Bleomycin for viral warts and keloids
Bleomycin is an effective treatment for viral warts and keloids
At Midland Skin we offer Bleomycin for viral warts and keloids treatment for patients in Birmingham, Solihull, Coventry, Wolverhampton, Worcester and the Midlands.
Bleomycin for viral warts and keloid scars in Birmingham and Solihull – Fact sheet
This fact sheet provides information on Bleomycin injection for viral warts and keloid scars.
The treatment involves the injection of Bleomycin directly into skin lesions.
Quick facts about Bleomycin treatment [TO UPDATE]
- You need three 45 minute treatments – one every 3 to 4 weeks
- The results get better with time and at one year there is an average reduction in inflammatory spots of 97% according to clinical studies
- There are no harmful side effects
- The treatment is safe in all skin tones and all year round
- You do not need to take long-term tablets or creams
- There can be short-lived purges which can be managed with medications
Bleomycin treatment for viral warts
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. Clinicians have used bleomycin for viral warts since the ’70s, and it is both safe and effective in children from the age of five. Compared with many other methods it clears a higher proportion of warts, causes much less discomfort during treatment, and the lesions are less likely to return.
Bleomycin is thought to cause localised damage to the DNA of viral wart infected cells. Bleomycin may also affect the blood vessels feeing a viral wart.
Scarlett Greenwood
What happens during bleomycin 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.
What are the benefits of bleomycin treatment for resistant or recurrent viral warts?
Bleomycin is a highly successful treatment for viral warts and can work well even when other treatments have not worked. Studies show clearance rates ranging from 60-90%.
What are the risks of bleomycin treatment?
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.
What are the side effects of bleomycin treatment?
- 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.
Additional points of consideration
Patients undergoing bleomycin treatment for viral wart 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 fibrosi are all contra-indications. So is having previous bleomycin for a cancer.
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How many bleomycin 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.
Can I have a bleomycin treatment at the same day as my consultation
We need to see you for a consultation first. At that visit we assess your condition, talk through all treatment options, and decide whether bleomycin is suitable. Suitability is assessed on a case by case basis. A quote for the treatment is also provided at the consultation. If it’s something you would like to proceed with, we will book you into a dedicated bleomycin clinic. These run on set days, so the first treatment usually takes place a few weeks after your first consultation.
What are the alternatives to bleomycin treatment?
Warts may clear on their own. Other treatments include wart paints, cryotherapy, cautery, curettage and laser. You can read more about wart treatment options here.
Keloid scars can be treated with silicone gel or sheets, steroid tapes or creams, laser and cryotherapy.
Bleomycin treatment in children who are under 18-year-olds
Bleomycin is also used to treat vascular birthmarks in infants as young as a few months old. 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.
Update August 2025
This treatment is not available at present. If you are interested in being notified when the treatment is offered again, please contact us to be put on the waiting list.
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References used for this article
Dhar S B, Rashid M M, Islam A, Bhuiyan M. Intralesional bleomycin in the treatment of cutaneous warts: A randomized clinical trial comparing it with cryotherapy. Indian J Dermatol Venereol Leprol 2009;75:262-267
Mohan AT, Adams S, Adams K, Hudson DA. Intralesional bleomycin injection in management of low flow vascular malformations in children. J Plast Surg Hand Surg. 2015 Apr;49(2):116-20. doi: 10.3109/2000656X.2014.951051. Epub 2014 Sep 10. PMID: 25204206.
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: 9th Mar 2026
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