Warts: Causes, Treatments, and Skin Care for Common and Plantar Warts

Dr. Chris Irwin

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Introduction

Warts are very common benign skin growths caused by a viral infection. Specifically, warts arise from an infection with certain strains of the human papillomavirus (HPV). They can occur at any age but are especially frequent in children and teenagers. This pamphlet focuses on common warts (typically found on hands or other skin surfaces) and plantar warts (found on the soles of the feet). It will explain what causes warts, how they spread, who gets them, and detail the full range of treatments – from at-home remedies and skin care tips to advanced therapies (including cantharidin ointment, LED/light treatments, lasers, and more). The goal is to help you understand your options and how to care for your skin when dealing with warts.

What Causes Warts?

Warts are caused by infection with the human papillomavirus. HPV is a DNA virus with over 150 different types. The types that infect the skin (causing common and plantar warts) are usually not the same as the types that cause genital warts or cervical cancer – so a common wart on the finger is a different strain of HPV than those more serious strains. The virus enters the skin through tiny cuts or abrasions and triggers the skin cells to grow faster than normal, forming a thick, hard bump (the wart).

HPV is contagious and can spread by direct skin-to-skin contact or through contaminated surfaces. For example, walking barefoot on a warm, moist surface like a locker room or pool deck can expose you to HPV and lead to plantar warts on the soles. After contact, it can take months for a wart to actually appear (HPV’s incubation period can be as long as 12 months). Warts can also spread on your own body (autoinoculation). If you pick or scratch at a wart, the virus can infect nearby broken skin and cause new warts in a line or cluster around the original. Similarly, shaving over a wart (for instance, on your face or legs) might spread the virus to other areas of skin. Maintaining good hygiene and avoiding direct contact with warts (or surfaces that have touched them) is key to preventing spread.

Common vs. Plantar Warts: Signs and Symptoms

Common Warts (Verruca Vulgaris): These are the warts most often seen on the hands, fingers, and around nails (they can occur elsewhere too). They usually appear as small, raised bumps with a rough “cauliflower-like” surface. Common warts are generally flesh-colored or greyish and have a hard, keratinized surface. If you look closely or pare down the surface, you might see tiny dark red or black dots inside – these are tiny clotted blood vessels. Common warts are usually not painful. However, warts around or under the fingernails (periungual warts) can be tender and can sometimes disturb nail growth if they enlarge or spread under the nail. Many people seek treatment for common warts due to cosmetic concerns or because the warts are growing/spreading.

Plantar Warts (Verruca Plantaris): Plantar warts occur on the soles of the feet (the word “plantar” refers to the bottom of the foot). Because they are on weight-bearing areas (heels, balls of the feet, or underside of toes), plantar warts are often pressed inward and may be flatter in appearance, sometimes with a layer of thick callus over them.

Plantar warts can be painful, feeling like you have a stone in your shoe when standing or walking. They often have the tell-tale black pinpoint dots (thrombosed capillaries) within them, and one distinguishing feature is that normal skin lines (footprints) on the sole are interrupted by the wart – whereas with a callus, your skin’s striation lines would continue through the lesion. The skin around a plantar wart might be thick and yellowish (callused). Plantar warts can make physical activities uncomfortable, and if they cluster or grow large, they may affect your gait.

Are warts harmful? In most cases, common and plantar warts are benign (non-cancerous) and harmless to your overall health. They do not turn into skin cancer. The biggest issues they cause are discomfort (especially for plantar warts) and cosmetic or social embarrassment. In children, warts can sometimes lead to teasing or self-consciousness about appearance. Very rarely, in people with certain genetic conditions or severely weakened immune systems, wart viruses can contribute to other skin problems, but for the average person, they remain a localized skin issue. The main reasons to treat warts are to relieve pain, improve appearance, and prevent them from spreading to other sites or people.

Who Gets Warts? (Risk Factors)

Warts can affect anyone, but certain groups are more prone:

Children and Adolescents: Warts are especially common in school-aged kids and teens. One survey found that about 7–10% of the general population has warts at any given time, with peak frequency between ages 12 and 16. Kids tend to get warts more because their immune systems are still learning to recognize the virus, and they are often in close contact in schools or play (making transmission easier). Also, children are more likely to get minor scrapes or pick at their skin, which can give HPV an entry point.
People with Eczema or Dry/Cracked Skin: If you have chronic dermatitis (eczema) or very dry, cracked skin, your skin’s protective barrier is weaker. HPV can more easily infect broken skin, so individuals with these conditions may get warts more readily (especially if they scratch). Keeping skin moisturized and intact helps maintain a barrier to infection.
Nail Biters or Cuticle Pickers: Warts around the nails (periungual warts) often start because the virus enters through the damaged skin from habits like nail biting or cuticle picking. Stopping these habits can make a big difference in preventing spread around fingertips.
Immunosuppressed Individuals: People with weakened immune systems – for example, those on immune-suppressing medications (after organ transplants) or with illnesses like HIV – tend to get more numerous warts that are harder to treat. Their immune system is less able to naturally fight off the HPV infection, so warts can be more persistent. In fact, warts in immunosuppressed patients may be very extensive, and special aggressive treatments may be needed.
Others: Having excessively sweaty feet (a condition called hyperhidrosis) can predispose one to plantar warts, since the constantly moist, softened skin is easier for the virus to infect. Athletes who use communal showers or locker rooms (swimmers, gymnasts, wrestlers, etc.) are at risk due to exposure of bare feet to surfaces with the virus. Wearing protective footwear in such environments helps reduce this risk. There’s also some evidence that tobacco smokers might experience more frequent wart recurrences, possibly due to effects on the immune system, though anyone can get warts regardless of smoking status.

Do Warts Go Away on Their Own?

Often yes – especially in children. The immune system can recognize the virus over time and clear the wart naturally. Clinical observations show that in children, about 50% of warts will disappear on their own within 6 months, and about 90% will be gone within 2 years without any treatment. So if a child has a small wart that isn’t bothering them, a parent might choose to simply watch and wait, knowing there’s a good chance the wart will eventually go away as the child’s immune system kicks in. This is super important to understand as treatment always carries the risk of (small) scarring – the option for least scarring is to leave it alone.

In adults, warts are more likely to persist longer. They can still go away spontaneously, but it tends to take more time – the “wait and see” approach might mean dealing with a wart for several years. Many adults opt for treatment rather than waiting, especially if the wart is in a bothersome location. However, even in adults, some warts do eventually clear up on their own as the body mounts an immune response.

