Wart also known as Common wart/ plane wart.

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Warts come in different shapes and size and can grow in different areas such as finger tips, toes , soles of our feet (squeezed by our body weight into different shapes) and face. 

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One of our patients, Ms Chan went to a nearby nail salon and enjoys some free feet cleansing and massages. Afterwards, she started to notice some lumps on the sole of her feet and was seen later at our clinic, diagnosed to have plantar warts and need cryosurgery to remove them. 

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Wart is one of the most common skin disease of our generations, even more so than fungal infections of our toe nails. Thus, you will need to pay attention to the hygiene conditions of places where you might go barefooted such as swimming pool and it’s best to wear slippers where in doubt. It is quite common to have quite a number of warts on the feet when patients come to us as people don’t quite often examine their feet.

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Wart is the skin infection by the virus of Human papillomavirus. The virus live in a moist environment such as washroom, changing rooms and swimming pools. It can be spread from human to human especially when there is small cuts or wound in our skin. Wart will only grow on our skin or mucous membrane and will not spread inside our body. However, the numbers of wart can range from a few to more than a hundred. 

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Treatment of Skin wart:

1. Topical acids: Some medical grade acids in topicals can slowly shrink the wart and our own immune system will remove it slowly. It takes time though. 
2. Topical medicinal cream: they are used to enhance our skin immune system to combat the virus
3. Cryotherapy: using extreme low temperature of liquid nitrogen to spray to the wart and kills the virus. 
4. Electrosurgery: using surgical instruments to remove the warts and then stop the bleeding by electrosurgery equipment, needs to apply local anaesthetic beforehand
5. Laser: using CO2 laser as a tool to remove the wart, need local anaesthetics as well. 
   

Comparison of three main surgical methods of removing Warts

Cryotherapy

Using special equipment and containers, liquid nitrogen is sprayed onto the lesion. The extreme low temperature will freeze the lesion and its surrounding skin. The lesion will gradually come off in 1 weeks time. 

Pros: No need for aesthetics, no surgical wound, can manage more than 1 lesions in 1 treatment sessions

Cons: may have small blisters, many patients need more than 1 treatment to cure the wart. The treatments are separated by two weeks time

Electrosurgery

Apply local anaesthetics, then Using Surgical blades to remove the wart, and then using electro-surgical units to stop any bleeding. 

Pros: can treat many many warts in one treatment session and most warts can be removed in one go

Cons: there might be surgical scars

Laser 

After applying local anaesthetics by injection or topicals, Use CO2 laser to remove the lesion and to stop the bleeding at the same time

Pros: lower risk for scarring and infection compared with electrosurgery (low already)

Cons: there still might be surgical scars, cannot treat too many lesions in 1 session

As to the choice of treatment options, as you can see, there are different pros and cons for each option. Our specialist will discuss with the patient as to the best option for each taking into consideration on their values and expectations. In a general sense, we can still safely use cryotherapy as a safe and effective treatment for pregnant ladies with warts. 

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