Most warts clear up without treatment. However, the time it takes for a wart to disappear will vary from person to person. Warts may last longer in older children and adults.
Research has shown that without treatment, 65-80% of cases of warts will clear up within two years. However, warts in adults and in people with a weakened immune system are less likely to clear up on their own and are less likely to respond well to treatment.
Leaving the wart to get better by itself is an option that may be recommended. However, treatment will be considered if:
- the wart is causing you pain
- the wart is interfering with your everyday life
- the wart or its position is causing you embarrassment
- you have one or more of the potential risk factors for developing cancer (see Warts and verrucas - diagnosis)
Treating warts
Several treatment options are available for treating warts and verrucas. Some treatments for warts can cause side effects such as:
- pain
- blistering
- skin irritation around the wart
The aim of all types of treatment is to:
- remove the wart without it returning
- treat the wart without any scarring developing as a result
- encourage long-lasting immunity to HPV, which causes warts
No single treatment for warts is 100% effective, and there is no guarantee that the warts will not return. Treatment for warts includes:
- salicylic acid
- cryotherapy
- duct tape
- surgery
- chemical treatments
These are described in more detail below.
Salicylic acid
Many treatments, such as creams, gels, paints and medicated plasters, are available over the counter from pharmacies. The active ingredient in most of these treatments is salicylic acid. In two-thirds of cases, research has shown that hand warts clear up within 12 weeks of treatment with salicylic acid.
There is limited evidence available to show which type of salicylic acid treatment (ointment, cream or gel) is most effective. However, it has been shown that salicylic acid is effective at treating warts.
Salicylic acid and other wart treatments also destroy healthy skin, so it is important to protect your skin before applying the treatment. You can use petroleum jelly or a corn plaster to cover the skin around the wart.
Before applying the treatment to your wart, use an emery board to rub any excess outer skin on the affected area (avoid sharing these with others). Then soak the wart in water for around five minutes to soften the skin.
After soaking your wart, follow the treatment instructions that came with the medication. You may need to apply the treatment daily for 12 weeks or longer. However, stop the treatment if your skin becomes sore and seek advice from your GP or pharmacist.
If you have warts on your face, avoid using treatments that contain salicylic acid and seek your GP’s advice about the best type of treatment.
If you have poor circulation, for example, if you have a condition such as diabetes or peripheral vascular disease, consult your GP before using over-the-counter treatments that contain salicylic acid. This is because there is an increased risk of damage to your skin, nerves and tendons.
Cryotherapy
In cryotherapy, liquid nitrogen is sprayed onto the wart to freeze and destroy the cells. A sore blister develops, followed by a scab, which falls off seven to ten days later.
Cryotherapy treatment usually takes 5-15 minutes and can be painful. Treatment is usually carried out at hospital skin clinics or at your GP surgery. Large warts sometimes need to be frozen a number of times, a week or so apart, before they clear up.
The exact method of cryotherapy that is used may differ between healthcare professionals. Liquid nitrogen may be sprayed directly onto the wart or it may be applied using a stick with cotton wool on the tip. This method may be preferred for treatment around the eyes or for small children.
Cryotherapy may be recommended if you have a wart on your face. This is because the risk of irritation for this method is lower than using salicylic acid or duct tape.
Cryotherapy is not usually recommended to treat young children because they may find the treatment too painful or it may be difficult for them to stay in the same position while they are having the treatment.
Possible side effects of cryotherapy include:
- pain
- blistering
- your skin may become darker (hyperpigmentation) or lighter (hypopigmentation), particularly if you have black skin
- your nails may develop an abnormal change in shape or structure if cryotherapy is used to treat periungual warts
A very cold spray (dimethyl-ether/propane) is also available from pharmacies, which you can apply yourself. You should avoid using this spray on your face. There is a lack of evidence to support the effectiveness of dimethyl-ether/propane spray compared with cryotherapy with liquid nitrogen.
Duct tape
Treatment with duct tape involves placing a piece of duct tape over your wart for about six days. If the tape falls off you simply replace it with a fresh piece. After six days the tape is removed and the wart is soaked in water.
After soaking the area in water, use an emery board to rub away any rough areas. The wart should be left uncovered overnight and a new piece of duct tape applied the following morning. This procedure is then repeated for a period of up to two months.
There is limited evidence to support the effectiveness of treatment with duct tape. Limited research has shown that side effects are uncommon. However, in some cases, skin irritation may occur and the tape could easily fall off.
If you are considering using duct tape, you may want to discuss it with your GP so that you are fully aware of the treatment’s potential benefits and weaknesses.
Surgery
In most cases, surgery is not recommended for treating warts because they often come back afterwards. It is estimated that the wart returns and further treatment is needed in around a third of cases where surgery is used to remove warts.
The aim of surgical treatment is to remove all traces of the warts. The techniques that are sometimes used to remove warts surgically are:
- curettage, where tissue is removed by scraping
- cautery, where tissue is destroyed by burning using an instrument or an electric current
Surgery to remove warts will usually be carried out under local anaesthetic. The anaesthetic will numb the affected area so that you will not feel any pain during the procedure.
Warts can be cut out of the skin (which can be useful if you have a few, large warts) or the skin of the wart can be scraped off using a spoon-like instrument called a curette. However, this type of surgery is usually avoided for warts and verrucas on the soles of the feet because of the risk of scarring.
Chemical treatments
Warts can also be treated using chemical treatments that contain chemicals such as:
- formaldehyde
- glutaraldehyde
- podophyllin
These chemicals are poisonous to skin cells and are dabbed on to the warts to kill the skin cells. Chemical treatments are available on prescription.
Potential side effects of chemical treatments include:
- staining the skin brown (with glutaraldehyde)
- intense swelling (with podophyllin)
- infection following treatment (with podophyllin)