It’s important to realize that the behavior of warts can be somewhat unpredictable. Some warts may shrink and vanish suddenly, while others might stubbornly stick around or even spread. Warts sometimes recur even after successful treatment, or conversely to vanish for no obvious reason. If the virus remains in the skin (in the deeper layers), the wart can come back in the same spot after it was removed, or new warts can pop up elsewhere. Because of this unpredictable nature, a wart that is not causing problems can reasonably be observed for a while if the patient prefers; but if it’s growing, spreading, or causing pain, active treatment is recommended.

Should Warts Be Treated?

Treat or not treat? Not every wart needs treatment from a strictly medical standpoint, It’s really up to you! Certain issues with warts may push us more to treatment though –

Pain or Functional Problems: If a wart is painful (for example, a plantar wart making it hard to walk comfortably) or is located where it repeatedly gets irritated and bleeds (perhaps on a knuckle or under a nail), treatment is advised to relieve discomfort and avoid further injury.
Spreading Warts: If you notice warts multiplying on your body or spreading to family members, treating them can help curb this spread. Warts are infectious, so reducing the viral load on your skin by removing warts can protect you and others from new lesions.
Cosmetic or Psychological Impact: Warts on visible areas (hands, face) can cause embarrassment or self-consciousness. Many people want them removed for aesthetic reasons or to avoid social stigma. For instance, common warts on the hands can be quite noticeable and might affect one’s confidence at work or socially. It’s perfectly valid to treat warts for cosmetic reasons if they bother you.
Persistent Warts: If a wart has shown no signs of going away after many months, or if it has grown large or developed “babies” around it, it’s unlikely to suddenly vanish and more likely to worsen. Treating such persistent warts is usually warranted.
Certain Locations: Warts on the bottom of the feet (plantar) often need treatment because of the pain they can cause. Warts around the nails might need treatment to prevent nail damage. And warts on the face should be evaluated by a doctor; what looks like a wart could be another kind of growth, and if it is a wart, special careful treatment is needed on facial skin. Do not use over-the-counter wart medications on the face or genital area, as those areas are too sensitive and require physician management (strong chemicals can cause scarring on the face).
Immune System Concerns: If you have an immune system issue or diabetes (which can affect healing), you should consult a doctor about warts. For example, a diabetic with a plantar wart should see a doctor – the wart may need treatment to prevent it from enlarging and risking a foot ulcer, and the treatment chosen might be different to avoid injuring surrounding skin. Immunocompromised patients often require more aggressive treatment because their warts might not regress on their own and can proliferate.
Uncertainty of Diagnosis: If you are not 100% sure a growth is a wart, have it checked. Occasionally, other skin problems (like seborrheic keratoses, skin tags, calluses, or rarely, skin cancers) can be mistaken for warts. I can usually tell by examination. If a wart is atypical – for instance, it’s very large, irregular in color, bleeding, or not responding to therapy – a doctor might perform a biopsy to confirm it’s nothing more serious. This is rare for common warts, but it’s a consideration for unusual cases.

In summary, treating warts is often a matter of personal comfort. From a medical perspective, it’s reasonable to treat warts that hurt, spread, or bother you aesthetically. If you’re content to watch a small wart for a few months to see if it goes away, that’s fine too – just be mindful of hygiene to avoid spreading it. When in doubt, or if the wart is in a tricky spot (face, genitals, under nail) or you have other health conditions, seek a healthcare provider’s advice. They can confirm the diagnosis and guide you on the safest and most effective treatment approach.

Preventing the Spread of Warts and Skin Care Tips

Because warts are contagious (to yourself and others), it’s important to take some simple precautions if you have warts (or are around someone who does). Good skin care habits can also help prevent getting new warts or avoid aggravating existing ones. Here are some my recommended tips for wart prevention and skin care:

Don’t pick, scratch, or bite warts. Avoid touching warts unnecessarily. Picking at a wart can release virus into the surrounding skin or under your nails. This can cause more warts to develop in those areas. If you have a habit of biting fingernails or hangnails and there’s a wart nearby, do your best to stop – biting can create tiny cuts that let the virus in and can spread warts around your fingertips.
Keep your skin moisturized and intact. HPV infects through broken skin. If your skin is dry and cracked, or if you have cuts, it’s easier for the virus to take holdorg. Use moisturizers to prevent cracking, especially on hands and feet if they are prone to dryness. Cover any cuts or scrapes with a bandage until healedaad.org. If you have conditions like eczema that cause a lot of skin breaks, work with your doctor to manage them, as this will help make your skin less vulnerable to warts.
Wash hands and maintain hygiene. Washing hands regularly can remove viruses you may have picked up from surfaces or contactsorg. This is especially important after you’ve touched your own wart (for example, after applying a wart treatment at home) – wash your hands so you don’t inadvertently spread the virus elsewhereaad.org. Also, keep your feet clean and dry; if you tend to have sweaty feet, change socks daily and let shoes air out. For excessive foot sweating, treatments for hyperhidrosis can help, as constantly damp skin is more susceptible to wart infectionaad.org.
Don’t share personal items. HPV can cling to objects. To prevent transmission, give everyone their own towel, washcloth, nail clippers, shoes, socks, etc.org. For example, if someone in the household has a wart, they should have their own nail file/pumice for it and not use it on healthy skin (and not share it with others). Likewise, avoid sharing razors, gloves, or footwear. Launder socks and towels regularly.
Wear footwear in public areas. To avoid picking up plantar warts, always wear flip-flops, sandals, or water shoes in communal showers, locker rooms, pool decks, and similar warm, wet areasorg. The virus thrives in those environments, and going barefoot makes it easy to catch. This tip is especially relevant for swimmers, gym-goers, and dormitory residents.
Avoid shaving over warts. If you have a wart in an area you normally shave (like the face or legs), be very careful. Shaving can slice the wart and potentially spread the virus along the path of the razor. If possible, skip shaving that area until the wart is treated. Or use an electric razor for a gentler approach, and disinfect it after each use. This will reduce the chance of “auto-inoculating” yourself with new warts in the shave areacom. Men who get warts in the beard area, for example, should not shave through them – many flat warts on the beard are spread by shavingdermnetnz.org.
Protect your feet and hands. If you have a plantar wart, consider covering it with a bandage or duct tape when walking around your home, so you don’t shed virus particles on the floor that could infect others or re-infect yourself. In swimming pools, some people use waterproof plasters over warts for the same reason. If you have warts on your hand, donning gloves or finger bandages while doing common tasks (like gym equipment or gardening) can protect both you and others. And remember to keep any wart area dry; if you spend a long time in water (e.g. taking a bath), the wart can macerate and potentially spread virus more easily, so afterwards dry the area well.

