Scalp Warts: Treatment Options and What to Expect

A small wart on the scalp?

I have a small black, bald spot on my head, approximately 0.2 x 0.2 cm in size.
It looks similar to a mole, and I have long thought it was a mole.
However, when I wash my hair and scratch it, it often bleeds.
I went to see a dermatologist, who initially said it looked like a mole, but later diagnosed it as a wart.
I underwent cryotherapy for about 2 to 3 months, and there were two instances where it completely fell off, but it grew back after about a week.
Should I expect it to keep growing back? So, is it indeed a wart? Can I continue cryotherapy until it no longer grows back, or if it doesn't affect my daily life, can I just leave it alone? Will it heal on its own? Thank you.

Mr. Wu, 30~39 year old female. Ask Date: 2018/08/10

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to determine the issue.
If it is very concerning, please seek medical attention as soon as possible.
Only after an examination can the problem be identified and addressed.

Reply Date: 2018/08/10

More Info

Scalp warts, also known as verrucae, are benign growths caused by the human papillomavirus (HPV). They can appear anywhere on the body, including the scalp, and may resemble moles or other skin lesions. Your description of a small, dark, raised area that has been treated with cryotherapy (freezing) suggests that it is indeed a wart rather than a mole.
Cryotherapy is a common treatment for warts, where liquid nitrogen is applied to freeze the wart, causing it to eventually fall off. It is not uncommon for warts to require multiple treatments, as the virus can be persistent. The fact that your wart has fallen off twice but has returned indicates that the underlying HPV infection may still be present.
In terms of treatment options, continuing with cryotherapy is a valid approach. It can take several sessions to completely eradicate the wart, especially if it keeps recurring. Other treatment options include topical treatments such as salicylic acid, which helps to peel away the wart, or other methods like laser therapy or electrosurgery. However, these options should be discussed with your dermatologist to determine the best course of action based on your specific case.

If the wart is not causing you significant discomfort or affecting your quality of life, you might choose to monitor it rather than pursue aggressive treatment. Some warts can resolve on their own as the immune system eventually fights off the virus. However, this can take time, and there is no guarantee that it will happen.

It's essential to keep in mind that while warts are generally harmless, they can sometimes be mistaken for other skin conditions, such as melanoma or other types of skin cancer. If you notice any changes in the wart's appearance, such as increased size, color changes, or bleeding, it is crucial to return to your dermatologist for further evaluation.

In summary, the best course of action for your scalp wart would be to continue with the cryotherapy as advised by your dermatologist, while also monitoring the lesion for any changes. If it continues to recur or if you have concerns about its appearance or discomfort, discussing alternative treatments with your dermatologist would be beneficial. Remember, patience is key when dealing with warts, as they can be stubborn and may require time and multiple treatments to resolve completely.

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