Human papillomavirus infection: treatment options for warts

Human papillomavirus can produce verrucae, or warts, on cutaneous and mucosal surfaces. Although the diagnosis is usually straightforward, issues regarding the need for treatment and the choice of treatment are complex. The rationale for the treatment of viral warts is based on the prevention of spread to other areas of the body or to other people; the prevention of irritation, bleeding and other unwanted local effects of the wart; cosmetic and psychosocial considerations, and the possible association with neoplasia. A significant proportion of warts resolve spontaneously within two years. Many treatment options appropriate to primary care are available, including local application of salicylic acid, cantharidin, liquid nitrogen and podophyllum. Direct injection of interferon is a choice in selected cases. The decision to treat and the choice of modality must be individualized.