By following these precautions, you can greatly reduce the risk of spreading warts. And even if you don’t have warts, these steps (like wearing flip-flops in public showers and moisturizing your skin) can help prevent you from getting them in the first place.

Treatment Options for Warts

There is a wide range of treatments available for warts – from simple home remedies to high-tech medical therapies. The good news is that we have many tools to remove warts. The challenging news is that no single treatment works 100% of the time for every wart or every persondermnetnz.org. Warts can be stubborn, and sometimes it takes multiple rounds of treatment (or a combination of methods) to fully eradicate them. The choice of treatment often depends on factors like the patient’s age, the location and size of the wart, how many warts are present, and what treatments have been tried beforepmc.ncbi.nlm.nih.gov. Your dermatologist will help tailor a plan that’s right for you.

Before diving into specific treatments, it’s important to set realistic expectations: wart treatments remove the wart tissue, but they do not kill the HPV virus outrightdermnetnz.org. The virus can hide in the deeper layers of skin. So, a wart might recur if some virus-infected cells remain. This is why persistence and follow-up are often needed – you have to keep at it until the immune system finishes the job or the wart doesn’t regrow. With that in mind, here are the main categories of wart treatments:

At-Home and Over-the-Counter Treatments

For small warts that are not too troublesome, you might start with some at-home treatments. These are generally lower in cost and non-invasive, though they may require daily diligence over many weeks.

Salicylic Acid Wart Treatments: Over-the-counter wart removal liquids, gels, pads, or plasters almost all use salicylic acid, a keratolytic agent. This means it softens and dissolves the thickened skin. Salicylic acid essentially peels the wart layer by layer. For best results, dermatologists recommend a routine: Soak the wart in warm water to soften it, then gently file or pumice the surface to remove dead skin, and then apply the salicylic acid product directly on the wart (careful to keep it on the wart and off healthy skin)org. Cover it with a bandage or duct tape and leave it on as directed (often 24 hours for pads, or overnight for liquids). The next day, remove it, wash the area, and repeat the process. Consistency is key – this is usually done daily or at least several times a week for a number of weeks. It can take 2 to 3 months of continuous treatment to see full results. Studies show about 70% of warts can be cleared within 12 weeks of diligent daily salicylic acid usedermnetnz.org. This method is safe and effective for most common and plantar warts. The main side effect is mild skin irritation or tenderness; if the surrounding skin gets sore, you can take a short break until it calms downdermnetnz.org, or apply petroleum jelly to the skin around the wart to protect it from the acid. (Do not use salicylic acid on the face or genital area, and check with a doctor before using it on diabetics’ feet or if you have circulation issues.) Patience is important, but salicylic acid has the advantage of being inexpensive and painless compared to many in-office treatments, which is why it’s often the first-line recommendation for home care.
Duct Tape Occlusion Method: A famous home remedy for warts involves covering the wart with duct tape for an extended period. The theory is that occluding the wart might stimulate the local immune response and also macerate the tissue. A common approach is to wear a small piece of duct tape over the wart continuously for about 6 days, then remove it, soak and gently debride the wart, leave it uncovered overnight, and reapply tape in the morning, repeating the cycle. Some people just keep the tape on and change it every few days. Does it work? The evidence is mixed. An early study in children reported that duct tape therapy cleared most warts, generating excitement about this low-tech solution. However, a later placebo-controlled trial in adults did not find duct tape to be significantly more effective than a placebo tapeorg (in that study, about 21% of warts cleared with duct tape vs 22% with a moleskin placebo after 2 months)dermnetnz.org. Despite the mixed research, many dermatologists feel it’s a harmless thing to try, especially for kids (since it’s non-painful). Some patients do report success anecdotally. If you try the duct tape method, use silver duct tape (the sticky adhesive may contain something additional compared to clear duct tape, some speculate it might help). If no improvement is seen after 2–3 months of diligent taping, it’s probably not going to work for that wart. As a side note, keep in mind that occluding a wart can sometimes make the skin a bit soggy and easier to spread virus, so always wash your hands after handling the tape or wart.
Over-the-Counter Freezing Kits: Pharmacies sell cryotherapy kits (with names like “Freeze Away” etc.) that use a cold gas (usually a mix of dimethyl ether and propane) to freeze warts. These can be moderately helpful for small warts near the surface. However, OTC freezing kits are not as powerful as the liquid nitrogen freezing done in a doctor’s office. Liquid nitrogen is around -196°C and can freeze very quickly and deeplyncbi.nlm.nih.gov, whereas the over-the-counter products only freeze to about -70°C and often do not penetrate as deeplypmc.ncbi.nlm.nih.gov. As a result, the OTC freeze might stunt or shrink a wart but often doesn’t eradicate a well-established wart completely. Still, for a new small wart, you could try it – carefully follow instructions to avoid damaging surrounding skin. If it doesn’t work, your doctor can perform a much colder freeze in-office. Do not use OTC freeze sprays on your face or genitals (risk of injury in those sensitive areas). Also, avoid spraying for longer or closer than instructed; you can cause an ice burn if overdone. In summary, OTC cryotherapy is safe for limited use but temper your expectations, and see a professional for resilient warts.
Topical Prescriptions (Vitamin A derivatives): Prescription peeling agents, such as tretinoin cream (a retinoid, derived from Vitamin A), or stronger acids like tricloracetic acid (TCA), are sometimes given for warts – particularly flat warts. Flat warts (plane warts) often respond well to tretinoin because it causes the skin cells to turn over more normally and can disrupt the growth of the wart virus in the skincom healthwire.pk. Dermatologists have used tretinoin (which is commonly an acne/wrinkle medication) off-label for flat warts on the face or backs of hands, applied nightly. It causes peeling and can clear flat warts over several months. Similarly, chemical peel acids like glycolic acid or lactic acid in strong concentrations can be applied to multiple flat warts to exfoliate them – these are often done under medical guidance. For common warts, these are not first-line, but if other treatments fail, a doctor might suggest a retinoid cream or even oral retinoids in stubborn casespubmed.ncbi.nlm.nih.gov. If you have access to an over-the-counter retinol (a weaker form of retinoid) cream, it likely won’t be as potent, but theoretically could help a bit for flat warts over a long time. With retinoids, be mindful they can irritate the skin (redness, peeling) – that’s expected to some degree. Use sunscreen on any area treated with a retinoid, as the new skin can be sun-sensitive. This approach is something to discuss with a dermatologist rather than a standard home remedy, but it’s good to know about as part of the anti-wart arsenal.
“Natural” and Other Home Remedies: A host of folk remedies exist for warts. Some people apply garlic (for its antiviral allicin content), use tea tree oil, dab on apple cider vinegar, or even try banana peels or potato slices. The scientific evidence for most of these is limited. Garlic actually has a bit of data – a small study and some case reports indicated that applying a lipid-soluble garlic extract led to wart clearance in some patientscom. Garlic is a caustic substance, though, and can cause significant skin irritation or even burns if left on the skin too longpmc.ncbi.nlm.nih.gov. If you try garlic, use it carefully (for example, applying a cut slice of garlic or garlic oil to the wart for a short period, and protecting surrounding skin). Apple cider vinegar is also popular; it’s basically a mild acid (acetic acid). It may work similarly to salicylic acid by slowly eroding the wart. Again, dilution and caution are key to avoid chemical burns. Some have reported success with simply soaking the wart in warm water daily (heat can possibly stimulate immune activity)pmc.ncbi.nlm.nih.gov – one method used warm water at 45°C (113°F) soaks for several minutes daily and noted improvement in hand/foot warts in anecdotal casespmc.ncbi.nlm.nih.gov. Zinc supplements (oral zinc or topical zinc ointment) have shown mixed results in studies; zinc is important for immune function, and high-dose oral zinc led to wart clearance in some trials (particularly if the person was zinc-deficient to start) – but you should only take high-dose zinc under medical supervision because of potential side effects. Toothpaste, baking soda, aspirin paste, and many other household items have been tried without reliable success. Duct tape, as mentioned above, falls into the home remedy category too. While most home remedies lack solid proof, some may work anecdotally by irritating the wart or boosting local immunity. Just be cautious: “natural” doesn’t always mean “safe” – even garlic or vinegar can hurt your skin if misused. If a home method causes significant pain, swelling, or redness, stop using it. And if you have diabetes or poor circulation, do not use home surgery or strong chemicals on your warts – seek professional care to avoid non-healing wounds.

