Aftercare and Recovery from Wart Removal Procedures: All You’ll Need to Know

Recovery from a wart removal procedure depends on several factors. The ones of particular importance are the type of treatment done, the lesion’s location and severity and the patient’s immune status.

Your skin specialists at BHSkin Dermatology have a number of quick, safe and effective solutions even for the most stubborn warts. You might have even discussed some office procedures with your BHSkin doctor on your last visit. Understandably, questions may remain about how each treatment is performed, how uncomfortable it would be and how long it would keep you from your daily activities.

Here, we explain the recovery process from each procedure and what you can do to ensure proper healing.

What Are the Factors that Can Impact Recovery from a Wart Removal Procedure?

In-office wart treatments produce some kind of controlled skin injury. As such, recovery focuses on the post-treatment wound’s healing. Many factors affect skin repair, and your care provider at BHSkin Dermatology will evaluate your fitness for a procedure based on these.

The Lesion’s Location

The specific concerns here include occurrence in a weight-bearing area, growth on a site involved in movement, circulation and sun exposure.

The pressure from one’s weight delays healing because of oxygen depletion. Post-treatment wounds in weight-bearing areas, like the soles of the feet, need to be protected until they heal. Patients who have just undergone plantar wart removal may be advised to wear loose footwear and crutches for a while.

You’ll know that healing is well on its way when walking on the affected foot becomes comfortable again. For some individuals, this may happen in as little as 2-3 weeks, but others may need to be on crutches longer.

Other forms of pressure, such as that coming from a pen when writing, may also slow down recovery.

Sites involved in movement, like those on hand joints, may also heal slowly without immobilization. Movement stretches the contracting regions of the skin. Skin contraction is a natural body process needed to close up wounds.

Poor circulation is a complication of diseases like diabetes mellitus and peripheral arterial disease. Patients may experience slow healing, even non-healing, of wounds in areas where blood, oxygen and nutrient supply are inadequate. Doctors usually discourage invasive procedures in these sites due to the risk of non-healing and secondary bacterial infection.

Changes underneath a closed wound will continue for months, even years. Sun exposure can darken newly repaired skin and break down its new connective tissues. To get the best cosmetic results, you may need to continue sun protection long after resuming normal activities.

The Post-Treatment Wound’s Size and Shape

Smaller post-treatment wounds generally heal faster than big or scattered ones. Inflammation of small skin breaks typically subsides within a few days to a week in healthy individuals.

Meanwhile, the repair time for bigger lesions largely depends on the post-treatment wound’s shape. Thin incisions allow the skin’s top surface to contract easily, so they typically heal faster than round wounds. Stitches, skin glue, skin tape and surgical staples help speed up wound closure. They are appropriate for slit-like cuts but not for round or wide lesions.

The Wart Removal Procedure

The type of procedure influences pain severity and duration, as well as recovery time.

Generally, less invasive office procedures hurt less and only briefly. They include bleomycin injections, which produce only puncture wounds, and the non-invasive cantharidin treatment. These therapies require little to no downtime, depending on the wart’s location and other factors.

Cryotherapy is minimally invasive, but patients do not usually need numbing medication during the session. However, it will create a blister that can stay sore for days. Little to no downtime is required if it is done in non-weight-bearing areas.

Other office procedures burn the warts or create larger incisions, requiring pain medication during the session, and sometimes, afterward. They include electrosurgery and curettage, VBeam laser treatment and excision. Recovery time is variable.

The Patient’s Immune Status

When the skin breaks, immune cells go to the site to clean it up and prevent damage spread. They initiate inflammation, killing off any microbes that may be present in the area. Healing starts after the immune cells have done their job. Individuals with poor immune status, such as persons with HIV and diabetes mellitus, are at risk for delayed recovery or non-healing.

Other Factors that Can Delay Wound Healing and Recovery

A number of other health factors can also slow down healing and recovery time. They include the following:

• Clotting abnormalities, as clotting is the first process that closes up a wound. Liver disease, inborn clotting disorders, low platelet counts, blood thinner intake, etc. can put patients at risk of significant bleeding and wound non-closure.
• Treatments that suppress the immune system, such as steroid intake and radiotherapy in a nearby site.
• Factors that prolong the inflammatory process, like post-treatment wound infection and bruising (hematoma) and radiotherapy in a nearby location. Foreign bodies like dirt and retained gauze can irritate the skin further and delay recovery.
• Connective tissue disease, since wound healing generates a lot of new connective tissues. Therefore, healing would be difficult for individuals with conditions like Ehlers-Danlos syndrome, SLE, etc.
• Malnutrition, because the formation of new connective tissues requires healthy levels of proteins, carbohydrates, fats and vitamins.
• Surgery in another body part, because the other post-surgical wound will divert nutrients from the wart removal site.
• Age, because elderly individuals typically experience slower wound healing than younger ones.
• Smoking, because it introduces free radicals and other toxins that can delay recovery. It also causes blood thickening and blood vessel narrowing, both of which deplete the wart removal site of oxygen and nutrients.

