Medical & Surgical Treatments for Warts

The human papillomavirus (HPV) can cause genital warts and other types of warts. There are treatments available to remove or manage the warts associated with the infection.

Topical Treatments

Keratolytic Agents

Keratolytic agents are substances that help remove dead cells from the outer layer of the skin and are used in some cases to treat warts caused by the human papillomavirus (HPV).

The keratolytic action refers to the ability of a substance to dissolve or shed keratinized cells, which are cells rich in keratin, a fibrous protein found in the outer layer of the skin. Keratin is a key structural protein in the epidermis, nails, and hair.

When a keratolytic substance is applied to the skin, it works by breaking down or softening the keratin cells, thereby facilitating the removal of dead or abnormal cells. This action is beneficial in treating various skin conditions such as warts, calluses, corns, and other lesions where there is excessive thickening of the stratum corneum of the skin.

In the context of wart treatment, keratolytic agents like salicylic acid, lactic acid, and glycolic acid are used to soften and help shed the affected layers of skin that make up the warts. This can make it easier to remove the warts over time.

Salicylic Acid

Prescription-strength wart medications containing salicylic acid work by gradually removing layers of a wart.

Studies show that salicylic acid is most effective when combined with freezing

Trichloroacetic Acid (TCA)

This acid is applied directly to the wart and destroys the affected tissue. With this method, the doctor first shaves the surface of the wart and then applies the acid with a wooden applicator. Treatments need to be repeated approximately every week. Side effects include stinging and burning.

Glycolic and Lactic Acid

Both are alpha-hydroxy acids (AHA). They work by exfoliating the skin’s surface layer, promoting cell renewal, and softening skin texture.

They help to soften and exfoliate the affected skin.

Blistering Agent

A blistering agent generally refers to substances that can cause blisters or vesicles on the skin. Cantharidin, a chemical that generates a blister under the wart, is applied. You may need to return to the clinic in about a week to have the dead wart tissue removed with tweezers.

Cantharidin is a chemical obtained from the blister beetle Lytta vesicatoria, commonly known as the “Spanish fly.” Cantharidin has vesicant properties, meaning it can cause blister formation on the skin. Historically, it has been used in topical applications for the treatment of warts, especially common warts.

In the context of wart treatment, cantharidin is applied as a topical solution directly on the wart. The idea is that the substance causes a blister under the wart, and when the blister detaches, it removes the wart layers with it. However, cantharidin does not directly destroy the human papillomavirus (HPV), which is the underlying cause of warts.

It is important to note that the use of cantharidin for wart treatment is not as common today as it was in the past. There are other treatments that are safer and more effective, such as salicylic acid, cryotherapy, trichloroacetic acid (TCA), and other topical agents, which are usually preferred due to their proven safety and efficacy profiles.

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