In general, if an at-home treatment is going to work, you’ll see signs of improvement within a few weeks (the wart might get smaller, or black dots might increase which can indicate it’s dying as blood supply is cut off). If nothing changes after 2–3 months of consistent home therapy, it’s time to see a doctor for other options. There’s no shame in trying home methods first for ordinary warts, but don’t be discouraged if you end up needing in-office treatments – warts can be tenacious, and dermatologists have many additional tools to tackle them.

In-Office Medical Treatments

If home treatments aren’t successful or a wart is too large, painful, or numerous to deal with at home, a dermatologist can provide in-office treatments. These tend to work faster than at-home methods, but some can cause more discomfort. The choice of method will depend on the wart and the patient. Often, a combination of treatments yields the best result (for example, pairing a topical treatment with a procedure). Here are the common in-office wart treatments explained:

Cryotherapy (Professional Freezing): Cryotherapy is one of the most common treatments for warts and is often done during a dermatologist visit. The doctor applies liquid nitrogen, an extremely cold substance, to freeze the wart and a rim of surrounding skin. This is typically done with a spray device or a cotton-tipped applicator. The goal is to freeze the wart quickly and thoroughly – usually until a little 1–2 mm white frost halo forms around itncbi.nlm.nih.gov. The freezing causes tissue damage to the wart; afterward, the area might blister or scab over within a day. Cryotherapy exploits both direct tissue destruction and an immune response (the freezing induces inflammation which can rally the body’s immune cells to fight the virus)pmc.ncbi.nlm.nih.gov. Is it painful? It can be uncomfortable – you often feel a sharp stinging/burning during the freeze, which lasts for a minute or so. Afterward, as it thaws, it might ache like a bruise for a day. Pain is usually mild to moderate and varies per person and location of wart. If needed, a doctor can reduce pain by using a numbing spray or anesthetic, especially for large plantar warts. How many treatments? Warts usually require multiple cryotherapy sessions, spaced about 1 to 3 weeks apart. On average, clearance rates around 50–70% after about 3–4 treatments (over 2–3 months) are reporteddermnetnz.org pmc.ncbi.nlm.nih.gov. Some warts may need more sessions if they are very thick or longstanding. Aggressive freezing (holding the freeze for 10–30 seconds or doing a double-freeze-thaw cycle) can increase effectiveness but also increases blistering and painpmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov. Your dermatologist will balance how aggressive to be based on your tolerance and skin type. Side effects: The most common is a blister or scab that can last up to a week or two. After it sloughs off, you might have some temporary redness or a light/dark spot. In people with darker skin, cryotherapy can cause hyperpigmentation or hypopigmentation (dark or light spots) at the sitepmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov – these usually fade over time, but sometimes the color change can persist. Rarely, an overly aggressive freeze could leave a small scar. There have been isolated reports of tendon or nerve damage if freezing is done over thin skin areas with important nerves (like sides of fingers)pmc.ncbi.nlm.nih.gov, but this is uncommon when done carefully. Another possible phenomenon is a “ring wart” – sometimes after a central wart is frozen and heals, a ring of smaller warts might appear around it (perhaps due to partial treatment or viral spread); if that happens the dermatologist will treat the perimeter as wellpmc.ncbi.nlm.nih.gov. Despite these risks, cryotherapy is generally very safe in experienced hands and is a quick procedure. It’s often the first in-office treatment tried for common warts. (One caution: because HPV can survive extreme cold, doctors take care to use fresh supplies – like not reusing the same cotton swab from one patient to another – to prevent any chance of transmitting warts between patientspmc.ncbi.nlm.nih.gov. Clinics also handle the liquid nitrogen equipment carefully for the same reason. This is more of a concern for the provider than the patient, but it’s good to know the procedure is hygienic.)
Cantharidin (“Blister Beetle” Wart Treatment): Cantharidin is a topical medication that causes a controlled blister on the skin. It’s derived from a substance produced by blister beetles (historically known as “Spanish fly”). How it works: The dermatologist will dry the wart and oftentimes pare (trim) the thick surface of the wart with a blade or curette firstorg. Then a drop or two of the cantharidin solution is carefully applied to just cover the wart. It’s usually a mix of cantharidin plus some other chemicals (sometimes combined with salicylic acid or podophyllin in a formulation) that aid penetration and drying. After application, the area is covered with a piece of nonporous tape or a bandage. The cantharidin is left on for a few hours – your doctor will tell you how long (commonly about 4–6 hours up to 24 hours)dermnetnz.org pmc.ncbi.nlm.nih.gov, then you wash it off. Over the next day or two, a blister forms under the wart. This lifts the wart off the skin; essentially the wart dies as the blister separates it. Within the week, the blister dries out and the wart is usually dead. The doctor will often have you return in about 1 week for a follow-up: at that visit, they can remove the dried blister or any remaining wart bits with forceps or by gentle scrapingdrmoma.org. If the wart isn’t fully gone, the treatment can be repeated in another week or two after the skin has healeddermnetnz.org. Does it hurt? The application of cantharidin is painless – you typically feel nothing at the time of painting it onpmc.ncbi.nlm.nih.gov. Later, when the blister forms (hours later or next day), the area can be sore or tender, sometimes quite sore if it’s a large blister on a weight-bearing areadermnetnz.org. Many patients, especially children, tolerate it well with only mild discomfort. If a large blister is very tense and painful, you can prick it with a sterile needle to drain fluid (usually the doctor can do this at follow-up). Advantages: The big advantage of cantharidin is that it doesn’t require any injection (no needles) and causes little to no pain during the procedurepmc.ncbi.nlm.nih.gov drmoma.org. That makes it wonderful for kids (and adults who are squeamish about pain). Also, it tends not to scar because it mostly affects the epidermis (upper skin layer) and doesn’t harm the deeper skin layerdermnetnz.org. In the U.S., cantharidin was used widely decades ago, then it became less available, but dermatologists now often obtain it through specialty pharmacies and it’s a mainstay for pediatric wart treatment. Effectiveness: Cantharidin works best on common warts (like on fingers) and periungual warts. It can be used on plantar warts, though very thick plantar warts might respond less well if the blister doesn’t lift the entire deep portion. Some studies and reports indicate clearance rates on the order of 70–80% with a few treatments of cantharidin for common wartspmc.ncbi.nlm.nih.gov. In fact, one study found no significant difference in cure rates between pulsed-dye laser, cantharidin, and cryotherapy – all were