Treating Warts Effectively: A Case Study


By Dr. Ashley Baldree, Village Dermatology

Warts, or verruca vulgaris, are a common skin issue caused by human papillomavirus (HPV) infections. These small, rough bumps can be stubborn and spread through direct contact. Today, I’ll share the case of a 37-year-old patient who came in with a wart on his left index finger and discuss effective treatment options and preventive care.

Case Overview

Our patient, a 37-year-old male, presented with a rough, mildly irritating wart on the left proximal radial dorsal side of his index finger. The wart had been present for several months without any active treatment, and he expressed interest in finally addressing it. After evaluating the lesion, I recommended cryotherapy as an initial treatment and counseled him on additional options for warts if further intervention is needed.

For more on what warts are and how we treat them, visit our Warts Treatment page.

Skin Care and Treatment Options for Warts

Warts can be persistent, but various treatments can help remove them and prevent their spread. I explained several options to the patient, including:

  • Retinoids: These vitamin A derivatives help disrupt skin cell growth, potentially breaking down warts.

  • Aldara (Imiquimod): An immune response modifier that can stimulate the body to fight the viral infection within the wart.

  • 5-Fluorouracil (5-FU): This topical treatment disrupts cell growth and is sometimes used for stubborn warts.

  • Salicylic Acid: Often found in over-the-counter products, this exfoliating acid helps soften and peel away wart tissue.

  • Cryotherapy: Freezing the wart with liquid nitrogen, which was selected as the treatment for this visit.

  • Bleomycin: An injected medication sometimes used for warts that resist other treatments.

  • Candida Antigen Injections: This involves injecting an antigen to stimulate the immune system’s response to the wart.

Expectations and Aftercare

I explained that warts often appear as cauliflower-like growths and can easily spread to other parts of the body or even to other people. Since HPV, the virus that causes warts, spreads through direct contact, it’s important to keep the area clean and avoid picking at or touching the wart.

After the cryotherapy treatment, I advised him to monitor the area and expect some possible side effects, such as:

  • Crusting or Scabbing: This is a normal response to freezing and should resolve on its own.

  • Blistering: Blisters may form as the frozen tissue heals.

  • Pigmentary Changes: Temporary or permanent lightening or darkening of the skin is possible.

  • Scarring: Although rare, scarring can sometimes occur after cryotherapy.

The patient was instructed to contact our office if he notices any new warts, spread of the wart, or unusual healing reactions, such as excessive redness, pain, or infection.

Procedure and Next Steps

The cryotherapy procedure was quick and well-tolerated. After discussing the possible risks, the patient provided consent, understanding the benefits and potential side effects. If the wart persists or recurs, we may explore additional treatment options, or, if needed, perform a biopsy to rule out any other conditions.

If you or someone you know is struggling with warts, visit our Village Dermatology Warts page for more information on available treatments and how we can help. Regular dermatology check-ups are essential for monitoring skin health and addressing any concerns promptly.

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Managing Lichen Planus: A Holistic Approach to Skin Care

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Follow-Up on Tinea Versicolor: A Case Study by Dr. Caroline Vaughn