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Warts

Wart Treatment in Melbourne (Ivanhoe + Diamond Creek)

Hand warts, plantar warts (verrucas), peri-ungual warts and facial warts — safe, effective options from simple home care to advanced laser + photodynamic therapy.

Warts are benign (non-cancerous) skin growths caused by human papillomavirus (HPV). They can be stubborn, spread to nearby skin, and in some locations (especially feet or around nails) become painful or hard to clear. (1–4)

Bookings

Option 1 — Discuss your wart options
[Book a 20 minute appointment with Dr Chris] (diagnosis, tailored plan, and step-by-step next steps)

Option 2 — Book directly into our advanced laser wart pathway
[automed link — wart laser session booking] (20 minutes with Dr Chris, then the same booking workflow as precancer PDT for staff)

If you have multiple warts and want a comprehensive cosmetic plan (and product/aftercare guidance), you can also choose a combined booking: 20 minute medical appointment + 40 minute dermal therapist appointment.

Key takeaways

  • Warts are harmless, but they are contagious and can spread on your skin or to others. (1–3)
  • Many clear naturally over time, but that can take months to years — and some persist. (1–3)
  • Standard treatments (salicylic acid, cryotherapy, cantharidin, immune creams) help many people, but recurrence is common. (1–4)
  • For stubborn warts, energy-based treatments (Nd:YAG, ablative lasers, PDT) have a growing evidence base. (4–7)
  • Notably, histologic studies reported absence of HPV DNA after Nd:YAG treatment, compared with 96% of HPV DNA still present after cryotherapy. (4)

Jump links

  • What are warts?
  • How warts spread (and how to stop spread)
  • Types of warts
  • When to get a wart checked
  • Our advanced 4-step laser + PDT wart protocol
  • Evidence behind each step (plain English)
  • Other wart treatment options (home + medical)
  • Aftercare and prevention
  • FAQs
  • Book

What are warts?

Warts form when HPV infects the top layer of skin, usually entering through tiny breaks. The virus triggers extra growth of skin cells, creating a rough keratinous bump. (1–3)
They occur in both children and adults — adults commonly present with persistent plantar (foot) warts, peri-ungual warts, or recurrent warts after partial treatment. (1–3)

How warts spread (and how to stop spread)

HPV can spread by direct contact and via shared surfaces/items, especially in warm moist environments (pools, change rooms). The incubation period can be long, so exposure isn’t always obvious. (1–3)

Simple prevention steps:

  • don’t pick or shave over warts
  • cover warts during sport/gym/pool use
  • don’t share nail clippers/razors/towels
  • wear footwear in communal wet areas (1–3)

Types of warts

  • Common warts (hands/fingers)
  • Plantar warts / verrucas (soles) — often painful because pressure pushes them inward
  • Flat warts (face/legs/hands) — can occur in large numbers
  • Filiform warts (face) — finger-like growths
  • Peri-ungual warts (around nails) — can distort the nail and are often stubborn (1–4)

When to get a wart checked

Book a review if:

  • the diagnosis is uncertain (not everything rough is a wart)
  • it bleeds repeatedly, ulcerates, or is rapidly changing
  • it’s on the face or genital region (sensitive areas)
  • it’s painful (especially plantar), spreading, or persistent
  • you are immunosuppressed, diabetic (feet), or have poor circulation (1–3)

If you’re unsure what a lesion is, see Other Dermatological Conditions).

Our advanced 4-step laser + PDT wart protocol

For stubborn, recurrent, thick, peri-ungual, mosaic, or multiple warts, we offer an advanced multi-modality pathway that targets different “pillars” of wart persistence. (4–7)

Why this matters: warts are often resistant because HPV-infected tissue can persist below the visible surface, and because partial treatment can leave a viable “base” behind. (1–4)

Step 1 — Nd:YAG (1064 nm): reduce blood supply and weaken the wart

Nd:YAG targets haemoglobin within the wart’s vascular supply. Histologic studies describe devascularisation effects and dermo-epidermal separation after treatment. (4)
Key virology point: histologic studies reported HPV DNA absent after Nd:YAG, compared with 96% HPV DNA remaining after cryotherapy. (4)

Step 2 — Complete Er:YAG ablation: remove wart tissue precisely

Ablative Er:YAG physically removes wart tissue with high precision. In the energy-based device literature, Er:YAG cohorts report high clearance outcomes (e.g., large series reporting clearance in the ~90% range). (4,6)

Step 3 — Fractional Er:YAG “wells”: improve penetration into deeper wart structures

Fractional ablative laser creates micro-channels that bypass the barrier of the epidermis, improving topical delivery into deeper structures — the basis of laser-assisted drug delivery. (8–10)
In our protocol, this step is used to help the photosensitiser reach deeper residual wart tissue before PDT.

Step 4 — Apply ALA and perform photodynamic therapy (PDT)

PDT uses a photosensitiser (such as ALA) plus light to generate reactive oxygen species that destroy infected keratinocytes. Systematic reviews report meaningful clearance in recalcitrant warts, and one plantar wart study reported ~91% clearance with ALA-PDT vs ~23% with cryotherapy. (4,7)

Why we combine these steps

Each step targets a different vulnerability:

  • Blood supply + HPV burden (Nd:YAG)
  • Complete physical clearance (Er:YAG ablation)
  • Depth and delivery (fractional wells / laser-assisted drug delivery)
  • Microscopic residual infected cells + recurrence reduction (ALA-PDT) (4,6–10)

In our clinical experience, this combination is extremely effective for appropriately selected patients, particularly when standard methods have failed.