around ~70% effective in that analysispmc.ncbi.nlm.nih.gov. While we lack large randomized trials exclusively on cantharidin, the clinical experience is quite positive. Many dermatologists see stubborn warts resolve nicely with it, especially when combined with salicylic acid between visits. Side effects and precautions: The main side effect is the intended one – blistering. Occasionally, the blister can be large or uncomfortable; elevate the area and use ordinary pain relief (like acetaminophen or ibuprofen) if needed until it subsides. A dry crust will form; keep it clean and you can bandage it if it’s oozy. Sometimes a ring of redness develops around the site (in rare cases, a ring of tiny new warts can appear around the treated wart – but this can happen with any destructive treatment, possibly from viral spread before the wart was killed)dermnetnz.org. Cantharidin must be applied by a professional – you can’t get it OTC. It should not be used on infected skin, on mucous membranes (like mouth or genital warts), or on very large areas. It’s also typically avoided in very young infants or pregnant women to be safe. Overall, cantharidin is a valuable, relatively painless treatment. Patients (and parents of child patients) often appreciate that it doesn’t involve needles or intense pain, even though it requires a return visit for evaluation. If your dermatologist suggests “beetle juice” for your wart, this is what they are referring to. Many find it to be an excellent first-line in-office therapy for kids’ warts or those who dread more uncomfortable proceduresdrmoma.org drmoma.org.
Laser Treatment: Various lasers can be used to treat warts, usually when other treatments haven’t worked or for particularly resistant warts. Lasers work by emitting focused light that either burns off the wart or targets the wart’s blood supply to destroy it. Here are the common types:
- Pulsed Dye Laser (PDL): This laser targets hemoglobin (the red pigment in blood). Warts have those tiny blood vessels in them (the “seeds”), so by zapping the blood supply, the wart tissue dies off and sloughs out. PDL treatments are done with brief pulses of a yellow light (often a 585–595 nm wavelength). It usually feels like a quick snap (they often say like a rubber band snap). PDL is generally less painful and has a lower risk of scarring compared to older laser types like CO₂ncbi.nlm.nih.gov. After PDL, the treated area might bruise (PDL is actually used for treating port-wine stain birthmarks and can cause a temporary purplish bruise). It heals over a couple of weeks with minimal wound care neededpmc.ncbi.nlm.nih.gov. Studies have shown very mixed clearance rates – some report as high as ~95% clearance, others around 50%, depending on the wart and patientpmc.ncbi.nlm.nih.gov. On average, cure rates in the range of 50–70% after a few sessions are common, not dramatically different from traditional methodspmc.ncbi.nlm.nih.gov. Interestingly, one controlled trial found PDL (66% cure) was about equally effective as cryotherapy or cantharidin (70% cure) for warts, suggesting PDL is an option but not necessarily superior in all casespmc.ncbi.nlm.nih.gov. PDL can be very useful for warts that simply won’t respond to anything else, or for facial warts or warts in children who may not tolerate more aggressive surgerypmc.ncbi.nlm.nih.gov. It usually requires multiple sessions (e.g. 2–4 sessions spaced a few weeks apart). The benefit is low scarring and minimal downtime – just some redness or a scab. It’s also quick. The downside is cost (lasers are expensive and insurance coverage for wart laser therapy varies) and that not every dermatologist has a PDL machine on hand.
- CO₂ Laser: A carbon dioxide laser is essentially a powerful burning laser. It emits infrared light that is absorbed by water in the skin, resulting in vaporization of the tissuencbi.nlm.nih.gov. CO₂ lasers act like an invisible scalpel – the doctor can use it to excise or destroy the wart tissue layer by layer. Because it’s not selective (it burns anything it hits), it can damage surrounding skin too, so it’s used carefully. Typically, CO₂ laser is reserved for recalcitrant warts that have failed other treatments. It’s especially considered for difficult deep warts like some periungual or subungual warts (around/under nails)pmc.ncbi.nlm.nih.gov, or very large plantar warts that haven’t responded to anything else. The procedure often requires local anesthesia (injection of lidocaine to numb the area) because it can be painful. The laser essentially ablates the wart, and what’s left is an open wound which then heals over 1–2 weeks (healing by secondary intention)pmc.ncbi.nlm.nih.gov. Effectiveness: CO₂ laser can often remove the wart in one session. Some studies show it can clear most warts but recurrence can happen, especially in immunosuppressed patientspmc.ncbi.nlm.nih.gov. Recurrence rates of 10–20% or higher are noted, meaning some warts come back even after a seeming laser successpmc.ncbi.nlm.nih.gov. Drawbacks: There is a risk of scarring, which on the foot can be an issue (a scar on a weight-bearing area can itself cause discomfort)pmc.ncbi.nlm.nih.gov. There have been reports of hypertrophic (thick) scars after CO₂ laser for plantar warts in patients on immunosuppressantspmc.ncbi.nlm.nih.gov. Pain after the procedure can last days until the wound starts healing. Also – and this is important – the smoke plume generated by a laser can contain airborne virus particles. HPV DNA has been found in the laser plume when warts are treatedpmc.ncbi.nlm.nih.gov. Therefore, physicians use smoke evacuator devices and wear masks to avoid inhaling it. As a patient, you generally need not worry about this as long as your provider is using proper precautions (which they will). Because of the pain and aftercare involved, CO₂ laser is not a first choice, but it can be a valuable last resort to physically eliminate a stubborn wart that has not responded to anything else.
- Nd:YAG and Er:YAG Lasers: These are other types of lasers that can be used on warts. Nd:YAG laser (neodymium-doped yttrium aluminum garnet) typically emits at 1064 nm (infrared). It can penetrate deeply and essentially heats the wart from inside. Some case series showed good results (wart remissions with no recurrences in some reports)ncbi.nlm.nih.gov. It’s another way to thermally destroy wart tissue. Er:YAG laser emits at 2940 nm, which is absorbed more superficially (14-18 times more by water than CO₂)pmc.ncbi.nlm.nih.gov. Er:YAG acts sort of like a milder CO₂ laser – it ablates in a more precise, shallow way with less collateral damage (hence theoretically less scarring)pmc.ncbi.nlm.nih.gov. One study found Er:YAG cleared 75% of patients’ warts in one treatment, but about a quarter of them relapsed within a yearpmc.ncbi.nlm.nih.gov. The advantage of Er:YAG is minimal thermal damage, so healing is faster and scarring is less likely. These lasers are not as commonly used as PDL or CO₂ for warts, but some specialists may employ them for particular situations.
  In summary, lasers can be effective, especially for warts that don’t yield to other methods. PDL is popular for its low pain/scar profile. CO₂ is a heavy-duty option when needed. The availability and cost of laser treatment means it’s not for every wart, but if you have a recalcitrant wart, your dermatologist might consider if laser therapy is suitable.
