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Wart Removal by Electrosurgery and Wart Curettage
Warts are benign skin growths
caused by infection with human
papilloma virus, HPV. Though
harmless of themselves they may
cause pain if they are located
in sensitive areas such as near
nail plates. Many people are
also embarrassed by the
appearance of warts, and though
they usually spontaneously
vanish this can be a slow
process; in extreme cases it may
take up to 2 years before they
disappear.
The surgical procedures to
eradicate warts do not
necessarily sound pleasant, but
they can be effective.
Wart electrosurgery involves passing
a high frequency electric
current through the wart to burn
it. The tissue is destroyed by
the heat generated by the
electric current. The procedure
is simple enough, and usually
takes about 30 minutes to
perform.
Electrosurgery Procedure
The wart, and the surrounding
skin are thoroughly cleansed and
a local anesthetic is
administered. A needle is
heated by electricity which is
then placed on the wart to burn
it. The procedure is also
known as electrodessication. The
doctor or surgeon will then
remove the offending wart with a
surgeon’s knife. This is known
as curettage. Electrosurgey and
wart curettage are usually offered in
tandem.
The reason so many people opt
for electrosurgey is that the
results can be seen
immediately. It has been
observed to be particularly
effective on filiform warts on
the face and limbs
(Sterling JC, Handfield-Jones S,
Hudson PM. Guidelines for the
management of cutaneous warts.
Br J Dermatol 2001; 144: 4-11).
And overall success rates for
wart removal by electrosurgery
or thermocautery are 65-85%
(Pringle WM, Helms DC.
Treatment of plantar warts by
blunt dissection. Arch Dermatol
1973; 8:70-82).
Electrosurgery Disadvantages
Electrosurgery can be used for
single warts or a few warts, but
not large areas where clusters
of warts are located. The
procedure can leave scar tissue
behind and recurrence cannot be
ruled out. Whilst the technique
is successful in removing the
growth or growths it does not
treat the underlying viral cause
and infection could occur again
at any time.
A study in the Indian Journal of
Dermatology compared
electrosurgery with topical 5%
5-fluorourcil. Whilst surgery
yielded much quicker results it
was deemed to be the less
successful treatment of the two
because of the relatively high
recurrence rate – a mean 48%
amongst the 25 test subjects (Dogra
A et al. Comparative efficacy
of topical 5% 5-fluorouracil
with electrosurgery in treatment
of warts. Indian Journal of
Dermatology 2006; 51 (2):
1080110).
Though the recurrence rate in
this study was high, the current
belief is that an infection rate
of up to 30% should be expected.
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