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Wart Removal

Wart removal is a process of removing the wart tissue from the surface of the skin. Warts are usually  viral infections and rarely from a genetic history. They have varied presentation on the skin. Once they appear, it is best to remove them by any of the methods described below depending on the location and other factors. They are usually contagious and can spread to other parts of the body and to other people who are in regular close proximity.

Ways to remove warts

Explaining each method in brief

  1. Topical Method
    1. Chemical cauterisation – Chemical cautery is a technique of applying caustic chemicals such as trichloroacetic acid (TCA), or salicylic acid  to remove the wart. The chemicals are used at various strengths depending on the type and site of the lesions and it can be done in multiple sittings. How is the procedure performed? The area surrounding the wart is protected by applying white soft paraffin.  Application of the 50 – 70% Trichloroacetic Acid (TCA) is done with a swab stick taking care not to spill in the surrounding area. On application white frosting is seen. Patient is informed that a crust will be formed which will fall off and to apply antibiotic cream twice a day for 4 – 5 days.
      Indication

      • Superficial warts
      • Medium size warts
      • Used in individuals apprehensive for burning the wart tissue or in children who are not very complaint for doing other treatments.

      Agents used

      • Salicylic Acid
      • 100% TCA i.e Trichloroacetic acid

      Are there any side effects? Sometimes there can be hyper or hypo pigmentation but its not permanent.

      How many session required? Sometimes if the wart doesn’t fall in one session a second treatment many be required.

    2. Immunotheraphy – This method uses the patient’s own immune system to fight against the wart. Indication
      • Resistant warts
      • Warts not responding to other treatment
      • Recurrent warts

      Agents used are? A chemical called as diphencyprone (DCP) is applied to the warts and a mild allergic reaction occurs around the treated warts. This reaction may cause the wart to go away.

  2. Cytostatic Method – Bleomycin is an anti cancer medicine which is used to inject in individual lesions. This method is painful but chances of recurrences are few. Bleomycin is diluted in normal saline and then injected every 2 – 3 weeks till resolution occurs.
  3. CryoTherapy – Removal of the wart tissue with liquid nitrogen which causes the freezing of the wart tissue. The blood vessels is freezed which forms a hematoma under the wart and hence a scab gets formed which makes the wart fall off. When the patient comes to the clinic the area is cleaned and then the wart tissue is freezed with the gas. The procedure is not painful, slight throbbing sensation might be present. After the procedure patient is instructed that a vesicle (boil) might be formed and it might require to be drained by the dermatologist. After which a scab will form and the wart tissue will fall off. The entire process takes a week to heal. It is common to need repeat treatment after 3 – 4 weeks. Disadvantage
    • By damaging the surrounding tissue by spraying liquid nitrogen on it, the virus can spread on the surroundings of the skin.
    • Require number of treatments
    • It can leave behind dark spots if not done properly
  4. Radio Frequency – Removing wart with radio waves is the most efficient and newer method to remove wart from the skin or mucous tissue. A local anesthesia is applied 45 minutes before the procedure on the lesion. After anesthesia, radio waves are used to go over the surface of the wart, which makes it evaporate. Curettage is needed only on the hands and feet after the radio waves in order to be sure that the root of the wart is removed. Patient goes home with a dressing and it will heal in 6 – 7 days. Indications
    • Common warts
    • Filiform warts
    • Foot warts
    • Warts on the face and neck area

    Advantage

    • Chances of scar is very less
    • No post inflammatory pigmentation
    • No repeat treatment required
  5. Laser Removal – Laser removal is a method which uses a laser beam, and the principle of heating and evaporating the wart is the same as in radio wave removal. Healing is somewhat longer than in other methods considering the fact that the skin is damaged more during the intervention.
Dr. Batul Patel is a passionate and dedicated dermatologist based out of South Mumbai with expertise in all fields of dermatology, trichology and aesthetic dermatology.

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