Dermatology Center of Northwest Houston Dermatology Center of Northwest Houston - Lisa D Hitchins MD : (281) 256-2000
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Warts - Kissed any Frogs Today?

Warts – Kissed any Frogs Today?Warts are harmless outgrowths on the skin caused by human papilloma virus (HPV) infection. They grow on all body parts including face, fingers, feet, legs, hands, knees, inside your mouth, and on the genital and rectal areas.

Warts are classified into different types based on the area of the body on which they appear:

  • Common warts - Appear on fingers, hands, knees and elbows; small, rough, greyish brown fleshy bumps with or without black dots
  • Plantar warts - Appear on the bottom or soles of your feet; light brown bumps with tiny black dots in them
  • Genital warts - These appear on the genital and rectal areas and are sexually transmitted
  • Flat warts - These appear in places which are frequently shaven; they are smaller and smoother than other warts and can be pink, brown or yellow and can appear in clusters

Warts can spread from one person to another with skin contact. Warts may also spread by using towels or other personal items which have been used by a person with warts. Warts can bleed if picked or cut and can cause pain, especially plantar warts.


Warts will be diagnosed by simple observation of the lesions. Your doctor may scrape the top layer of the wart and check for clotted blood vessels and at times a biopsy may be ordered.


Warts disappear naturally but may take months or even years to disappear. Warts can be treated with different type of chemicals such as salicylic acid, liquid nitrogen to freeze the warts,, and also by laser treatment. Applying salicylic acid once or twice a day will help you to destroy the warts. If the warts do not heal then they may be removed surgically. Warts can recur even after treatment is used to remove them.

Other treatments include:

Cantharone: It is a medicine derived from the Japanese blister beetle, is applied with a Q-tip on the warts. It causes a blister at each site and after sometime warts are destroyed. This treatment is very effective for most warts and is painless.

Bleomycin: It is an anti-cancer agent is also used. Pulsed dye laser is magnetized to the blood vessels which feed on warts, and carbon dioxide (CO2) lasers are also used for warts.

Squaric Acid Therapy for Warts

Squaric Acid Therapy for WartsSquaric acid dibutyl ester, commonly called squaric acid, is used to treat warts in children. Squaric acid is a very dilute liquid that causes a mild allergic reaction in the skin. Warts are skin infections caused by a virus called human papilloma virus (HPV). They are usually skin colored, rough to touch and usually grow on the fingers, nails, back of the hands and soles of the feet.


Squaric acid therapy is mainly used in children who present with warts. It can also be used to treat alopecia areata, a form of hair loss. Squaric acid therapy has been shown to help many warts to resolve.


To start the treatment the patient must first be sensitized to the solution. This is done by applying a small amount of 2% squaric acid on the inside of the right upper arm. This often causes no reaction, although occasionally there may be mild redness of the skin. If no reaction occurs, it does not mean that it is not working properly. The first treatment with the squaric acid will be given in the office after two weeks. Then your doctor will instruct you to apply the solution on the warts at home.

It is advised to wear gloves while applying squaric acid. A Q-tip is used to apply the solution directly on to the warts. The squaric acid evaporates leaving no residue. Initially it is applied 3 times a week preferably at night. After the first week the frequency is increased to 4 nights a week then to 5 nights a week. Do not increase the frequency if your child experiences itching or soreness at the application sites. The main aim of the treatment is to have mild redness for the medicine to work and get rid of the warts. The medicine should be kept out of reach of children.

Adverse effects

Adverse effects include tiny blisters, redness, scaling, pustules and broken skin. If any of these effects occur stop the therapy immediately and consult your dermatologist. Irritation and dermatitis may occur at the site of sensitization.


Not to be used in pregnant women, as the allergic reaction provoked may harm the fetus. The treatment takes time, sometimes weeks to several months, before results are seen. Squaric acid therapy does not work in all patients; in such cases other alternative treatments will be discussed.

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