To ensure fast recovery, doctors will advise measures that can hasten skin repair. Post-treatment wound care, proper diet and rest, medication adherence and avoidance of smoking can all help shorten your downtime.

What Can You Expect During the Procedure, and How Do You Treat the Area After Wart Removal?

As previously mentioned, office wart treatments differ according to their level of invasiveness. Consequently, they require different pain management approaches and aftercare regimens. The type of procedure also determines the need for post-treatment activity limitation and repeat sessions. Below, we describe these aspects for the office wart treatments that BHSkin Dermatology specializes in.

Cryotherapy

What to expect: In this procedure, the doctor will freeze the wart with liquid nitrogen. It is quick and may be done in a few minutes. Some patients try thinning the wart down beforehand with buffing and salicylic acid, but cryotherapy requires no pretreatment preparation.

Is cryotherapy painful? During the procedure, you will feel a cold sensation and some discomfort on the site, which will last only a few seconds. Numbing medication is usually not required. The area will get inflamed and blister within 24 hours. Blistering may cause mild to moderate pain for a few days.

Downtime: The recovery period after cryotherapy depends on the body part involved. You may resume normal activities as soon as it is done. However, if the treated area is in a weight-bearing or repeatedly compressed location, you may have to protect it for a week to let it dry up before returning to your usual routines. The site can be washed while bathing.

Aftercare: The blister will need a plaster for protection. It is expected to form a scab a week after treatment. However, if it breaks before scabbing, make sure to apply an antiseptic on the site and avoid touching the fluid. The scab will fall off on its own. Until then, do not pick at the site, as that will spread the virus.

Cryotherapy rarely leads to bacterial infection, but call your doctor if the wart removal site develops signs of infection. One or two treatments may be enough for small warts, but bigger ones will require more.

Cantharidin

What to expect: The doctor will apply a chemical on the wart and cover it with non-porous tape. It should take only a few minutes. Cantharidin application does not require any pretreatment preparations.

Is cantharidin treatment painful? Cantharidin application itself is painless, but blistering will occur in 1-2 days, making the site feel tender. The discomfort will go away in 4-7 days as the blister dries up.

Downtime: As in cryotherapy, the downtime for cantharidin treatment also depends on the body part involved.

Aftercare: The doctor will instruct you to wash the area with soap and water after 4 hours. You can take it off sooner if you feel a burning sensation or severe pain on the site. You may wash the treated area while showering and cover it with a plaster afterward.

Occasionally, patients develop bigger, more painful blisters, needing fluid drainage. If this happens, you may apply an antiseptic solution to the area then prick one side of the blister with a sterilized needle. Do not touch the fluid or remove the blister roof. Dry the area with gauze and sterilize it again once drainage is done.

The wart will dry up a week after the treatment. Your doctor can clip the dead wart on follow up if it has not fallen off by then.

Complications are rare after cantharidin treatment, but call your dermatologist if you experience severe bleeding, itchiness or pain. Resistant warts will require multiple sessions.

Electrosurgery and Curettage

What to expect: The doctor will clean the area and give you numbing medication before the treatment. A small blade or spoon-like device will be used to scoop out the wart. A pen-like, electric heating device will stop the bleeding and burn the rest of the growth. The session’s duration depends on the wart’s severity, but it usually takes about 15 minutes, which includes the injection of the numbing drug.

The procedure creates a round or wide wound that will not need suturing. Depending on your health status, your dermatologist may advise you to get medical clearance or stop some medications a few days before the session.

Are electrosurgery and curettage painful? The combined treatment is painless because of the anesthetic, but the site may feel tender for 1-2 weeks, requiring over-the-counter painkillers.

Downtime: The recovery period after electrosurgery and curettage depends on the post-operative wound’s depth, size, and location. You may be advised to avoid exertion in the first 1-2 weeks. Wounds from this procedure take 2-4 weeks to heal.

Aftercare: Your doctor will give you specific post-operative wound care instructions. Generally, the wound is kept dry and bandaged for the first 24-48 hours to let it clot properly. You can then wash it afterward with gentle soap and water. Change the bandage regularly.

If done expertly, electrosurgery and curettage rarely cause complications. However, you may call your doctor if you experience severe pain, bleeding, and fever, or if the site develops a yellowish discharge.

