Viral warts – What next after conservative measures fail?
Often in my practice, I am referred patients with chronic warts that have failed other conservative measures.
Examples:
Warts in foot – often because of the long duration, the roots of the warts are digging deep into the sole causing pain on walking
Warts in fingers and palms
Warts on the nostril, around the face
Treatment options
1. Cryotherapy – liquid nitrogen. I often find it useful to consider this option first before considering surgery. For cryotherapy to be effective, the roots of the warts need to be frozen off as well. This requires a more prolonged application of the liquid nitrogen and often several repeat freeze-thaw cycles. The benefit is that it avoids surgery and leaves less scar. Risks with cryotherapy – discomfort and pain on application, blood blister(this can form after but the benefit is that the wart will usually fall off with time). Cryotherapy also needs to be repeated several times for it to work especially in chronic warts with deep roots. Once the warts resolves, the area may be darker or lighter than the surrounding skin.
2. Surgery – excision with scalpel or diathermy. This is more painful and requires either a local anaesthesia or general anaesthesia. Risks – the smoke from the diathermy may contain carcinogens(and be potentially infectious); surgery will cause bleeding and leave a scar.
I have a wart that has been on the sole of my foot for about a year, (stupidly I was in denial about it), and now it is in between the size of a 5-10cent piece; and one of the biggest ones my podiatrist has seen… I recently had cryotherapy on the plantar wart & am having more debridement/cryotherapy in 3 weeks time.
What do you do if the blood blister does not fall off with the wart? Are there any complications I should be aware of? How do you know that you have got all the roots of the wart once you have had cryotherapy?? Once the wound is healed, should I use patches with Salicylic acid to make sure it does not come back & ensure the roots are killed?? Any advice is welcome.
Make sure you see a doctor to diagnose and confirm that it is a wart. Your doctor should be able to then advice you about those issues during the consult.