrosurgery (burning), excises the wart, especially for larger or resistant lesions. Immunotherapy, which stimulates the immune system to fight HPV infection, involves topical creams like imiquimod or injections of antigens such as Candida.
Preventing Future Warts
Preventing periungual warts involves consistent hygiene to minimize HPV exposure. Regular hand washing is an effective step, especially after touching surfaces that may be contaminated. Avoiding nail biting and cuticle picking is also important, as these actions can create tiny cuts or abrasions that allow the virus to enter the skin.
Also avoid direct contact with warts on others and refrain from sharing personal items. Do not share towels, nail clippers, or other personal hygiene tools that harbor the virus. Wearing protective footwear in public wet areas, such as swimming pools or locker rooms, can further reduce the risk of contracting or spreading the virus.