Most people will have warts at some stage in their life. They develop as small lumps, sometimes in clusters. Most commonly they are found on the hands and feet, although they can appear elsewhere on the face and body. Warts come in different shapes and appearances; they are not cancerous but they can sometimes resemble certain cancers. This is one important reason why you should have a wart checked out if it does not clear up after a few weeks.
Warts affect children and teenagers more than adults. Verrucas on the soles of children’s feet are probably the best known type of wart, and often our first experience of one.
Warts are not usually painful, but they can itch or bleed, and some types, such as verrucas,can hurt.
Warts are caused by an infection with the human papilloma virus (HPV). Here are the characteristics of the three most common types:
Although warts aren't considered very contagious,they can be caught by skin-to-skin contact and transmitted via contaminated objects or surfaces, such as the edge of a swimming pool. If your skin is wet or damaged it is more at risk of infection. It can take weeks or even months for a wart or verruca to appear.
Most warts are harmless and clear up without treatment but it can, on average, take up to two years for the virus to leave your system and the warts to disappear. It takes longer in older children and adults. Any unidentified lump on your skin should be looked at by a GP or a Skin Care Network Dermatologist. This is particularly so if the wart:
Warts are less likely to clear up on their own in people with a weakened immune system.
There are many treatments for warts, some traditional and some cutting edge. Our aim in treatment is to destroy and remove the wart for good and without scarring. There is no antiviral treatment specific for HPV but it is likely that the stimulation of the immune system in the region of the wart maximizes the chance of immunological response to the infected keratinocytes (the predominant cell type in the epidermis). Thus some of the available therapies interfere with the viral life cycle.
Salicylic acid (SA) formulations are the most common preparation used in the treatment of viral warts. They can be bought over the counter and applied at home as cream, gel, paint or plasters. It works by wearing away and might also stimulate host immunity. At high concentrations it is an irritant and can also destroy healthy skin, so it needs to be used carefully. Cover surrounding, healthy skin with a tissue or lint when applying. Weaker cream preparations are used for facial warts, but you should seek medical treatment for this important area. This is also recommended if you have poor circulation as there is an increased risk of damage to your skin, nerves and tendons.
The wart is filed once a week and SA should be applied daily for three months or more. You should stop the treatment if your skin becomes sore, and seek advice from your GP or pharmacist.
Liquid nitrogen is applied to your wart for a few seconds to freeze and destroy the affected skin cells. A sore blister can form which will scab and fall off seven to 10 days later. Each session of cryotherapy takes 5 to thirty seconds and can be painful. The number of sessions needed depends on the size of the warts, with a few weeks between each treatment.
Cryotherapy is done either by spraying liquid nitrogen onto the wart, or by applying with a cotton wool bud or tweezers. The second method is more suitable for treatment around the eyes.
Possible side effects of cryotherapy include pain and blistering, bleeding into the blister and a change in skin pigmentation (decreased or increased pigmentation)
Other chemical treatments are available on prescription and include formaldehyde, trichloroaceteic acid, glutaraldehyde and silver nitrate, although there is little evidence of their benefits. Potential side effects include skin staining and burns to the surrounding skin.
We also offer laser technology which clinical trials have shown to be effective in the treatment of warts. It may be used when conventional treatments haven’t worked or when there are many large warts.
Laser surgery uses an intense beam of light (the laser) to burn and destroy the wart tissue. We may use a local anaesthesia, depending on the number of warts to be removed or the size of the area to be treated.
After laser surgery the wound may be painful for a few days. Recovery time depends on the location and number of warts removed but in most instances you will have no side effects. You should contact us if you have prolonged bleeding, a fever, pain or a discharge, which may mean an infection.
Pulsed Dye Laser
The Pulsed Dye Laser (PDL) uses a liquid dye as the lasing media and delivers short bursts of light that last only a fraction of a second. PDL (585 nm) is the laser used most frequently. It works by destroying the blood vessels in the wart, and may also direct thermal injury to the heat-sensitive HPV virus. This treatment is carried out by our dermatology Consultants and Nurses.
The main side-effects of PDL include local pain (not generally severe), bruising and, rarely, blistering. A change in pigmentation and scarring may occur.
Photodynamic Therapy (PDT) has been shown to be effective in a number of clinical trials. This is a high energy light-based technology, often used to treat basal cell carcinoma and actinic keratosis. It is safe and produces excellent clinical and aesthetic results, with usually minimal or no scarring or side effects.
PDT is carried out by our dermatology Consultants and Nurses. A photosensitising cream is applied to the wart four hours prior to treatment. PDT can be effectively used in combination with laser treatment.
CO2 Ablative Laser
The Encore uses a CO2 laser to vaporise the wart. It has been called the ‘bloodless scalpel’ which excises and treats recalcitrant warts. By using the latest ablative resurfacing CO2 techniques the skin heals quickly, resulting in good clinical outcomes. More than one treatment is often required but the success rates for both first and recurrent treatments is high compared to other methods.
To ensure the best possible healing we will give you a care sheet which details the pre-procedure care and after care recommended. Treatment takes one hour.