Internal link: For a broader overview of our laser devices and how each modality works, see Laser & Light Treatments hub.

Evidence behind each step (plain English)

  • Nd:YAG: systematic reviews report efficacy and highlights histologic studies showing HPV DNA clearance after Nd:YAG versus persistence after cryotherapy. (4)
  • Er:YAG ablation: the same evidence base includes Er:YAG wart cohorts with high clearance outcomes in multiple wart subtypes. (4,6)
  • ALA-PDT: systematic reviews show clearance ranges across sites/protocols, and includes comparative data showing high ALA-PDT clearance in plantar warts versus cryotherapy in trials. (4,7)
  • Fractional channels: laser-assisted drug delivery reviews support that ablative fractional lasers create channels that enhance penetration of topicals (including ALA-based approaches used in PDT). (8–10)

Other wart treatment options (we tailor to you)

We don’t “over-laser” everyone. Many warts respond to simpler options, especially early.

Home and pharmacy options

  • Salicylic acid (wart paints/plasters): first-line when used consistently for weeks to months. (1–3)
  • Duct tape occlusion: low risk, mixed evidence; sometimes used as an adjunct. (2–3)

In-clinic options

  • Cryotherapy (liquid nitrogen): common; can cause hypo or hyperpigmentation, often needs multiple sessions; can be painful. (1–4)
  • Cantharidin: useful for selected sites/patients; typically well tolerated at application. (2–4)
  • Curettage/electrosurgery: selected cases; effective but scar risk depends on location. (2–4)
  • Topical immune / prescription options (selected cases):

○Imiquimod (Aldara) (immune modulation) (2–4)

○5-fluorouracil (selected flat wart protocols) (2–4)

○Retinoids (often for flat warts) (2–4)

  • Immunotherapy (selected stubborn cases): contact immunotherapy and antigen approaches in appropriate settings. (2–4)

Aftercare and prevention

  • Follow dressing and aftercare instructions to reduce infection and pigment change risk.
  • Avoid picking/shaving over the area.
  • Use footwear in communal wet areas. (1–3)

FAQs

Who is a good candidate for your laser + PDT wart protocol?

This is often ideal if you have:

  • plantar verrucas that are painful or recurrent
  • peri-ungual warts
  • mosaic warts
  • multiple warts that keep spreading
  • warts that have not responded to standard therapy (4–7)

How many sessions will I need?

It depends on wart type, thickness, and location. Some clear quickly; stubborn plantar and peri-ungual warts often need staged care. The aim of our protocol is fewer “partial results” and a stronger emphasis on completeness. (4–7)

What is the downtime?

Most treatments create a healing phase (crusting or a superficial wound). We’ll tailor dressings and activity advice based on location (hands vs feet) and your work/sport needs.

Book

Option 1 — Discuss your wart options
[Book a 20 minute appointment with Dr Chris]

Option 2 — Book directly into our advanced laser wart pathway
[automed link — wart laser session booking] (20 minutes with Dr Chris, then the same booking workflow as precancer PDT for staff)

Ivanhoe: Unit 1, 1065 Heidelberg Road, Ivanhoe VIC 3079
Diamond Creek: Shop 12, 67 Main Hurstbridge Road, Diamond Creek VIC 3089

References

1.Al Aboud AM, Nigam PK. Wart. StatPearls (NCBI Bookshelf). 2023. https://www.ncbi.nlm.nih.gov/books/NBK431047/

2.DermNet NZ. Viral warts (verrucae). https://dermnetnz.org/topics/viral-wart

3.Cleveland Clinic. Warts. (Last updated 20 Feb 2024). https://my.clevelandclinic.org/health/diseases/15045-warts

4.Le M, Conte S, Hsu JTS, Li MK. Energy-Based Devices for the Treatment of Cutaneous Verrucae: A Systematic Review. Dermatologic Surgery. 2024. https://pubmed.ncbi.nlm.nih.gov/38551277/

5.Australasian College of Dermatologists. Warts. (Last updated Feb 2025). https://www.dermcoll.edu.au/atoz/warts/

6.Iranmanesh B, Khalili M, Zartab H, Amiri R, Aflatoonian M. Laser therapy in cutaneous and genital warts: A review article. Dermatologic Therapy. 2021. https://pubmed.ncbi.nlm.nih.gov/33314577/

7.Maranda EL, Lim VM, Nguyen AH, Nouri K. Laser and light therapy for facial warts: a systematic review. J Eur Acad Dermatol Venereol. 2016. https://pubmed.ncbi.nlm.nih.gov/27356496/

8.Waibel JS, Wulkan AJ, Shumaker PR. Update of ablative fractional lasers to enhance cutaneous topical drug delivery. Dermatologic Surgery. 2017. https://pmc.ncbi.nlm.nih.gov/articles/PMC5565660/

9.Thunshelle C, Yin R, Kerscher M. Current advances in 5-aminolevulinic acid mediated photodynamic therapy. Photodiagnosis Photodyn Ther. 2016. https://pmc.ncbi.nlm.nih.gov/articles/PMC5287697/

10.Lee WR, Shen SC, Wang KH, et al. Fractional laser as a tool to enhance the skin permeation of 5-aminolevulinic acid with minimal disruption. J Control Release. 2010. https://www.sciencedirect.com/science/article/abs/pii/S0168365910002221