Eyelid warts, or filiform warts, are usually removed by a medical professional by paring with a scalpel or scissors or freezing with liquid nitrogen. Additional options include curettage or light electrocautery. This variant of the common wart is characterized by long, narrow, and frondesque growths that can appear on the face, neck, and eyelids. Although they can be unsightly, eyelid warts are often easy to treat and usually benign.
The first step toward the removal of eyelid warts is to consult with a medical professional who can properly diagnose the presence of this type of growth. Such warts are long and slender with a visible base and projections that look like toothbrush bristles. These warts are likely to disappear without treatment after a few months, but there is no guarantee. They are typically asymptomatic, benign, and easy to treat, but patients should not attempt to remove them on their own because of the risk of damaging sensitive facial skin and surrounding tissues.
Instead of over-the-counter wart removal products, doctors can suggest alternative and safer treatments for eyelid warts. As these warts do not tend to manifest in clusters, treatment and removal are often as simple as paring. Paring involves cutting the wart off at its base with a scalpel or similar instrument, such as surgical scissors. A similar method involves removing the wart by scoping or scrapping the tissue with a curette. If the warts persist, more comprehensive treatment options may be considered.
An alternative treatment for filiform warts is freezing with liquid nitrogen, which should be applied so that approximately 0.08 inches (2 millimeters) of skin around the wart turns white. The skin will thaw in approximately 10 to 20 seconds, but blisters can form within two days of treatment. Additionally, there is a risk of hypopigmentation and permanent depigmentation associated with this type of treatment. Given that the eyelids are very fragile and sensitive, liquid nitrogen is not a common treatment option for eyelid warts.
Light electrocauterization is also used to treat filiform warts. This process destroys tissue via heat conduction from a needle. The needle is heated with electricity and then inserted into the wart. This treatment can cause scarring and is therefore not often used with eyelid warts.
Eyelid warts are caused by strains 1, 2, and 3 of the human papilloma virus (HPV). There are approximately 100 different strains of the HPV virus, and most spread through person-to-person contact. Skin damaged by a razor nick, scrapes, or dry weather is also vulnerable to HPV infection. Most types of warts will disappear on their own without treatment after a few weeks.
Over-the-counter wart removal medications should not be used on the face or neck. Many of these products contain ingredients that can damage or destroy the delicate eyelid skin as well as the wart. As filiform warts like eyelid warts form in sensitive areas, patients should seek medical treatment rather than attempt to remove these growths on their own.