Surgical removal of warts

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Department of Genito-Urinary Medicine Nottingham University Hospitals NHS Trust.

This leaflet is aimed at patients undergoing surgical removal of warts, giving information about the procedure and skin care after it.

It is likely that alternative treatments (such as creams or freezing) have not been effective or that the size and characteristics of your warts make surgical removal more suitable for you.

Please bring a list of any medication you are on. If you are on Warfarin, please make sure to have your INR checked 2-3 days before your biopsy appointment. If it is below 2 or above 3.5 please contact us as your appointment may need to be rescheduled.

There is no need to stop antiplatelet medicines (such as Aspirin or Clopidogrel) or other anticoagulants such as Rivaroxaban. The risk of bleeding and bruising is higher with these medications but we do not recommend stopping them.

Please tell us if you have any allergies to medications, including local anaesthetics.

You can eat and drink as normal before your appointment.

The doctor will explain the procedure and answer any questions you may have.

A verbal consent will be obtained once you agree to have the procedure and you understand what it involves.

Surgical removal means that the warts will be removed

using a knife or curettage (a modified scalpel).

First, a local anaesthetic is injected superficially with a fine needle, into the area where the warts are, in order to numb it. More than 1 injection may be needed

depending on the number and size of the warts. The injection itself may cause a momentary discomfort (it may sting for a few seconds) but the rest of the procedure is pain free, once the local anaesthetic takes effect. You may feel some pressure/pulling but no pain. As the warts extend above the skin, the removal/ curettage will be superficial and therefore stitches are very rarely required.

Any bleeding stops with pressure or a special solution called Monsell’s solution or with application of Silver Nitrate. Very rarely a stitch may be needed.

The duration of the procedure is dependent on the extent of your warts. For most it will be a 15 to 30 minutes appointment. The aim is to remove all the

warts in a single visit but occasionally, when the warts

are extensive, a second appointment may be required.

Once the warts have been removed, there is usually no need for follow up but this will be discussed with the doctor during your appointment.

Once the local anaesthetic wears off (usually 30-40 mins) you may experience a small degree of soreness. If so, this can be managed with simple pain relief such as Paracetamol.

Healing takes place within 1 to 3 weeks depending on the size of the area treated but you should be able to return to normal activity within 1 to 3 days.

Avoid sexual intercourse until the area heals and soreness gone.

Keep the area dry for 48 hours. After this you can shower and wash the area gently, although soaking in the bath (or swimming) should be avoided for a few more days. Avoid perfumed products or chemicals until healing is achieved. Use water and mild soaps only.

Pat dry the area.

You may use a thin layer of clean Vaseline on the area or an antiseptic ointment if so advised.

If there is any bleeding, apply pressure using a gauze

for 5 to 10 mins.

Scarring may rarely occur.

Surgical removal still has a risk of recurrence in which case you might need further treatment, either medical or surgical. Contact the GUM clinic if this happens.

Please remember that the clinician performing the procedure may be either male or female. If you wish to be seen by a clinician of a specific gender, please inform the clinic beforehand.

We appreciate and encourage feedback. If you need advice or are concerned about any aspect of care or treatment please speak to a member of staff or contact the Patient Advice and Liaison Service (PALS):

Freephone: 0800 183 0204

From abroad: +44 115 924 9924 ext 85412 or 82301

Deaf and hard of hearing: text 07812 270003

E-mail: nuhnt.pals@nhs.net

Letter: NUH NHS Trust, c/o PALS, Freepost NEA 14614,

Nottingham NG7 1BR