Treatment Overview
For many people, discovering a wart can be a source of embarrassment and frustration. These rough, bumpy growths on the skin are caused by the human papillomavirus (HPV) and can appear anywhere, though they are most common on hands and feet. While they are generally harmless, they can be unsightly, and in the case of plantar warts on the soles of the feet, quite painful. It is common to feel self-conscious or worry about spreading the virus to family members or other parts of the body.
Treatment is often necessary to speed up the healing process, which can otherwise take months or even years. The primary reasons to treat warts are to alleviate pain, improve appearance, and lower the risk of transmission. Because warts can be stubborn and the virus hides within the skin cells, treatment effectiveness varies significantly from person to person. A medication that works quickly for one individual may require repeated applications for another (American Academy of Dermatology, 2024).
Overview of treatment options for Warts
The goal of wart treatment is twofold: to physically destroy the wart tissue and to stimulate the body’s immune system to recognize and fight the virus. Medical approaches generally start with the least invasive options before moving to more aggressive therapies.
Topical medications are the standard first-line defense for common and plantar warts. These treatments are often applied at home or in a doctor’s office. While procedures like cryotherapy (freezing) or laser surgery are available for resistant cases, chemical and biological agents remain the foundation of therapy for most patients. The choice of treatment often depends on the location of the wart and how thick the skin is in that area.
Medications used for Warts
The most widely used medication for warts is salicylic acid. This is a peeling agent available in various strengths, ranging from over-the-counter liquids and patches to stronger prescription formulations. Clinical experience suggests that daily application of salicylic acid is as effective as cryotherapy for many common warts, provided the patient is consistent.
For warts that do not respond to salicylic acid, doctors may use cantharidin. Often referred to as “beetle juice” because it is derived from the blister beetle, this liquid is applied by a healthcare provider in the office. It is typically painted onto the wart and covered with a bandage.
In cases where warts are resistant to standard destruction, immunomodulators may be prescribed. Imiquimod is a topical cream originally designed for genital warts but is sometimes used off-label for stubborn common warts. Another option for difficult cases is topical fluorouracil, a medication that stops cell growth, which is sometimes prescribed in combination with salicylic acid.
Bleomycin, an antibiotic that inhibits viral DNA, can be injected directly into the wart for severe, recalcitrant cases, though this is considered a more aggressive medical intervention (Mayo Clinic, 2022).
How these medications work
Salicylic acid is a keratolytic agent that dissolves the keratin protein in the wart and thick dead skin layer. This chemically exfoliates the wart layer by layer, slowly removing the viral cells. The mild irritation also alerts the immune system to the virus.
Cantharidin works by creating a blister underneath the wart, lifting it off the skin. As the blister heals, the dead wart tissue falls off with the scab.
Immunomodulators like imiquimod work differently; instead of attacking the skin, they stimulate the local immune system to produce interferon and other chemicals that fight the HPV virus directly (Food and Drug Administration, 2023).
Side effects and safety considerations
Topical wart treatments like salicylic acid and cantharidin damage skin, causing expected irritation. Salicylic acid may cause redness, stinging, and peeling of healthy skin; petroleum jelly is often recommended to protect the surrounding area. Cantharidin causes uncomfortable but necessary blistering.
Individuals with diabetes or poor circulation should generally avoid strong over-the-counter acids on their feet due to risks of poor healing and infection. Patients should seek medical attention for signs of bacterial infection, such as red streaks, pus, or severe swelling.
Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- American Academy of Dermatology. https://www.aad.org
- Food and Drug Administration. https://www.fda.gov
- Mayo Clinic. https://www.mayoclinic.org
- MedlinePlus. https://medlineplus.gov
Medications for Warts
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Warts.