Introduction

Warts are a viral infection acquired by contact with a person with warts. It is unusual for the virus to enter intact skin but it may enter through small cuts. Warts are found in 5-10% of school children but are less common in adults. 65% disappear within two years without treatment, and 93% within 5 years.

Primary care

Treatments is:

	Salicylic acid paints - achieves 67% cure rate at 3 months
	Cryotherapy (i.e. freezing with liquid nitrogen) – achieves 69% cure rate within 3 months. This treatment is painful and few children under 10 can tolerate it, however cryotherapy has the advantage that the patient does not have to remember to use the treatment every night and it has a powerful placebo effect.

 

Referral Advice

Most patients with warts can be managed in primary care. Referral to specialist services is advised if:

 

	The warts fail to respond to a least six months of wart paint applied daily
	The warts fail to respond to cryotherapy for at least six months at four weekly intervals

 

Immediate

Urgent

Soon

Routine

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