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Warts and verrucae - Management
How should wart/verruca treatments be applied?

  • Topical salicylic acid:
    • Before applying, soften the area by soaking it in warm water for 5–10 minutes.
    • Peel off any film remaining from the previous application.
    • Avoid applying the treatment to the surrounding skin.
    • Debride the surface of the wart/verruca with an emery board once or twice a week, to remove excess hard skin.
    • Do not apply to the face or areas that are extensively affected because of an increased risk of skin irritation and scarring.
  • Cryotherapy:
    • Only practitioners who have been trained in the use of cryotherapy should carry out this treatment.
    • Before performing cryotherapy, obtain informed consent and document:
      • When cryotherapy is undertaken.
      • The thaw times and freeze times used.
    • A spray is commonly used to apply liquid nitrogen. The spray is applied until a halo of frozen tissue appears around the wart, and is then timed for 5–30 seconds depending on the site and size of the wart.
    • Cotton buds may be preferable when treating children or for warts near the eyes. If cotton buds are used, to reduce the possible transmission of viruses:
      • Decant liquid nitrogen into a separate disposable container (from a Dewar flask).
      • Use one cotton bud for each person treated, discard left-over liquid nitrogen, and keep the Dewar flask cleaned and full.
  • Duct tape:
    • Cover the wart with duct tape for 6 days (if the tape falls off, apply a fresh piece).
    • Remove the tape after 6 days, soak the wart in water, and gently debride with an emery board or pumice stone.
    • Leave the wart uncovered overnight and reapply a fresh piece of duct tape the next day.
    • Continue treatment for up to 2 months.

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