Bleomycin for viral warts
Injection treatment for stubborn warts that have not cleared with other treatments
Bleomycin injections in Birmingham for resistant hand and foot warts that have not cleared with cryotherapy or paints.
What is bleomycin and how does it work?
Bleomycin is a chemotherapy agent that has been used to treat viral warts since the 1970s. When used for warts it is injected directly into the lesion in very small amounts, rather than given into a vein.
Bleomycin is thought to cause localised damage to the DNA of viral wart infected cells. Bleomycin may also affect the blood vessels feeding a viral wart.
Which warts is bleomycin used for?
Bleomycin can clear stubborn, resistant and recurrent warts on the hands and feet that have not cleared with time or with remedies such as salicylic acid wart paints or cryotherapy. In trials of resistant warts, bleomycin has cleared a higher proportion than cryotherapy, with low recurrence after clearance, though study methods and follow-up vary.
Bleomycin is also used to treat vascular birthmarks in infants. Doses used for birthmarks are much higher than the doses used for viral wart treatment. We offer treatment for viral warts in children over twelve years of age.
How effective is it?
Bleomycin is a highly successful treatment for viral warts and can work well even when other treatments have not worked. Across published trials, clearance rates typically fall between 70% and 90%, though results vary with technique, concentration and the number of sessions given. Warts can still return after clearing.
While the treatment is highly successful, it does not work for everyone, and some individuals may find that their warts do not respond to treatment or that they come back after the course of treatment.
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What happens during treatment?
We perform Bleomycin treatment as an outpatient procedure. Your healthcare professional will cleanse the area and pare down any area of hard skin with a scalpel. Bleomycin is then injected directly into the wart. A light dressing may be applied.
If you are a female of childbearing age, you will be asked to submit evidence that you are not pregnant. You must avoid pregnancy during the entire course of treatment and for one month after your last treatment. Please submit a pregnancy test 24 hours before each appointment.
How many treatments are needed?
It varies from person to person. Most patients need three to five sessions, spaced about three to four weeks apart. Some respond with fewer treatments; others may need more, and we carry on as long as we are seeing progress. If there is no clear improvement after three or four sessions, we stop.
Side effects
- Discomfort. There may be some discomfort during treatment and for a few days after. You can manage discomfort by taking Paracetamol. Occasionally the discomfort can last 14 days.
- Redness. The area may become red and swollen for a few days
- Colour change. The wart may darken and develop a black scab which will take 3 to 4 weeks to separate.
- Bleeding points. Occasionally, bleeding points within the wart from the injections will be seen. They settle within a few minutes. Rarely a haematoma can develop, where a bleed occurs under the skin.
- Infection. Infection is unusual, but if there is evidence of ongoing redness, pain, swelling and discharge, you will be given antibiotics.
- Tingling. Occasionally there can be tingling at the site of injection. Permanent numbness is very rare.
- Scarring and colour changes. A scar may remain after the wart clears. The skin may also become permanently pale, white, dark, or red during or after healing.
- Nail damage. Rarely, treatment of warts around the nails can risk permanent damage to the nail such that the nail may be lost or damaged.
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Safety, dose and contraindications
Patients undergoing bleomycin treatment for viral warts have not experienced the following side effects, though they are still listed as potential adverse reactions. This includes nausea, loss of appetite, and skin darkening over joints or on the back.
There have been reports of lung damage associated with bleomycin administration in large amounts (more than 250mg) via a drip into the veins. This has not been reported with the treatment of viral warts, as the total dose per treatment is no more than 1 or 2mg, and the total amount per course is no more than 10-20mg. In addition, the treatment is not given into the veins but into the skin.
Infertility is a theoretical risk as Bleomycin is a chemotherapy agent. No firm evidence shows this is a concern as infertility is usually associated with a different group of chemotherapy drugs and will be related to the administered dose, which is very low in this treatment.
Breastfeeding, severe peripheral vascular disease, Raynaud’s, active infection at the site, and known pulmonary fibrosis are all contra-indications. So is having previous bleomycin for a cancer.
What treatments are available instead?
Bleomycin is one option. Warts may clear on their own, and Midland Skin also offers cryotherapy and prescription topical treatment. You can read more about other wart and verruca treatment.
Fees
Bleomycin wart treatment Show pricing
Book ConsultationInitial dermatology assessment
Up to 25 minutes
Bleomycin Band A
Per session
Bleomycin Band B
Per session
Review consultation
Standard, up to 20 minutes
References used for this article
- Intralesional immunotherapy and conventional intralesional therapy for non-genital viral warts: a review. Int J Mol Sci. 2025;26(12):5644.
- Intralesional bleomycin for the treatment of resistant palmoplantar and periungual warts. Dermatol Res Pract. 2021;2021:8655004. doi:10.1155/2021/8655004.
About the Author
This page has been written and/or medically reviewed by Dr Sajjad Rajpar, Consultant Dermatologist and Medical Director of Midland Skin, Birmingham.
Dr Rajpar is on the GMC Specialist Register in Dermatology and has over 20 years’ experience in clinical dermatology. He provides clinical oversight to ensure the information on this page is accurate, balanced and consistent with current dermatology practice.
Dr Sajjad Rajpar
Date last updated: 22nd Sep 2026
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The content on this website is provided for general information only. It is not, and must not be treated as, medical advice, a diagnosis, or a recommendation for any particular treatment. We make reasonable efforts to keep information accurate and up to date, but medicine and technology change, and content may not reflect the most current evidence, guidance, product information, or individual practice. You should not rely on this website to make decisions about your health or treatment. Always seek personalised advice from an appropriately qualified healthcare professional. Any examples, images, testimonials, and outcome descriptions are illustrative only. Results vary between individuals and no outcome can be guaranteed.
