From the Guidelines
Treatment options for warts include both at-home remedies and medical interventions, with the most recent and highest quality study recommending salicylic acid, cryotherapy, and imiquimod cream as effective treatments. For common warts, over-the-counter salicylic acid products (like Compound W or Dr. Scholl's) are effective first-line treatments, applied daily for several weeks until the wart disappears 1. Cryotherapy with liquid nitrogen is a common medical treatment where a healthcare provider freezes the wart, typically requiring multiple sessions spaced 1-3 weeks apart. For stubborn warts, prescription-strength treatments may be necessary, including stronger salicylic acid formulations, prescription retinoids, or immunotherapy agents like imiquimod cream.
Some key points to consider when treating warts include:
- Protecting surrounding healthy skin during treatment
- Continuing treatment until the wart is completely gone to prevent recurrence
- Considering the patient's preference, available resources, and the experience of the healthcare provider when choosing a treatment
- Being aware of the potential side effects and interactions of each treatment option
For genital warts specifically, treatments include:
- Podofilox (0.5% solution for home use), applied twice a day for 3 days, followed by 4 days of no therapy, for up to four cycles 1
- Imiquimod cream (applied 3 times weekly for up to 16 weeks) 1
- Cryotherapy with liquid nitrogen or cryoprobe, repeated every 1-2 weeks 1
It's essential to note that the safety of some treatments during pregnancy has not been established, and certain treatments may weaken condoms and vaginal diaphragms. Therefore, it is crucial to consult a healthcare provider to determine the best course of treatment for individual cases of warts.
From the FDA Drug Label
It is recommended that patients wash their hands before and after applying Imiquimod Cream. Imiquimod Cream should be applied 3 times per week to external genital/perianal warts. Apply twice daily morning and evening (every 12 hours), for 3 consecutive days, then withhold use for 4 consecutive days
The treatment options for warts include:
- Imiquimod Cream: applied 3 times per week to external genital/perianal warts until total clearance or for a maximum of 16 weeks 2
- Podofilox Topical Solution 0.5%: applied twice daily for 3 consecutive days, then withheld for 4 consecutive days, and repeated for up to four weeks 3
From the Research
Treatment Options for Warts
- Cryotherapy: a common treatment method that involves applying liquid nitrogen to the wart, resulting in a cure rate of 39% after 13 weeks 4
- Salicylic acid: a topical treatment that can be applied daily, with a cure rate of 24% after 13 weeks 4
- Combined cryotherapy and salicylic acid: a treatment regimen that combines in-office cryotherapy with daily application of 70% salicylic acid, resulting in a cure rate of 89.2% 5
- 5-Fluorouracil 0.5%/salicylic acid 10% solution: a topical treatment that has shown effectiveness in treating ano-genital warts, with a response rate of 88% after 3 months and 94% after 6 months 6
- Monochloroacetic acid: a treatment that has been shown to be an effective alternative to cryotherapy for common and plantar warts, with cure rates of 43% and 46% respectively 7
- Topical zinc oxide: a painless and safe treatment option that has shown efficacy in treating warts, with a cure rate of 50% 8
Comparison of Treatment Options
- Cryotherapy is more effective than salicylic acid for common warts, but not for plantar warts 4
- Combined cryotherapy and salicylic acid is more effective than cryotherapy alone for plantar warts 5
- 5-Fluorouracil 0.5%/salicylic acid 10% solution is a effective treatment option for ano-genital warts, with fewer side effects compared to other treatments 6
- Monochloroacetic acid is a effective alternative to cryotherapy for common and plantar warts, with less treatment pain and burden 7
- Topical zinc oxide is a painless and safe treatment option that can be considered for patients who are looking for a non-invasive treatment 8