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General Medical Questions
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Q: How do you treat HPV warts other than freezing or lasering them. Is there a cream or something you can treat them with? Also, is there a way to get rid of them?
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Rebecca Campen, M.D., J.D., is an assistant professor of dermatology at Harvard Medical School and former deputy director of the Harvard/Massachusetts General Hospital Cutaneous Biology Research Center (CBRC). She currently serves as senior advisor to the CBRC, and divides her time between clinical practice of dermatology at the Massachusetts General Hospital and private practice in Savannah, GA. Dr. Campen is the author of two books for medical students and residents, "Going Into Medical Practice" and "Blueprints in Dermatology."

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July 29, 2008
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A:

Warts are noncancerous (benign) growths of skin caused by the human papilloma virus (HPV). You can develop a wart if your skin comes in contact with the virus. This can happen by touching a wart or by coming in contact with the virus indirectly, such as by walking barefoot around a swimming pool where people with warts on their feet have walked. Your skin is especially vulnerable to infection by HPV if there are cuts or abrasions on your skin.

It is difficult to get rid of a wart, especially one that has been present for a long time. Most warts will eventually go away within a few years without treatment, but the risk of spreading the infection remains until the wart is gone. There are many home remedies for treating warts. They have varying degrees of success. For example, some people have found duct tape useful; others have not. Applying one of the over-the-counter salicylic acid wart treatments is a good first step towards treating a wart yourself, but see your doctor if the warts persist.

Your doctor may prescribe topical medications such as Retin-A or prescription-strength salicylic acid preparations or may treat the wart with cryosurgery (freezing warts with liquid nitrogen). This is a very common treatment for warts. For best results, freezing the wart every two to three weeks is necessary until the wart is gone. Electrodessication (burning), curettage (scraping the wart), laser, or surgically removing can also be effective, but scarring and the returbn of the wart often occur.

For especially resistant warts, your doctor may use a topical application of an anti-cancer drug such as 5-Fluorouracil or inject an anti-cancer drug such as Bleomycin or interferon-alfa. Trichloroacetic acid, cantharidin (extract of the blister beetle) or other irritants may also be applied.

Imiquimod, approved by the Food and Drug Administration for the treatment of genital warts, is an example of a new topical medication that uses the body's own immune system to reject the wart. Your doctor may biopsy a wart that does not respond to treatment, since some skin cancers can resemble warts.

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