Warts need only one session of electrosurgery and curettage.

Excision

What to expect: The doctor will clean the area, inject a numbing medication, cut out the wart then close the wound. The whole session takes about 15-30 minutes.

The procedure will create a wound that may be cauterized or stitched up. Depending on your health condition, your dermatologist may advise you to get medical clearance or avoid some medications a few days before your appointment.

Is wart excision painful? The procedure itself is painless because of the numbing medication, but the site will feel tender for a couple of weeks. You may need pain medications after your session.

Downtime: Recovery from wart excision depends on the lesion’s size, shape and location. You may be advised to avoid strenuous activities for 2-4 weeks to avoid trauma to the site. You may use crutches to relieve the pressure from plantar excisions.

Aftercare: The specialist will advise you about proper wound care, similar to that in electrosurgery and curettage. Call your doctor if you experience severe pain, bleeding, and fever, or if the site develops signs of infection.

Warts need only one session of excision surgery.

VBeam Laser Treatment

What to expect: Your dermatologist will use a powerful light beam to break down the wart’s blood vessels. Each session takes about 15 minutes to 2 hours, depending on the problem’s severity.

Prior to your appointment, the doctor may ask you to avoid sun exposure, chemical peels, vitamin A-containing medications and other treatments that may cause your skin to become photosensitive.

Is VBeam laser treatment of warts painful? Your care provider will use a device that sprays a cold, numbing mist on the skin while the laser is being applied. Most patients experience minimal discomfort during the procedure, although warts in sensitive areas may need topical pain medication. The site may feel mildly tender for up to 2 weeks.

Downtime: The duration of the recovery period after laser surgery depends on the wart’s size, distribution and location. Downtime is minimal if it is small and away from the plantar areas or other frequently compressed sites. Otherwise, recovery will take a few weeks.

Aftercare: The wart will dry up in 1-2 weeks, and the site may turn black as it heals. Keep it clean, dry and sun-protected. You may experience some itching or bruising, but it will go away in a few days. Avoid picking at the area before it fully heals

Drink plenty of fluids. Your body will help in clearing the site of dead cells and infection, making hydration important.

Some warts respond immediately to VBeam laser treatment, but most cases require multiple sessions.

Bleomycin Injection

What to expect: Your dermatologist will clean the site and inject an anti-cancer drug into the wart. It should take only a few minutes. Brief, pinpoint bleeding may occur. Bleomycin injection does not require pretreatment preparations.

Is bleomycin treatment of warts painful? A bleomycin shot can cause discomfort on the injection site, but numbing medication is usually not necessary. Warts in the palms and plantar areas may be more sensitive to the injections. Slight tenderness may persist for up to 2 weeks.

Downtime: Bleomycin injections require no downtime. You may proceed with your normal activities after the session.

Aftercare: Rarely, patients experience wart bleeding at home. If this happens, you may dress up the site with clean gauze and elevate the affected body part. Keep the area clean and dry. Call your doctor for persistent bleeding, signs of infection, severe pain or intolerable allergic reactions.

Bleomycin is not injected in a hairy area or close to the nails, as it can affect hair and nail growth. It can also cause uneven skin tone on the wart removal site.

Bleomycin responses vary, but most patients require at least 4 sessions spaced 3-4 weeks apart. Drying up of the wart indicates that the treatment is effective.

The table below compares the recovery processes of the different office wart treatments that we just described.

As in any other health condition, treatment success depends on the care provider’s expertise. However, a large part of your recovery also depends on your adherence to the aftercare regimen. Your doctor at BHSkin Dermatology will discuss other important details with you and walk you through a personalized treatment plan.

Conclusion

In-office wart treatments result in limited skin injury, so recovery depends on factors that can affect wound healing. Foremost of these factors is the type of procedure performed because it also impacts pain management, aftercare, the need for post-treatment activity limitation and treatment efficiency. Choosing the right dermatologist ensures the procedure’s success, but aftercare adherence increases the chances of a speedy recovery.

Stubborn Warts? Not a Problem! The Best LA Dermatologists Got You

Warts are persistent, infectious lesions that can ruin your perfect complexion and become a source of personal distress. Still, they are no match for the expertise of our specialists at BHSkin Dermatology. They can get rid of any stubborn wart without leaving unsightly marks on your skin. Come pay us a visit at our Encino and Glendale clinics or connect with us through our virtual portal for telederm consults.

Book your appointment today so you can be one step closer to having that flawless complexion you’ve always wanted!

Author: Don Mehrabi

Dr. Don Mehrabi is a board-certified dermatologist providing medical care to patients in the Beverly Hills, California area at BH Skin Dermatology.