There are two types of warts, and you rarely need to come see us for either of these:
Regular warts. These are the classic rough-topped wart that you can treat with OTC salicylic acid liquid (I like the liquid better than the band-aid type). They are caused by a virus. Simply apply the liquid on every night at bedtime, let it dry, and it works overnight while your child sleeps. It takes about 1 to 3 months for the acid to dissolve enough skin around the wart for you to then peel the wart out of its crater. You can also try duct tape (read online for directions) or homeopathic remedies like Naturasil or others.
These may start as firm lumps under the skin and may be slightly painful at this stage, especially if on the foot (plantar wart). I suggest waiting until the wart surfaces before starting treatment. Your child may get a few more warts during the months of treatment and that’s fine.
I can see you for an appointment to freeze off the warts if your child only has a few. If you have more than five, OR if the warts are on a cosmetically important area, I’d suggest a dermatologist instead. It is possible, however, that freezing may cause more spread of the warts than using the OTC wart acid. There’s no reason to see me to help you confirm the warts – just look online for pictures if you aren’t sure.
Molluscum warts. These are a different type of wart caused by a different virus. Look online for pictures as these have a very distinctive appearance. They are smaller than regular warts, varying in size from a pin head to half a pencil eraser head. They have a smooth dome-shaped top with a dimple in the middle, are slightly white-ish and skin-colored, and seem to be filled with a thick gel. They may also itch (relieve this with Benadryl or any anti-itch cream). They can occur as a single wart, but more often form clusters in any area of the body. They will almost always spread around and form a few dozen warts.
These will persist for about 12 to 18 months, then the immune system will eliminate the virus and the warts will fade away (it takes that long for our immune system to recognize the virus as foreign and attack it). New ones will crop up during this time, but will usually fade no longer than 18 months from when the first ones started.
I feel it’s best to just leave these alone and let them run their course, especially if they don’t bother your child and are covered by clothing. Treating them may cause irritation and more spread. If they irritate your child or occur on a part of the body that is visible to others and your child is embarrassed, you can try treating them.
OTC homeopathic remedies (like Naturasil or Zymaderm) may work. OTC wart acid isn’t recommended for these. A dermatologist can use a product made from the saliva of a beetle that irritates each wart and causes them to fall off (but these can cause some considerable irritation and spread). I only recommend such treatment when a child really needs them taken care of. Otherwise, just wait out the 18 months.
They are contagious, so avoid sharing bath-time with your child. They aren’t contagious enough to avoid school or normal daily contact with family and friends.
