Management of cutaneous viral warts

The prevalence of cutaneous viral warts in the general population is estimated to be 7-12%. Many patients present to primary care with pain and discomfort along with other concerns, such as cosmetic appearance. Although cutaneous viral warts are ubiquitous, no definitive treatment exists. Nevertheless, most warts resolve spontaneously and a large proportion of the remainder respond to simple recommended treatment. For these reasons, potential treatments must have minimal side effects and a favourable risk profile.

High quality evidence based studies are lacking in this discipline owing to confounding factors such as high rates of spontaneous resolution and a subpopulation of warts that seem recalcitrant to most treatments. Occasionally in medicine the longer the list of potential treatments the less effective they seem to be, and this situation is exemplified by viral warts.1 2 This article focuses on the preferred treatment of viral warts in primary care and alternative management in secondary care.