How to Safely Pare Down a Cutaneous Wart on Your Hand
Paring down a hand wart before treatment is recommended to remove the thick keratin layer that blocks penetration of topical medications, and should be done carefully to avoid abrading surrounding normal skin, which can spread the infection. 1, 2
Paring Technique
Soak the wart first in warm water for 5-10 minutes to soften the thickened skin before attempting to pare it down 1, 3
Use a disposable emery board, pumice stone, or callus file to gently rub down the wart surface, removing only the white, thickened keratin layer 1, 2
Avoid cutting or abrading the surrounding healthy skin, as damaging adjacent tissue can spread the viral infection to new areas through autoinoculation 1, 4
Stop if you see pinpoint bleeding, which indicates you've reached the capillary loops of the elongated dermal papillae—this means you've pared deep enough 1
Discard the paring tool after use or dedicate it solely to the wart to prevent spreading infection 1
When to Pare
Pare before each application of salicylic acid to maximize penetration of the medication into the wart tissue 1, 2, 4
Paring should be done immediately before treatment, not hours in advance, to ensure the medication reaches viable wart tissue 2
Common Pitfalls to Avoid
Do not use the same paring tool on healthy skin or other body areas, as this spreads the human papillomavirus infection 1, 4
Avoid aggressive paring that causes bleeding or pain, as this damages surrounding skin and increases infection spread risk 2, 4
Do not pare if the area is inflamed or infected—wait until any secondary infection resolves before resuming treatment 1
After Paring: First-Line Treatment
Apply salicylic acid 15-26% daily after paring, as this combination has the strongest evidence (Level 1+, Grade A recommendation) for treating hand warts 1, 2
Consider occlusion with a bandage or tape after applying salicylic acid to enhance penetration and effectiveness 1, 2
Continue treatment for a full 3-4 months before considering it a failure, as premature discontinuation is a common reason for treatment failure 2, 4