Photodynamic Therapy (LED Light Treatment): Photodynamic therapy (PDT) is a technique where a photosensitizing agent is applied to the wart, and then a special light is shone on it to activate the agent, which in turn destroys the wart tissue. It’s like using a targeted chemical + light to kill the wart. For warts, the commonly used agent is 5-aminolevulinic acid (ALA) or its variant MAL. This compound gets absorbed preferentially into the wart and is converted into a porphyrin that makes the wart cells very sensitive to light. After applying the ALA cream on the wart and letting it incubate (usually covered for a few hours to penetrate)org, the area is exposed to a strong light source. Often a red light (wavelength ~630 nm) LED lamp is used, because the porphyrins absorb red light and produce reactive oxygen species that destroy the cells. Sometimes high-intensity blue light is used for more superficial issues, but red light penetrates a bit deeper for thick warts. The patient typically sits with the light directed at the wart for a given time (e.g. 10-15 minutes or more, depending on protocol). Effectiveness: PDT has been shown to work quite well for some stubborn warts. In a clinical trial on recalcitrant hand and foot warts, about 50% of warts treated with ALA + red light cleared after a couple of sessions, compared to 35% clearing with a placebo cream + lightaafp.org. The difference was significant, meaning PDT outperformed placebo in that study. In other studies, cure rates with PDT vary, but can be high especially for thin warts – one study of plantar warts showed over 90% clearance with PDT after a few treatmentspmc.ncbi.nlm.nih.gov. Combining PDT with laser ablation has even achieved 100% clearance in a small studypmc.ncbi.nlm.nih.gov. So PDT is a promising method for recalcitrant warts. What to expect: The downside of PDT is that when the light is on, it can cause a burning or stinging sensation. Many patients experience pain during illumination, because the reaction that kills wart cells also can irritate nerves. In fact, in the study mentioned above, patients who got ALA reported more pain than those who got placebo creamaafp.org. Usually the pain stops once the light exposure is over. The treated wart will get red and possibly crusty afterward, and then hopefully begin to shrink or fall off in the following weeks. Benefits: PDT is non-invasive (no cutting) and can treat multiple warts at once if you apply the cream to many areas. It can be good for patients with numerous warts (for example, mosaic plantar warts or many warts on hands) who don’t want multiple injections or scars. Also, red light therapy in general has become an accepted part of dermatology for other conditions (it’s used in acne treatment and even some skin cancers)my.clevelandclinic.org, so its safety profile is well understood. PDT for warts isn’t usually first-line due to the need for special equipment and the cost, but it’s definitely something dermatologists consider for warts that are not responding to simpler measures. If your doctor offers photodynamic therapy, they will explain how to prepare (often you have to cover from sun for a day after, since the medicine can make you temporarily sensitive to sunlight too). Note: “LED therapy” for warts typically refers to this photodynamic approach (using an LED light source to activate a cream). Simply shining low-level red light alone (without a photosensitizer) is generally not proven to eradicate warts, though some anecdotal reports and theoretical basis exist for low-level light stimulating an immune response. For now, the evidence-based use is with a photosensitizing agent. If standard treatments fail, PDT is a worthwhile discussion to have with your dermatologist as an alternative.
Electrosurgery and Curettage: This is a minor surgical procedure to physically remove the wart. “Curettage” means scraping the wart off with a sharp instrument (a curette), and “electrosurgery” or electrocautery means burning the base of it with an electric needle to destroy residual wart tissue and seal blood vessels. The doctor will first numb the area with a local anesthetic injection (this involves a needle and can pinch, but once numbed there’s no pain). Then they use a curette to cut or scoop out the bulk of the wart. Next, the electrocautery device is applied to the raw base to burn any remaining wart and stop bleeding. This procedure removes the wart in one session, which is satisfying. However, it creates a wound that might take 1–2 weeks (or more, if on the foot) to healorg. You’ll need to keep it clean and bandaged, and perhaps apply antibiotic ointment. As it heals, a scar will form. On thick skin (palms/soles) the scar could be a firm area. Effectiveness: This method can be very effective for resistant warts – it physically takes them out. But it’s not foolproof; about 20% of warts may regrow even after a seemingly complete excision, because HPV can lurk in surrounding skindermnetnz.org. If a wart recurs in a scar, it can actually be harder to treat than before due to scar tissue around it. So, while electrosurgery has a high initial success rate, there is that recurrence risk. Downsides: The scar itself can be an issue – for example, a scar on the bottom of the foot can cause pain with walking just like the wart did (sometimes even more so)dermnetnz.org. Therefore, many doctors avoid cutting out plantar warts unless absolutely necessary. On fingers or other areas, scarring is usually a small white mark, which might be of cosmetic concern if it’s a large area. Additionally, any time you cut the skin there’s a small risk of infection, so proper wound care is important. This method is generally used for single, stubborn warts that have failed less invasive treatments, or if there’s a biopsy concern. In certain cases (like a filiform wart on a face) a modified version might be done where just a superficial removal with electrocautery is done carefully. But as a routine, because of pain and scar potential, electrosurgery is not the first treatment choice for common warts. It remains an option in the toolkit when needed, and some patients do prefer to just “cut the darn thing out,” accepting the small scar.
Immunotherapy (Boosting the Immune System): Since warts are a result of the immune system not clearing the virus effectively, one strategy is to stimulate the body’s immune response to fight the warts. There are a few ways this is done:
- Intralesional Antigen Injection: In this technique, the doctor injects a tiny amount of an antigen (a substance that causes an immune reaction, but is safe) directly into one of the warts. Common antigens used are Candida (a yeast), mumps, or Trichophyton (a fungus) – these are things many people have been exposed to, so their immune system recognizes them. By injecting it into the wart, the immune system gets alerted and in the process often attacks the HPV as well. The remarkable thing about this method is that not only the injected wart, but also distant warts, can shrink or go away as the immune system ramps upncbi.nlm.nih.gov. For example, a person with multiple warts might have only one wart injected, yet see all of them improve over weeks as the body responds. Clearance rates in studies of immunotherapy injections have been quite good, and it’s generally safe. The injection site may get a little swollen or red, like a little bee-sting reaction, and occasionally one can feel flu-like for a day (immune activation effect). This approach is great for patients with multiple warts or warts that failed destruction methods. It’s not painful beyond a quick needle pinch and is usually done every 3–4 weeks for a few sessions until warts hopefully resolve.
