There are two different types of warts, both caused by virus.

Verrucae vulgaris (Common wart)

This common skin disorder is caused by a member of the papillomavirus family. It is 1 of 2 kinds of "warts" that many children experience. These warts can be transmitted by skin-to-skin contact from one site to another in the same patient and from one person to another more rarely. Spontaneous resolution in a few months to five years is the rule. About 2/3 of warts disappear without treatment within 2 years. Parents and/or children may choose to have warts treated.

Treatment options are:

• surgical removal
• cryotherapy [freezing the cells in which the virus lives]
• application of acids.
• These and other treatments such as special immune-sensitizing methods are used by some dermatologists.
  

When treatment is indicated we gladly refer to a dermatologist or if preferred we will treat in the office with cryotherapy combined with acid application.

It may take several weeks for a wart to be "cured" by any means and warts may need to be treated more than once. More than 2 visits to treat a single wart or a group of warts is unusual.

Adverse effects:

• Blistering and/or redness/inflammation around the site of freezing and acid application may be moderately painful in some patients.

Molluscum Contagiosum

This common skin disorder is caused by a member of the poxvirus family and is transmitted by skin-to-skin contact and fomites, objects contaminated by the virus. Spontaneous resolution in 2-4 years is the rule. Parents and/or children may, however, choose to have the lesions treated.

Treatment options are limited:

• curettage [removal of the lesion or wart with a sharp insturment]
• cryotherapy or freezing and application of blistering agents such as cantharidin are the most common. Cantharidin is an extract of the blister beetle that penetrates the skin fatally damaging the cells in which the virus lives.

We offer cantharidin treatment in this office or we can refer to a dermatologist that may use another method. Blistering at the application site with fatal injury of cells supporting the virus is the goal. Lesions may need to be treated more than once, but more than 2 visits to treat a single group of lesions is unusual.

Adverse effects:

• Redness/inflammation around the site of application may last up to 3 weeks.
• Itching/pain at the site generally abate(s) within 24 hrs. of application.

Reference: Silverberg NB, Sidbury R and Mancini, AJ. Childhood molluscum contagiosum: Experience with cantharidin therapy in 300 patients. J Am Acad Dermat.2000;43:503-507.

©2002 South Valley Pediatrics
page updated April 7, 2002