From the Guidelines
The best treatment approach for a small protrusion wart on the right cheek is topical salicylic acid (15-27%) applied daily for several weeks, as it is a gentle and effective method for treating facial warts with minimal risk of scarring. According to the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1, salicylic acid formulations are the most common preparation used in the treatment of viral warts, and they work by promoting exfoliation of epidermal cells and stimulating host immunity.
For facial warts, the guidelines recommend using salicylic acid cream or ointment at a concentration of 2-10% or cautious use of salicylic acid paint at 12-17% without occlusion 1. This approach is preferred for facial warts because it minimizes the risk of scarring.
Some key points to consider when treating facial warts include:
- Avoiding picking or scratching the wart to prevent spread of the virus
- Using gentle treatments to minimize scarring
- Considering alternative options such as cryotherapy or imiquimod 5% cream if the wart does not respond to initial treatment
- Referring the patient to a dermatologist if there is uncertainty about the diagnosis or if the wart does not respond to treatment.
It's worth noting that the guidelines also mention that plane warts on the face are mainly a cosmetic problem and spontaneous clearance can often be awaited 1. However, if treatment is necessary, topical salicylic acid is a safe and effective option. Cryotherapy with liquid nitrogen is also an option, but it may be more likely to produce scarring on the face 1.
From the FDA Drug Label
Directions On cleansed, completely dry skin, apply a thick, even layer directly on the blemish or blemished areas avoiding eye area, eyebrows, and hairline. Do not rub in. IN the morning or when product is dry to the touch, gently peel off starting from the outer edges of the spot. Rinse any residue with warm water. The best treatment approach for a patient with a small protrusion wart on their right cheek is to apply salicylic acid topically, following the directions for use, which involves applying a thick layer to the affected area and gently peeling it off when dry, while avoiding sensitive areas like the eye, eyebrows, and hairline 2.
- Key considerations:
- Apply to cleansed, completely dry skin
- Avoid eye area, eyebrows, and hairline
- Do not rub in
- Gently peel off when dry to the touch, starting from the outer edges of the spot.
From the Research
Treatment Options for Warts
- Cryotherapy with liquid nitrogen: This method has been shown to be effective in treating cutaneous warts, with a cure rate of 39% after 13 weeks 3.
- Topical salicylic acid application: Salicylic acid has been found to be effective in treating warts, with a cure rate of 24% after 13 weeks 3. A study also found that a combination of cryotherapy and 70% salicylic acid was successful in eradicating warts in 89.2% of patients 4.
- Topical zinc oxide: Zinc oxide has been shown to be an efficacious, painless, and safe therapeutic option for wart treatment, with a complete cure rate of 50% in one study 5.
- Cantharidin-Podophyllin-Salicylic Acid (CPS) formulation: This formulation has been found to be effective in treating recalcitrant plantar warts, with a case report showing complete resolution of multiple warts after three sessions of CPS formulation 6.
Considerations for Treatment
- Location and type of wart: Different treatments may be more effective for different types of warts, such as common warts or plantar warts.
- Patient's health condition: The patient's overall health and any underlying conditions should be taken into account when choosing a treatment.
- Previous treatments: If the patient has previously tried other treatments without success, a different approach may be necessary.
Specific Treatment for a Small Protrusion Wart on the Cheek
- Given the location and type of wart, topical treatments such as salicylic acid or zinc oxide may be suitable options.
- Cryotherapy with liquid nitrogen may also be effective, but should be used with caution to avoid damaging the surrounding skin.
- It is recommended to consult with a healthcare professional to determine the best course of treatment for the individual patient 4, 5, 3.