- Topical Immune Creams: Imiquimod (brand name Aldara) is a prescription cream that stimulates the skin’s immune system. It’s FDA-approved for genital warts and certain skin precancers. For common warts, it’s an off-label use and the results are variable. Imiquimod is usually applied a few times per week to the wart and left on for 8 hours before washing off. It can cause significant skin inflammation (redness, peeling – which is part of how it works). In practice, imiquimod alone has limited effectiveness on hand and foot wartsorg – some warts respond, many do not, especially thick plantar ones. It might be more useful on thinner warts (like around nail or on the back of hands) or on patients who cannot tolerate other treatments. Sometimes imiquimod is used after another procedure (for instance, after laser or surgery) to try to prevent recurrence by clearing any residual viruspmc.ncbi.nlm.nih.gov. For children, imiquimod has the appeal of being painless to apply (though it can cause itching or burning from the inflammation). It’s something that might be used in combination with other treatments rather than as a first-line by itself for common warts.
- Oral Immunomodulators: The most well-known example is cimetidine (Tagamet) – an over-the-counter antacid medication that in high doses has an effect on certain immune cells. Some studies in the 1990s and early 2000s explored high-dose cimetidine as a wart treatment, with mixed results. Overall, controlled trials didn’t strongly support it, but there were anecdotal successes, especially in children with multiple warts. Dermatologists sometimes prescribe cimetidine (for example, ~20–40 mg per kilogram per day) for a few months to see if it helps extensive warts, given its low side effect profile. Some dermatologists have reported success using cimetidine in children who had numerous warts that were otherwise hard to treatorg. Another oral option is zinc (as mentioned earlier) – zinc sulfate pills have cleared warts in some studies (if the patient is tolerant of high doses). And in very extreme cases (like in immunosuppressed patients), doctors might try medications that specifically target HPV replication, such as oral retinoids (which have some immune-modulating effects on HPV)pubmed.ncbi.nlm.nih.gov or experimental use of antivirals. These systemic treatments are reserved for special scenarios. For most people, if needed, the antigen injections are an effective immunotherapy route. The advantage of immunotherapy is that it can potentially clear warts everywhere (even ones you don’t know about) by triggering a body-wide response, and it has a low risk of scarring or other local side effects. The disadvantage is it may take longer (several weeks to months) to see results and it doesn’t work for everyone (some immune systems just don’t get sufficiently activated or still might not “see” the HPV).
Other Specialized Treatments: A few additional treatments might be considered by dermatologists in particular cases:
- Bleomycin Injections: Bleomycin is a chemotherapy drug that, when injected into a wart in very small quantity, can kill infected cells. It’s typically used for the most recalcitrant warts (especially plantar warts or periungual warts that haven’t responded to anything else). The wart is usually numbed, then bleomycin is injected with a fine needle. It often causes the wart to turn black and necrotic over a couple of weeks. Clearance rates vary, and because bleomycin can also damage surrounding tissue, there is a risk of side effects like nail damage (for periungual warts) or scarring. It can also be quite painful during and after injection (some doctors do multiple needle pricks in the wart to distribute it). Due to these issues, bleomycin is not commonly the first or even second line – it’s more of a third-line for select cases. But it can be effective where other methods fail.
- Formaldehyde or Glutaraldehyde Soaks: These are older therapies where a patient soaks the affected hand/foot in a dilute formaldehyde solution or paints glutaraldehyde on the warts daily. These chemicals are virucidal (virus-killing) to some degree and also harden the skin. They have fallen out of favor due to strong odor and risk of skin irritation or allergy, but you might read about them in literature. They are mentioned in some guidelines as options for plantar warts that fail conventional treatmentsncbi.nlm.nih.gov. Use nowadays is rare and usually under a doctor’s direction if at all.
- Microwave Therapy: A newer device (approved in recent years) delivers microwave energy into the skin to heat and destroy wart tissue. One such device is the “Swift” microwave therapy system. The treatment involves placing a probe on the wart that emits a quick burst of microwave energy – this raises the temperature in the wart high enough to kill cells and perhaps expose viral antigens to the immune system. It typically requires a few sessions and is done in a podiatrist’s or dermatologist’s office. Early studies have shown promising clearance rates for stubborn warts on the feet, even upwards of 80%+ in some reportswiley.com pmc.ncbi.nlm.nih.gov. The pain during treatment is usually brief and manageable (a sensation of heat). Microwave therapy doesn’t break the skin surface, so there’s no wound or scarring. It’s an emerging option that not all clinics have yet, but it might become more widespread. If you have very resistant plantar warts, you might inquire if any specialist offers this modality.
- Vaccine Therapy: Interestingly, there have been cases and small studies indicating that the HPV vaccine (which is designed for preventing genital HPV strains) has, in some individuals, led to improvement in their common wartsorg. This is not an established treatment, but anecdotal observations suggest an immune crossover effect. Some doctors have tried giving the HPV vaccine off-label to patients with bad nongenital warts to stimulate immunity. While this isn’t standard, it’s a fascinating area of research. If you’re in the typical age range for vaccination and have warts, it’s reasonable to get the HPV vaccine for its intended benefits – any effect on warts would be a bonus.
- Experimental therapies: Dermatology literature contains reports of many other things that have been tried – from topical cidofovir (an antiviral cream, especially in immunocompromised cases) to DCP (diphencyprone) or squaric acid (which are contact sensitizers painted on warts to cause a local allergic reaction that fights the wart)org. These are usually used by specialists in certain scenarios. They work on the same principle as immunotherapy by causing a dermatitis that helps destroy the wart. Another example: combining treatments, such as doing a laser treatment and then applying a chemotherapy cream or immune cream on the wound to improve outcomespmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov. If you have a very difficult wart case, a dermatologist might employ one of these less common measures. The key takeaway is that there is always another treatment to try – it’s rarely true that “nothing can be done” for warts. It’s more a question of weighing the effort, cost, and discomfort of advanced therapies against the degree of bother the wart is causing.

