Warts of the hands and feet are common in children. Over 25% of children will have at least one wart of the hands or feet during childhood. These childhood warts are caused by viruses and are benign (non- cancerous). About 50% of childhood warts will resolve without treatment within one year. While warts are not harmful, they can be very annoying for children and their families. Here are some of my management tips for warts:

-If a wart is growing and bothersome to your child, the best over-the-counter/at home treatment is Compound W (salicylic acid). Compound W helps peel away the upper layers of a wart so you can get to the core of the wart, where the causative virus is living. It can take up to 3 months to remove a wart, so persistence is key. I recommended applying a thin layer of Compound W to a wart, then 24 hours later using a nail file or pumice stone to remove the dead skin and reapplying Compound W. Continue this 24 hour cycle until the skin appears back to normal (no longer thickened and peeling).

-If a wart is not improving after 2-3 weeks of at home Compound W and filing, there are more aggressive treatment modalities we use in clinic. Typically in clinic, we trim a wart down with a scalpel, then use liquid nitrogen spray to treat the wart virus. Because the wart virus is very persistent and present in multiple skin layers, even an in-clinic freezing treatment is just a “jump start” to killing off the wart. Several days after being seen in clinic for a freezing treatment, resuming Compound W and filing at home is recommended.

-In cases where warts are in a sensitive location or not responding to our traditional treatment methods, we may send a patient to a dermatologist where a wart can be surgically removed by “scooping out” the entire wart area and removing the virus from the area.

The bottom line with warts is that they require very persistent treatment. Outside of surgical excision, there is no quick treatment for warts. Starting Compound W early in the course of a wart can help children heal faster, but be prepared to be treating daily for weeks to months.