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WARTS - CUTANEOUS
Treatment Guideline Chart
Cutaneous warts, also called verrucae, are benign proliferations of skin caused by human papillomavirus (HPV).
Most common warts on the hands and feet are due to HPV types 1, 2, 4, 27 & 57.
HPV is usually transmitted by contact with skin of an infected individual or by transmission of virus living in warm moist environment.
Autoinoculation may occur from traumatizing lesions by biting or scratching.
Incubation period is unknown but may range from months to years.

Surgical Intervention

Surgical Removal

  • Although the success rates are reported to be 65-85%, surgical excision by curettage & cautery is not recommended as a standard therapy
    • Can be painful & cause scars that are difficult to treat
    • No assurance that warts will not recur
    • Recurrence rates can be as high as 30%

Electrocautery

  • Need to 1st anesthetize the area then remove verruca w/ surgical blade
    • Follow w/ carbonizing the surface w/ electrosurgical probe or hyfrecator tip
    • Repeat as necessary after removing charred tissue w/ moist gauze
  • Effects: Large warts on the torso, plantar warts or resistant warts may respond well to a single treatment of electrocautery
  • Scarring, pain & recurrence of warts can occur

Excision/Curettage

  • Filiform warts benefit from snip or shave excision
  • Surgical excision of wart should only be done if diagnosis is questionable
    • Recurrence of disease w/in scar tissue, scarring, delayed or inadequate healing may occur
  • Curettage of verrucae may be acceptable when treating isolated warts
  • Not recommended for plantar warts due to development of painful scars
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