Should I treat warts or plantar warts?

Decision Points focus on key medical care decisions that are important to many health problems.

Introduction

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

This Decision Point is not for people with genital warts. If you have genital warts, talk with your health professional about your treatment choices.

Key points in making your decision

  • Warts are harmless and will not become harmful.
  • Your wart will probably go away on its own. Research shows that most warts do go away within months or years.1
  • You cannot be sure that any particular wart treatment will work. Although there are many treatments for warts, little is known about their effectiveness.2
  • Even if you treat your wart successfully, warts often return, either in the same place or on a different part of the body.

Decision Point logo - Medical Information section presents medical information in question-and-answer format. Medical Information

What causes warts, and how are they spread?

A wart develops when a human papillomavirus infects the outermost layer of skin and causes the skin cells to grow rapidly. The virus can then spread from an existing wart to other areas of the body, causing more warts. Various types of this virus thrive in warm, moist environments such as showers, locker room floors, and swimming pool areas.

You are most likely to develop a wart where you have broken skin, such as a cut, hangnail, closely bitten nail, or scrape. Plantar warts are common in swimmers whose feet are not only moist and softened but are also scratched and broken by rough pool surfaces.

Warts are easily spread by direct contact with a human papillomavirus. You can reinfect yourself by touching the wart and then another part of your body. You can infect others by sharing towels, razors, or other personal items. It is unlikely that you will develop a wart every time you are exposed to a human papillomavirus. Some people are more likely to develop warts than others.

Why treat warts?

Many people do not treat warts. Warts do not cause cancer and generally go away on their own. However, you may consider treatment if you:

  • Have a plantar wart that is painful to walk on.
  • Have a wart problem that is getting worse, is easily irritated, or embarrasses you.
  • Are concerned about spreading the virus to others.

The benefits of treating warts should be considered with the drawbacks. Warts often come back, treatment is not always effective and may take a long time, and the cost may not justify the benefits. Some treatments can cause scarring.

How effective is treatment for warts?

Although there are many treatments for warts, little is known about how effective treatment is.2 Even with treatment, warts often return.

Nonprescription salicylic acid is as effective as or more effective than other treatments, with minimal risk and pain.3

  • A review of research suggests that salicylic acid is a safe treatment that effectively eliminates warts up to 75% of the time. By comparison, placebo or no treatment eliminated warts about 50% of the time.1
  • There is currently no evidence that cryotherapy is any more effective than salicylic acid.3

If you need more information, see the topic Warts and Plantar Warts.

Decision Point logo - Your Information section helps you decide about your personal comfort level and preferences about the decision. Your Information

Your choices are:

  • No treatment—wait to see whether the warts go away on their own.
  • Home treatment with salicylic acid or tape.
  • Treatment prescribed by a health professional, such as cryotherapy.
  • Surgery, such as curettage and electrosurgery.

Immunotherapy and bleomycin are generally considered experimental treatments and are usually only used if all other treatment fails. See a chart comparing these treatment options.

The decision about whether to treat warts or plantar warts takes into account your personal feelings and the medical facts.

Deciding whether to treat warts
Reasons to treat wartsReasons not to treat warts
  • You want to prevent the spread of wart virus to other people or other parts of your body.
  • You have a wart in a place where it is easily irritated.
  • An untreated wart problem may last longer than if you treated it.
  • You think your wart or warts are unsightly and embarrassing.

Are there other reasons why you might try wart treatment?

  • Most warts go away without treatment within months or years.1
  • Treatment is not always successful.
  • Treatment can be time-consuming, inconvenient, painful, and expensive.
  • Warts tend to recur, despite successful treatment.

Are there other reasons why you might not try wart treatment?

If you decide to treat your warts, it is important to know the advantages and disadvantages of different types of treatment.

Two types of home treatment for warts
Type of treatmentAdvantagesDisadvantages

Salicylic acid (nonprescription)

  • Salicylic acid is applied at home.
  • It is inexpensive.
  • It causes little or no pain, and the risk of side effects or scarring is low.
  • It offers up to 75% chance of cure, compared to 50% with placebo or no treatment.1
  • Salicylic acid can irritate the skin.
  • It requires 2 to 3 months of daily application and self-care.

Tape occlusion (duct tape)

  • Tape occlusion is applied at home.
  • It is inexpensive.
  • It has a low risk of side effects and pain and has been used to treat children.
  • It does not cause scarring.
  • It has an 85% cure rate according to one small study.4
  • Tape occlusion can take up to 2 months to work.
  • It requires wearing tape for periods of 6 days.

 

Wart treatment prescribed by a health professional
Type of treatment Advantages Disadvantages

Cryotherapy

  • Cryotherapy is a quick office procedure but is usually repeated at least once every 1 to 3 weeks.
  • It has a low risk of scarring.
  • It is effective about 35% to 65% of the time.1
  • Cryotherapy is no more effective than salicylic acid.3
  • It may be no more effective than using tape over the wart.4
  • It is moderately painful for up to 3 days.
  • It carries a slight risk of local nerve damage when a large wart is treated.
  • It may cause infections.
  • It is expensive compared to most other treatments.

Cantharidin

  • Cantharidin has a low risk of scarring.
  • It usually requires only one treatment.
  • It may be effective against some warts that are resistant to other treatments.
  • Cantharidin causes a painful blister and tender skin for up to 6 days.
  • It may cause infection.
  • It is not recommended for people with diabetes or peripheral arterial disease.
  • It is not well-researched or widely used.

Retinoid (Retin A)

  • Retinoid is applied at home.
  • It has a low risk of side effects and pain and has been used to treat children.
  • It has an 85% cure rate according to one small study.5
  • Although you apply it at home, you must have a prescription.
  • Retinoid is not safe for use during pregnancy, and breast-feeding safety is not known.
  • It is not yet well-researched or widely used for warts.

 

Types of surgical treatment for warts
Type of treatment Advantages Disadvantages

Curettage and electrosurgery

  • Curettage and electrosurgery are successful 65% to 85% of the time.5
  • Curettage and electrosurgery require a painful injection of local anesthetic.
  • They often result in scarring.
  • They are not recommended for feet, where scars are painful.

Laser surgery

  • Laser surgery has a success rate of about 66% according to one small study.1
  • There is normally no scarring.
  • Laser surgery is painful for a few days, and full recovery can take weeks.
  • It may result in infection.
  • It is not recommended for people with diabetes or peripheral arterial disease.
  • It may cause scarring.
  • It is expensive.

These personal stories may help you make your decision.

Decision Point logo - Wise Health Decision section helps you understand how you are feeling about the decision. Wise Health Decision

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about treating warts or plantar warts. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

I consider warts to be a problem.

YesNoUnsure

I have noticed that warts are spreading on my body or from me to other people.

YesNoUnsure

I understand that warts go away on their own, that treatment may not be successful, and that my warts may return, but I still want treatment.

YesNoUnsure

I prefer a quick, painful treatment, even if it's no more likely to succeed than a slow, painless treatment like salicylic acid.

YesNoUnsure

I have health insurance that covers wart treatments, or I have the financial resources to pay for them.

YesNoUnsure

Use the following space to list any other important concerns you have about this decision.

 

 

 

 

 

 

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to try or not try treatment for warts or plantar warts.

Check the box below that represents your overall impression about your decision.

Leaning toward treating warts

 

Leaning toward NOT treating warts

     

Return to the topic Warts and Plantar Warts.



Author: Sabra L. Katz-Wise
Ralph Poore
Last Updated: October 20, 2006
Medical Review: Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Randall D. Burr, MD - Dermatology

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