Problem with Wart Removal and When to Consider Surgery

Dear Ask The Doctor:  I have a huge wart on my right elbow, approximate size: 2cm x 2cm. I have had it for about 7 years, it started as a little wart but then I scraped it on the dirt in a game of Rugby and most of the wart came off but now it has grown back much bigger. I have been to see a nurse about it but they said that liquid nitrogen (freezing method) was the only option for me, I asked about surgery because it is very large and freezing would take at least 6 sessions. What other options are there for me? Thank you
 

Dear Patient:  Surgery is not a common option for wart removal and it is unlikely anyone would perform it without attempting other methods of treatment first.
The most common method of wart removal is cryotherapy. This is where liquid nitrogen or other freezing agents are used to kill the virus causing the wart.  Often multiple treatments are required on a weekly basis.  This method is relatively low risk when done by trained individuals.
When cryotherapy fails or individuals are not able to come in for weekly treatments.  Topical immune system modulators such as Aldara cream can be applied to kill the virus.  Treatment often takes a minimum of 12 weeks.
If any or all of the above methods fail, surgery may be considered.

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