What to Do If Freezing Treatment for Warts Fails in Children?

What should I do if cryotherapy for warts on my fingers fails?

Hello, an eight-year-old boy has a raised hard lump in the nail fold diagnosed by a dermatologist as a "wart." After cryotherapy, the lump is still present.
I would like to ask: 1.
Should he immediately undergo cryotherapy again? 2.
If we wait until four months later during winter break, will it affect the treatment outcome? 3.
Can we buy over-the-counter medication to apply? 4.
If we use electrosurgery, will it be a permanent solution? The child is afraid of pain and cries at the thought of another treatment, so I would appreciate the doctor's advice on the best treatment options.
Thank you!

elly, 40~49 year old female. Ask Date: 2008/09/10

Dr. Huang Ruiyun reply Dermatology

Hello! 1.
You can do it whenever you have time.
2.
If treatment is not performed, the warts may disappear on their own after four months, remain the same, or even multiply.
3.
Duofilm (wart treatment solution, manufactured by Steifel) should be used with caution and requires patience.
4.
Electrosurgery is quite painful and may leave permanent scars; it does not guarantee a one-time solution and is not recommended.
Wishing you peace and good health.

Reply Date: 2008/09/10

More Info

When dealing with warts in children, especially after a freezing treatment (cryotherapy) has failed, it's essential to approach the situation with care and consideration for the child's comfort. Here are some insights and recommendations based on your questions:
1. Should you immediately undergo another freezing treatment?
If the wart has not responded to the initial cryotherapy, it's not uncommon for dermatologists to recommend a second round of treatment. However, the timing and necessity of this should be discussed with the treating physician. They may want to assess the wart's characteristics and the child's overall skin condition before proceeding. Immediate re-treatment may not always be necessary, especially if the wart is not causing any pain or discomfort.

2. Will delaying treatment for four months affect the outcome?
Delaying treatment for a few months may not significantly impact the effectiveness of future treatments. Warts can sometimes resolve on their own over time, particularly in children, as their immune systems mature. However, if the wart is bothersome or growing, it may be wise to address it sooner rather than later. Consult with your dermatologist to determine the best course of action based on the wart's behavior during the waiting period.

3. Can you use over-the-counter wart treatments?
While there are various over-the-counter treatments available, it's crucial to consult with a healthcare professional before using them, especially on children. Some treatments may contain strong acids or chemicals that can irritate the skin or cause adverse reactions. If you decide to use an over-the-counter product, ensure it is specifically formulated for children and follow the instructions carefully.

4. Is electrosurgery a viable option for warts?
Electrosurgery, or cauterization, can be an effective method for removing warts, particularly if other treatments have failed. However, this method can be painful, and children may be apprehensive about the procedure. It's essential to discuss the potential pain and recovery process with your child beforehand. If you choose this route, ensure that the procedure is performed by a qualified professional who can provide appropriate anesthesia and post-treatment care.

Additional Considerations:
- Pain Management: Since children can be sensitive to pain, discuss pain management options with your healthcare provider before any procedure. Topical anesthetics or sedation may be options to consider.

- Follow-Up Care: Regardless of the treatment chosen, follow-up appointments are crucial to monitor the wart's response to treatment and to address any new developments.
- Psychological Support: Children may feel anxious about repeated treatments. Providing reassurance, explaining the process in simple terms, and possibly rewarding them for bravery can help ease their fears.

- Immune System Support: Encourage a healthy lifestyle that supports the immune system, including a balanced diet, regular exercise, and adequate sleep. A robust immune system can help the body fight off warts naturally.

In conclusion, while it can be frustrating when wart treatments do not yield immediate results, there are multiple avenues to explore. Always consult with a pediatric dermatologist for tailored advice and treatment options that consider your child's specific situation and comfort level.

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