As you can see, the armamentarium for warts is large. Often, a dermatologist will start with something standard (like cryotherapy or cantharidin) and if that doesn’t work, move to second-line options (like laser, immunotherapy, etc.). In tough cases, sometimes multiple methods are used together for synergy – for example, pairing salicylic acid at home with in-office cryotherapy has been shown to slightly improve results over either alonepmc.ncbi.nlm.nih.gov, or injecting an antigen and also freezing a wart, etc. The approach is individualized to the patient. Factors considered include your pain tolerance, the speed with which you want the wart gone, the cost (some procedures are more expensive), whether you can come for multiple visits, and your overall health. For children, the priority is usually to use methods that don’t traumatize the child – cantharidin, tape, or gentle cryotherapy are favored – because making a child scream in pain can cause long-term fear of doctors. For adults, more aggressive methods might be fine if it means getting rid of a painful wart quickly. Your provider will discuss the plan and you can absolutely voice preferences (for instance, if you strongly want to avoid needles, or conversely if you just want it surgically removed no matter what).

Prognosis and Outlook

The vast majority of warts can be cleared with appropriate treatment and care. No treatment has a 100% guarantee, and sometimes it takes a few different tries to find the therapy that works for a particular wartdermnetnz.org. But do not be discouraged – even the most stubborn warts often eventually succumb when the right method or combination is found. It’s important to keep in mind that wart treatment is a process: you might need several appointments or several weeks of home care. Persistence and patience are essentialdermnetnz.org. If you stay the course, you’re giving your immune system time to catch up as well, which is ultimately what will prevent warts in the long run.

Once a wart is gone, it is possible for it to return (if some virus was left) or for new warts to appear if you get exposed again or if dormant virus in your skin becomes active. For example, many people who had warts as kids might experience a few new ones in adulthood, and vice versa. There’s no way to guarantee a wart won’t come back, but following the prevention tips (to not spread or acquire new HPV infections) certainly helps reduce that risk. The good news is that as we age, we tend to get fewer warts – presumably because our immune system has seen more of these viruses and can fight them off more effectively, or perhaps our exposures reduce.

If you have a condition that gives you a lot of warts (such as immunosuppression), you may need maintenance therapy or periodic treatments to keep them at bay. In some cases, dermatologists may put you on things like a low dose of a retinoid or recommend continuing a topical treatment on any new tiny wart to nip it in the bud. It’s a bit like weeding a garden – occasional new “weeds” (warts) might sprout, but you now know how to tackle them before they spread.

On a positive note, warts are benign and do not harm your overall health. They don’t spread beyond the skin. So while they can be a persistent annoyance, you will not get sick from a common wart. The main impact is on quality of life – which is very important, of course. Clearing a painful plantar wart can significantly improve your ability to walk or exercise without pain. Removing visible hand warts can lift a social embarrassment and let you shake hands confidently again.

In summary: Warts are a common problem with many solutions. By understanding the causes and practicing good skin care, you can prevent many warts. If you do get warts, there are effective treatments ranging from simple home care to advanced medical procedures. In this pamphlet, we paid special attention to some notable treatments: cantharidin – a gentle blistering treatment great for children and those averse to pain – and laser/LED therapies – modern approaches for stubborn warts. These, along with traditional methods like cryotherapy and salicylic acid, give us a robust toolkit. Work with your dermatologist to find the approach that best fits your needs. And remember, even if it takes a bit of time, most people’s warts will eventually clear with appropriate management and the immune system’s helpdermnetnz.org. Stay persistent, keep up the preventative habits to avoid spreading the virus, and soon those warts will be a thing of the past!

Sources: The information in this handout is based on current dermatology resources and research, including the American Academy of Dermatology guidelines and dermatology textbooks, as well as studies on wart treatments (cryotherapy, cantharidin, laser, photodynamic therapy, etc.)dermnetnz.org pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov aafp.org. These sources provide evidence for the effectiveness of treatments and tips on management as summarized above. Always consult your healthcare provider for advice tailored to your specific situation.