Warts are common, noncancerous skin growths caused by infection with the human papillomavirus (HPV). The virus causes extra cell growth, making the outer layer of the skin thick and hard. While many warts resolve spontaneously, patients often seek professional removal due to discomfort, spreading, or cosmetic concerns after over-the-counter treatments fail. Understanding professional treatment options and providers can guide effective removal.
Professional Provider Options
The choice of medical professional depends on the wart’s type, location, and persistence. A Primary Care Physician (PCP) is typically the first point of contact for common, isolated warts. They can assess the growth and initiate first-line treatments, such as cryotherapy or prescription-strength topical acids.
For warts that are numerous, recurrent, or complex, a referral to a Dermatologist is appropriate. Dermatologists are skin specialists who manage stubborn cases and possess a wider array of advanced treatment options. They should also be consulted if the diagnosis is uncertain and a skin biopsy is required to rule out other conditions.
Individuals with warts on their feet, known as plantar warts, should consult a Podiatrist. Podiatrists specialize in foot and ankle care and have expertise in treating these warts, which are often pushed inward by walking pressure. Their specialized knowledge of foot mechanics leads to more targeted and successful treatment.
Standard Clinical Removal Methods
Cryotherapy, or freezing the wart, is a frequently performed in-office procedure using liquid nitrogen to destroy infected cells. The liquid nitrogen causes the tissue to blister, crust over, and fall off, typically within one to two weeks. Multiple treatment sessions, often spaced two to four weeks apart, are usually necessary for complete clearance.
Electrosurgery and curettage offer immediate physical removal of wart tissue, commonly performed under local anesthesia. Electrosurgery uses heat from an electrical current to burn the wart tissue and cauterize blood vessels. Following this, curettage involves scraping away the destroyed tissue with a sharp, spoon-shaped instrument called a curet.
Topical Cantharidin is a professional treatment where a blistering agent is applied directly to the wart and covered with a bandage. The compound causes a blister to form beneath the wart, lifting it away from the underlying skin. The treated area and blister roof are then typically removed by the clinician during a follow-up visit.
For persistent or widespread growths, doctors may use prescription topical treatments or intralesional injections. Stronger concentrations of salicylic acid or immune system modulators like imiquimod cream can be prescribed for home application. Injections of medications, such as the chemotherapy drug bleomycin or various antigens, may be administered directly into the wart tissue to stimulate an immune response.
Determining the Best Treatment Approach
The selection of the optimal removal method is individualized and relies on core factors assessed by the medical provider. The physical characteristics of the wart are important; for example, small common warts may respond to cryotherapy, while large plantar warts may require surgical scraping and strong topical agents. Warts in sensitive areas, such as the face, necessitate treatments that minimize scarring, often favoring less aggressive methods.
Patient-specific factors, including age and immune system status, also influence the decision-making process. Less painful options, like topical acids or Cantharidin, are preferred for young children to limit discomfort and anxiety. Since warts are more resistant to treatment in individuals with compromised immune systems, doctors may select more aggressive or immune-stimulating therapies.
The provider must also consider the likelihood of recurrence and the logistics of follow-up care for the patient. Procedures requiring multiple visits demand patient commitment to the schedule for full resolution. Specialized treatments, like laser therapy or injections, may be reserved for cases where standard, less expensive approaches have repeatedly failed, especially since cost and insurance coverage can vary widely.