Wart Removal: Surgical Curettage

There are different methods available for wart treatment. Modalities of treatment range from home-based remedies for small lesions to surgery for recurrent and larger warts. Medical treatment of warts usually takes the form of topical medications that are available over the counter or, in cases of more toxic drugs, must be administered by a licensed physician.

Some forms of treatment may call for medications to be administered by mouth, while others involve injections of immunomodulating agents to the actual wart itself. While there are many modalities available, none are uniformly effective. Therefore, start with the least painful and invasive method available. However, in cases of recurrent warts or those resistant to typical remedies, you will need to get in touch with a physician to discuss other options available and suitable to your particular condition.

You might want to consider not providing any kind of treatment at all for warts, because up to 65 percent of warts spontaneously regress after two years. However, choosing not to undergo any form of treatment carries the risk of the warts enlarging or undergoing autoinoculation to spread to other areas of the body. Treatment is definitely recommended if your warts are extensive or spreading, have been present for more than two years, are cosmetically not pleasing or are symptomatic.

Surgical Curettage

Due to their generally invasive nature and the high expense involved, procedures like surgery and the use of lasers are often reserved for extensive warts or cases that do not respond to topical or oral medications. If you have a compromised immune system, you are often refractory to wart treatment, and most likely need surgical and invasive procedures.

Curettage is a form of surgical wart treatment that involves incising the wart from the skin using a sharp knife or a small, spoon-shaped tool. It is often done together with electrosurgery, where warts are burned or cauterized using an electrical current.

What to Expect

  • Recurrences – While surgical curettage can eliminate the entire wart in a single procedure, it carries risks of recurrences. Even after curettage, warts may return to the affected site because the surgery only removed the skin lesion, but failed to eradicate the human papillomavirus (HPV), the virus responsible for causing warts.
  • Pain – The actual procedure of surgical curettage is virtually painless because the surgeon or the dermatologist will infiltrate the skin around the wart with a local anesthetic. The only pain you will experience is from the injection of local anesthetic before the procedure and once the anesthetic wears off after the procedure.
  • Scarring – Unlike nonsurgical modalities, surgical curettage is more likely to cause scarring. Hence, curettage is not recommended for warts that cover extensive areas of skin or involve areas where potential scarring will be cosmetically disfiguring (for instance, the face).
  • Cost – Among all methods of wart treatment, surgery is the most expensive.
  • Duration of Treatment – Surgery is the fastest way to remove warts. However, surgical treatments require multiple follow-up consultations with your physician to ensure that there will be no complications or recurrences.
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