Seunga Han, PharmD Student
In our previous articles, you learned what corns, calluses and warts are, how to prevent them, and how to treat corns and calluses. In this last article of the series, we’ll discuss various treatment options for plantar warts and highlight some important points about each one of them.
Before we start talking about treating plantar warts, let’s quickly review what they are. Plantar warts are often asymptomatic, producing pain only upon pressure. Usually, they appear as rough, firm, skin-coloured lesions and contain capillaries, which appear as black dots in the centre of the lesion.
Unlike with corns, the skin’s striations run around the wart and produces pinpoint bleeding upon debridement of the lesion.
Treatment is not always necessary for most warts, unless they cause pain, embarrassment, or interfere with mobility. If this is the case for you, then there are several effective treatment options to consider.
Cryotherapy with liquid nitrogen is considered a first-line treatment option for warts and may be administered by spray or cotton buds. This freezes the wart so it can’t host the virus. It also causes a blister to form underneath the wart, resulting in the wart “falling off” about 10 days after the treatment. While you may freeze a wart multiple times or for longer period of time, it’s important to watch for potential side effects like pain, blistering and scarring.
#2 Salicylic acid
Just like treating corns, salicylic acid in concentrations of 5-40% may be used to treat plantar warts. It’s generally safe, effective and is also considered a first-line treatment option. In children, salicylic acid is preferred over cryotherapy since it tends to have fewer side effects.
Just remember to only apply the salicylic acid to the wart itself as it may damage the normal skin around the lesion.
#3 Formalin solution
A 3% formalin solution may be used to soak the wart in a shallow tray or dish for about 20 minutes everyday. Before soaking, make sure to apply a white petrolatum barrier such as Vaseline® around the lesion and between the toes to protect them from the formalin solution.
You can increase the efficacy of this treatment by having the wart pared by a healthcare professional on a weekly basis.
Other treatment options
Hyperthermic treatment, CO2 laser therapy, pulsed-dye laser therapy, and the “duct tape method” are some other alternative treatment options. The specific treatment protocols may differ based on which centre is offering the service, but these treatments don’t appear to be as effective as what we’ve discussed above.
There are other topical agents besides salicylic acid that may be used to treat plantar warts. These agents, however, should only be handled by healthcare professionals to ensure they’re used safely.
With the treatment options mentioned above, cure rates are usually around 60-70%. There is a possibility that a wart may come back after a successful treatment, usually because the treatment failed to remove all the tissue containing the virus.
While plantar warts may be treated at home, if any of these home therapies result in pain, swelling, bleeding, or fever, or you don’t see improvement after 12 weeks of self-treatment, make sure you seek professional help from your healthcare provider.
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