Warts are caused by Human Papillomavirus infection. In order to remove the warts, we need to stimulate the body’s immune system to produce antibodies to kill the virus.
Warts are caused by Human Papillomavirus infection. Whilst the patient is concerned about the warts, Dermatologist sees not just the warts but also the presence of the virus on the warts and the surrounding skin. In order to remove the warts, we need to stimulate the body’s immune system to produce antibodies to kill the virus. The immune system can be stimulated via cryotherapy, electrosurgery or chemical treatment e.g. topical creams.
Cryotherapy is the most common physical treatment to treat warts. We used a cryo gun to spray liquid nitrogen focally on the warts for 6 to 10 seconds. The treated area is frozen to as low as -120 degree Celsius and it is slightly painful but bearable.
The treated area may blister up sometimes and blood blister may also develop. The treated area will dry or scab up and heal in 7 to 10 days time. Repeat treatments at two to four-weekly intervals are often necessary. The total number of sessions required can range from 1 to 10 and it really varies from patient to patient.
Cryotherapy is the preferred treatment for nearly all dermatologists because it is easy to administer and relatively hassle free for the patient. Cryotherapy is always carried out as an outpatient procedure as the whole treatment takes less than 5 minutes. The success rate is decent though not 100%.
These are the alternative treatments that Dermatologists use on warts that have not responded well to cryotherapy. After burning the wart, the base of the wart is exposed. Dr Wong can now treat any visible recurrence of the wart with medication to enhance the success rate of the treatment.
Electrosurgery can be done as an outpatient procedure or in the hospital day surgery operating theatre. In this treatment, local anaesthesia injection is required. After the wart is electrodessicated, the patient will end up with a wound. Wound review will be scheduled to check for wart recurrence and for change of dressing.
In comparison to cryotherapy, electrosurgery of warts is more tedious, takes slightly longer time for the wound to heal. This is especially so for the plantar warts, the deeper wound created from electrosurgery may take up to 4 weeks to heal at times. Even though the success rate is generally higher than cryotherapy, the injection, the wound management, the need for dressing and the longer healing time make this treatment the second choice option in the treatment for warts.
Topical salicylate acid is often used. There is minimal discomfort but it can take many weeks or months for treatment to succeed. Treatment should be stopped temporarily if the wart becomes sore.
Dr Wong also uses topical immunomodulator cream to stimulate the body’s own immune system to eliminate the Human Papillomavirus. Other applications like tretinoin and glycolic acid are often used for treating multiple flat warts.
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Mount Elizabeth Novena Specialist Centre
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