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Verrucas and warts (04/03 RMD)
Treatment Guidelines
1. No treatment is required if warts are
not painful and not causing any embarrassment.
This is because in time all warts will resolve when natural immunity to
the wart virus has been acquired.
2. If treatment is needed then topical
wart paints should be used. Do not use
these treatments for warts on the face or the genital area. see a doctor
instead.
3. There are several products available
over the counter but most contain
e.g: Salicylic Acid - Salactol, Compound W, Occlusal, Salatacand (all
are equally effective).
Glutaraldehyde - Glutarol
Formalin - Veracur
4. All these treatments do is to harden
the surface of the wart so that it can be pumiced off the next morning.
So treatment should be applied only to the wart (not normal skin) at
night.
The following day the hardened surface should be rubbed off with pumice
or emery board. Do not rub too hard.
If the skin is broken stop treatment until it heals.
Treatment should continue until the skin is flat.
Treatment should be restarted when the wart begins to grow again.
5. If the warts are not responding at
all to one treatment by 6 weeks then change to another treatment with a
different active ingredient e.g. Occlusal to
Glutarol
5b. Or try silver duct tape applied to
wart for 7 days then debride with pumice and
repeat for up to 2months.
6. If having changed treatments there is
still no response make an appointment to see the GP.
He may be able to prescribe other treatment such as Posalfilin.
7. Cryotherapy (freezing) and cautery
(burning) is no more successful that topical treatments.
It is particularly disappointing for the
treatment of foot warts. Cryotherapy and
cautery to nail warts is extremely painful & can result in permanent
damage to the nail. Cryotherapy and
cautery is unsuitable treatment for children as they are painful
procedures.
8 The vast majority of patients with warts will not require a hospital
referral. However, in the following
situations a hospital referral may be useful:
- Multiple extensive warts raising the possibility of
immunosuppression
- Unusual lesions
- Facial warts
- Painful foot warts which have not responded to topical therapy
including special treatments that only the GP can use such as
Posalfilin.
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 Whitnash
Medical Centre
110 Coppice Road
Whitnash
Warwickshire
CV31 2LT
Tel: 01926 316711
Fax: 01926 427260
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