Dr Phil: How can I remove warts on my four-year-old's fingers?

Pic: iStock

My seven-year-old son has developed four small warts on his fingers, which are not painful or itchy. He picks them when bored, though I’ve asked him not to. I used an over-the-counter medication but it didn’t work. What would you recommend?

Warts on the hands and feet are so common almost everyone has at some stage had them.

Warts are caused by papillomavirus, which gets into the skin following contact, and although we have all been told that you get them from swimming pools, research has failed to show you can contract the virus from surfaces.

Warts are tricky to treat as the virus hides from the immune system quite effectively. Eventually, the immune system spots it, and the warts tend to resolve quickly. In many cases, you can go from having a dozen different warts that have been present for years to all of them clearing up in the space of two to three weeks.

Most warts will disappear within 12-18 months of appearing and don’t cause any medical issues, so it is reasonable to leave them alone.

Picking at warts is very common and often doesn’t cause them to spread or last longer. This is not always true for warts at the edge of fingernails or toenails as trauma can make them bigger. Also, if your son bites his nails, this is a good reason to stop, as the warts will heal faster if he does.

The three first-line treatments for warts are topical/surface, cryotherapy (freezing) and occlusion. These treatments can and often are combined.

Topical treatment is usually with salicylic acid, which breaks down the surface of the wart while also prompting an immune response in the area. The solution should be applied every evening to dry skin and once per week the dead hard skin should be removed with an emery board. Soaking the skin beforehand can make this easier and more comfortable.

Most GPs provide cryotherapy, which involves applying liquid nitrogen to the wart to freeze it. This is not to ‘freeze the wart off’ but to cause damage to the virus and make it easier for the immune system to clear it. The big downside to this is that it can be quite painful, and I personally don’t usually offer this treatment to children younger than 12 for this reason.

Occlusion therapy is an interesting one. This involves applying silver-backed duct tape to the wart and leaving it in place for six out of every seven days. On the seventh day, remove the tape and any hard skin from the area and reapply. There is some argument over whether or not this is effective, and the studies to answer this question were never satisfactory, but I reckon there is no harm in trying it.

The main take-home with any of these treatments is they take time, and you should commit to at least six weeks of treatment before giving up on it.

If you have a question for Dr Phil Kieran, please send it to [e-mail]