In a previous episode I discussed what viral warts are and why they’re so difficult to treat and how frustrating treating them is. As a matter of fact, I said, treatment of warts has done more to ruin the reputation of dermatologists than anything else we treat. But let me tell you what treatments do work the best. Starting with topical treatments, we like to use chemicals that actually cause a small irritation in the skin. The reason we want to cause an irritation is because when the skin gets irritated then it becomes inflamed. An inflamed skin will wake up the sleeping immunity, which up until that point hasn’t recognized that viral infection and help wipe out the infection. And the two chemicals that I like to use the most are chemicals you’ve heard me talk about many times: glycolic acid and salicylic acid. Which at concentrations we discussed before usually are not irritating. Normally, we use salicylic acid at about 2% but for warts we use 16% or 17%. Normally, glycolic acid is used at 8%, 10% or even 12%. Here for wart treatments, we use it at 20% or stronger. Those are fairly effective ways to treat warts medically. If that doesn’t work we always have the default of falling back to surgical treatment, where under local anesthesia the warts are cut out, but I did explain in the other episode why in a quarter of the times we tend to get reoccurrences because those little tentacles that go out from the warts that we don’t see when we’re doing the surgery. There’s one more special situation and that’s plantar warts on the bottom of the foot. Anytime you go deep enough to completely cure a wart there’s a chance, surgically, there’s a chance that you may actually cause a scar. If you do get a scar on the bottom of the foot which is a weight bearing surface, then it hurts when you put pressure on that scar and that’s what happens every time you walk. So we try not to remove warts on the bottom of the foot surgically. Instead, the treatment that I like the best involves using lasers and specific lasers that attack the blood vessels that treat this little growth because if you can knock out those blood vessels you’ll cause the little growth to die. And when that happens the wart goes away and doesn’t leave a scar. So if you have any of these annoying infectious growths try topical treatments and if the topical at home treatments don’t work, see your dermatologist for a little help getting rid of your warts.
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