Effective Treatments for Persistent Viral Warts: Beyond Cryotherapy

Treatment methods for viral warts?

Hello Doctor, in mid-April this year, I had a growth on my hand that resembled a callus for a long time.
I visited a clinic, and the doctor diagnosed it as a viral wart.
After two sessions of cryotherapy, it fell off, and there were no small black dots.
The doctor also diagnosed it as healed (though there was still some white in the center).
However, I started to develop viral warts again on my hand.
I purchased over-the-counter wart removal liquid and used it until there were no black dots, but the viral warts keep recurring in the original spot where the first wart appeared.
I have used the wart removal liquid again, and there are still no black dots, but after two or three weeks, I noticed some faint black dots inside (only visible when pressing the skin).
The skin appears intact with no protrusions, but it feels like there is a "time bomb" buried there, and I am unsure when it will recur.
Aside from cryotherapy, are there any other methods that can provide a permanent solution?

Rongrong, 20~29 year old female. Ask Date: 2022/08/25

Dr. Wu Yuxin reply Dermatology

Some immunostimulatory medications can be used to enhance the effects, but a prescription from a physician is required.

Reply Date: 2022/08/25

More Info

Persistent viral warts, commonly caused by the human papillomavirus (HPV), can be quite frustrating to manage, especially when they recur after initial treatments like cryotherapy. While cryotherapy is a popular and effective method for treating warts, there are several other treatment options available that may help in achieving a more permanent resolution.

1. Topical Treatments:
- Salicylic Acid: This is one of the most commonly used topical treatments for warts. It works by gradually peeling away the wart tissue. It is available over-the-counter in various forms, including gels, pads, and solutions. Regular application is necessary, and it may take several weeks to see results.

- Imiquimod: This is an immune response modifier that helps the body’s immune system fight the virus. It is typically used for genital warts but can also be effective for common warts. It is applied directly to the wart and can take several weeks to show results.

2. Laser Therapy:
- Laser treatment can be effective for stubborn warts that do not respond to other treatments. The laser destroys the wart tissue and can also help stimulate the immune response against the virus. This method is usually performed in a dermatologist's office.

3. Electrosurgery:
- This technique uses high-frequency electrical currents to burn off the wart. It is often used for larger or more resistant warts and may be combined with curettage (scraping the wart off) for better results.

4. Cantharidin:
- Cantharidin is a blistering agent that is applied to the wart by a healthcare provider. It causes a blister to form under the wart, lifting it off the skin. This treatment is often effective and can be less painful than other methods.

5. Duct Tape Occlusion:
- Some studies suggest that covering the wart with duct tape may help in its removal. The tape is left on for several days, then removed, and the wart is soaked and filed down. This method may stimulate the immune response and is a low-cost option.

6. Intralesional Injections:
- Injecting a substance like bleomycin directly into the wart can be effective, especially for larger or resistant warts. This treatment is usually performed by a dermatologist.

7. Surgical Removal:
- For warts that are particularly large or resistant to other treatments, surgical excision may be necessary. This involves cutting out the wart and is typically done under local anesthesia.

8. Immune Therapy:
- In some cases, treatments that boost the immune system, such as interferon injections, may be considered, especially for extensive or recurrent warts.

It's important to note that while these treatments can be effective, warts may still recur due to the persistence of the virus in the skin. Therefore, a combination of treatments may be necessary for the best results. Additionally, maintaining good skin hygiene and avoiding skin trauma can help reduce the risk of recurrence.

If you are experiencing persistent warts despite treatment, it is advisable to consult a dermatologist for a thorough evaluation and to discuss the most appropriate treatment options tailored to your specific situation. They can provide guidance on the best course of action and monitor your progress to ensure effective management of the condition.

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