4. What are the different treatments for warts?
5. How many treatments will I need?
6. What should I expect after liquid nitrogen treatments?
7. Is there anything that can help decrease the burning from liquid nitrogen treatments?
8. How do I use the combination solution I was prescribed?
9. How does Aldara work?
10. The instructions you gave me are different than the information that came with the Aldara, why is that?
11. I thought Tagamet/cimetidine was used for heart burn, why am I using it for my warts?

1. What are warts?
Warts are common growths that occur as the result of exposure to a virus (human papiloma virus, HPV).


2. Are warts contagious?
Yes. The viral nature of these warts allows them to spread from person to person by direct contact. Warts can also occur from contact on pool decks, public gyms, showers, etc. The virus is hard to avoid as it is "everywhere."


3. Should warts be treated?
Yes. Untreated, warts can spread and multiply. In addition, in particular locations, they can increase in size and cause discomfort. Because of this, it is a good idea to have warts treated.


4. What are the different treatments for warts?
Treatments for warts can be divided in two main categories. The first is destructive therapy. This includes treatment such as liquid nitrogen (freezing), burning the areas, surgery, laser, etc. The second method is know as immunomodulatory therapy. What this means is that through the use of medications, we try and increase the activity of your immune system to help fight of the virus that causes the wart. This method includes the over the counter methods (salicylic acid) as well as new treatments including Aldara and fluorouracil.


5. How many treatments will I need?
Unfortunately, this is unpredictable. Some times, one is enough, while other times it takes many repeated treatments to achieve total clearance. The reason for this is that it is a matter of when your body's immune system helps to get rid of the virus. In general, warts on the feet and around the nails are the most difficult to get rid of.


6. What should I expect after liquid nitrogen treatments?
In general, the treatments can burn during the application of the liquid nitrogen but this burning quickly improves. A few days after the treatment, you will notice the area getting red and puffy. A blister may form. If a blister occur, it is OK to lance the area with a pin (after boiling or cleaning with alcohol) to relieve the fluid. Then, the area will form a scab and then peel off. The whole process usually takes between 2-4 weeks. Sometimes, on the feet, you can form a blood blister. This should not cause concern.


7. Is there anything that can help decrease the burning from liquid nitrogen treatments?
For patients that need treatment with liquid nitrogen and want to decrease the burning feeling, there are products available over the counter to help numb the skin. These products, EMLA and Elamax (5%) cream should be applied 1 hour prior to the treatment.


8. How do I use the combination solution I was prescribed?
Our office uses a combination solution that we have especially mixed up to help with your warts. If this is the treatment chosen for you then it should be applied nightly as follows:
A. Soak the area in warm water for 5 minutes
B. Pare/file the area with a file or pumice stone
C. Apply a thin layer of the solution
D. Wait 2 minutes and then re-apply another thin layer of the solution
E. Cover the area


9. How does Aldara work?
Aldara works by increasing the activity of the part of your immune system that fights viruses. By putting this directly on the warts, the immune system will hopefully help to clear the wart.


10. The instructions you gave me are different than the information that came with the Aldara, why is that?
Aldara is used for many things, but is currenlty only FDA approved for the treatment of genital warts. Because of this, the instructions you received from our office may be different than that on the package information. In most cases, you should use the medicine daily to the warts. Also, it is OK to re-use the packages, you DO NOT have to throw them out after a single use. If you have any questions about the use of this medication, please contact your doctor.


11. I thought Tagamet/cimetidine was used for heart burn, why am I using it for my warts?
Tagamet/cimetidine is an antihistamine. In addition to helping control acid, taking cimetidine can help boost the immune system response. By taking this, this may help to eliminate the virus causing your warts.