Persistent Warts: Struggling with Treatment and Seeking Solutions

Viral warts that have not healed for a long time?

Hello, I discovered that the first joint of my middle finger has been developing calluses for the past seven years.
I kept trimming it with nail clippers, but the calluses kept recurring.
Later, I saw a doctor who diagnosed it as a viral wart and performed electrosurgery.
However, after the wound healed, the callus did not disappear.
At that time, I didn't have the time for ongoing treatment.
I went to another clinic for electrosurgery once, but the callus still did not go away.
Since last year, I have been actively seeking dermatological treatment and have undergone cryotherapy over 20 times, but the thick skin continues to grow.
I am really frustrated; the thick skin does not resemble the black dot images of warts found online.
It looks more like a callus without any black dots.
I am even unsure if this is a wart.
One doctor I consulted said, "You've had cryotherapy several times, and I don't know what it originally was.
Since you've already had cryotherapy, I can only continue with that." This left me feeling helpless.
The current doctor says it looks like a wart and has been using a spray gun for cryotherapy.
This cycle continues; I have been undergoing cryotherapy since October of last year, and the thick skin has not stopped growing.
Please help me with advice on what to do.
Thank you.

EJ, 20~29 year old female. Ask Date: 2023/04/13

Dr. Wu Yuxin reply Dermatology

Without seeing the lesion, it is difficult to make a judgment or provide recommendations.
If it is a viral wart, cryotherapy remains the first choice of treatment.

Reply Date: 2023/04/13

More Info

Persistent warts, especially those that have been resistant to various treatments, can be incredibly frustrating and disheartening. It sounds like you have been through a lot over the past several years, and I want to acknowledge the emotional toll this situation can take. Warts, or verrucae, are caused by the human papillomavirus (HPV) and can be persistent due to several factors, including the strain of the virus, the immune response of the individual, and the location of the wart.

From your description, it seems that you have undergone multiple treatments, including electrosurgery and cryotherapy, but the hard skin continues to return. This could indicate that the wart is not being fully eradicated, or it may be that the treatment methods used have not been effective for your specific case. The appearance of the wart, as you described it resembling a callus without the characteristic black dots, can sometimes make diagnosis and treatment more challenging.

Here are some potential steps and considerations moving forward:
1. Re-evaluation by a Dermatologist: It may be beneficial to seek a second opinion from a dermatologist who specializes in treating warts and HPV-related conditions. They may have different insights or treatment options that have not yet been explored.

2. Alternative Treatments: There are several treatment options for warts beyond cryotherapy and electrosurgery. These include:
- Topical Treatments: Prescription-strength topical treatments containing salicylic acid or other keratolytic agents can help in gradually removing the wart tissue.

- Immunotherapy: This involves stimulating the immune system to fight the virus. Treatments may include topical immunomodulators like imiquimod or intralesional injections of antigens.

- Laser Therapy: Some dermatologists use laser treatments to target warts, which can be effective for stubborn cases.

3. Consideration of Other Conditions: Since you mentioned that the growth resembles a callus and lacks the typical appearance of a wart, it might be worthwhile to explore whether it could be another dermatological condition. Conditions like plantar keratosis or other benign skin lesions can sometimes be mistaken for warts.

4. Patient Education and Support: Understanding the nature of warts and the treatment process can help alleviate some anxiety. Joining support groups or forums where others share their experiences with persistent warts may provide emotional support and practical advice.

5. Lifestyle and Immune Support: Maintaining a healthy immune system can be beneficial in fighting off viral infections. This includes a balanced diet, regular exercise, adequate sleep, and stress management techniques.

6. Documentation and Monitoring: Keeping a detailed record of your treatments, responses, and any changes in the wart's appearance can be helpful for your healthcare provider in determining the best course of action.

In conclusion, persistent warts can be a complex issue requiring a multifaceted approach. It is essential to work closely with a knowledgeable dermatologist who can provide tailored treatment options based on your specific situation. Don't hesitate to advocate for yourself and seek out the care that you need to find relief from this ongoing issue. Remember, you are not alone in this struggle, and there are solutions available.

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