Every Halloween we see images of wicked witches with warts on their faces. Dermatologists know that these are filiform warts which appear not just on the face, but on the neck, lips and around eyelids.
These warts may not be evil, but they are a little nasty when you realise they are caused by human papilloma virus (HPV) infections. Most of the time, warts occur when the immune system is compromised and isn't fighting off the infection. Therefore, the best cure is when the immune system ramps up and takes out the virus on its own.
But if that doesn't happen, there are medical ways to get rid of these unattractive and sometimes uncomfortable growths.
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Over the counter topical treatments based on salicylic acid are widely available in drug stores. The patient can self-administer the treatment. Several applications may be required. The idea is that if the bulk of the wart and infection can be destroyed, the body will be able to fight off the little amount of HPV remaining in the skin. For small to moderate size warts this is often successful.
In more recent years, doctors have begun using immunotherapy with success. Physicians inject warts with medications which bolster the immune system to fight off HPV. Commonly used treatments include squaric acid dibutylester and a gel called Imiquimod marketed under the brand name Aldara. However, use of immunotherapy does not guarantee the wart will not return when the therapy stops.
When you want to make sure a wart is gone, the doctor can literally remove it, though a surgical approach is more invasive and traumatic than medication. Physicians can perform removal procedures in their offices with just local anesthetic. There are several options. Cryotherapy is when the doctor freezes off the wart using liquid nitrogen. Or, you can go to the other extreme and opt for electrocautery, where the doctor burns off the wart. Finally, there is old fashioned surgical excision using a surgical knife. .
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