Category: dermatology

Treating Hard to Control Warts

Unfortunately, there are no quick and easy ways to treat warts. In fact, because there are no quick and easy ways to treat warts, many pediatricians suggest that parents simply wait it out, and let the warts go away on their own.

Common Wart Treatments

If you don’t have the patience to wait for a wart to go away on its own, which can take months to years, you can try:
  • OTC topical liquid or gel wart remover treatments with salicylic acid
  • OTC wart remover treatments with salicylic acid on a pad
  • OTC wart remover treatments that freeze warts
  • duct tape
Your pediatrician might also try:
  • cryotherapy – “prescription strength” wart freezing, which may have to be repeated multiple times
  • cantharidin – not FDA approved in the US, but this blistering agent is often applied to warts to induce them to go away
And of course, your pediatrician might also simply recommend that you wait it out for a few more months or years, as the warts should eventually just go away. But why not treat the warts if treatments are available? Many experts say that at best, standard wart treatments only work half of the time. And they can be painful or leave scars.

Treating Hard to Control Warts

Again, treating warts is often hard, even in the best of circumstances. Warts can be even harder to treat if they are around your child’s nails (periungal warts) or on the bottom of their feet (plantar warts).
Plantar warts can be hard to treat.
Plantar warts can be hard to treat. Photo by happyfeet34 (CC BY 2.0)
Still, if you are not getting anywhere, you should ask yourself these questions and share the answers with your pediatrician:
  • Does your child really have warts?
  • Did you follow the directions on the label carefully?
  • Are you gently rubbing away hard skin from the surface of the wart with a pumice stone or emery board each week?
  • Are you softening the skin on and around the wart by soaking the area in warm water for at least 5 minutes before your wart treatments?
  • Did your child’s wart mostly go away and then come right back in the same spot?
  • Did your child’s wart completely go away, but new warts came up in different places?
  • Did your child get a much bigger wart around the site of a previously treated wart (a ring wart)?
A dermatologist can treat your child’s truly resistant warts with cryotherapy, cantharidin, higher strength salicylic acid paste than is available OTC, yeast injections, electrosurgery, or pulsed dye laser therapy, etc.

What To Know About Treating Hard to Control Warts

Although multiple wart treatments are available, warts are not easy to treat and so it is not unreasonable to just leave them alone if they aren’t bothering your child.

Best Treatments for Nail Fungus Known as Onychomycosis

Nail Fungus or Onychomycosis, is an infection of the nail bed often caused by a fungus called a dermatophyte.

A fingernail or toenail infected with fungus will often have a yellow, thickened appearance with debris underneath the nail that crumbles easily. To determine if an individual has onychomycosis, we can perform a fungal culture which takes 3 weeks to grow.

There are topical and oral medications approved to treat this nail condition.

  • Penlac is a topical antifungal in a nail polish form that is applied to the affected nails every day until they clear. This is practical if there are only a few nails involved and the infection is mild, otherwise the effectiveness is not great.
  • The oral drug of choice is Lamisil, which is taken for a 2-3 month period (depending if it is fingernails or toenails), and has an 80% cure rate. It usually takes a full 6-12 months to see a completely normal, healthy nail again because nails only grow about a millimeter a month! There is an extremely small incidence of liver inflammation with this drug so we do need to monitor with blood tests.

If you have yellow thickened toenails that you want to look nice by spring/summer, now is the time to come in for an evaluation and to start treatment!

Warts… what you need to know.

Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called human papilloma virus (HPV). Warts are usually skin-colored and feel rough to the touch, but they can be dark, flat and smooth. The appearance of a wart depends on where it is growing. Warts are passed from person to person, sometimes indirectly. The time from the first contact to the time the warts have grown large enough to be seen is often several months.

We offer a wide variety of successful treatments for warts and we are able to customize treatments for each patient. The treatments include a prescription cream applied to the warts daily, an oral pill taken daily, freezing the wart with liquid nitrogen, or an injection into each wart with either an anti-cancer drug called bleomycin or an immunotherapy drug called candida.

Molluscum contagiosum is also a common skin disease caused by a virus which affects the top layers of the skin. The name molluscum contagiosum implies that the virus develops growths that are easily spread by skin contact. Similar to warts, this virus belongs to the poxvirus family and enters the skin through small breaks of hair follicles. It can also be spread through a warm pool or bath water. Molluscum is usually small flesh-colored or pink dome-shaped growths that often become red or inflamed. They may appear shiny and have a small indentation in the center. We have effective treatments to eradicate molluscum. These treatments include cantharidin also known as “beetle juice” which is painted on each molluscum, a prescription topical cream used at home, or removal of the molluscum via liquid nitrogen or curettage.