Plantar warts, or verruca plantaris, are common growths found on the soles of the feet. These benign skin lesions are caused by infection with the Human Papillomavirus (HPV), which enters the skin through tiny cuts or breaks on the foot’s surface. Unlike warts elsewhere on the body, plantar warts are often flattened and grow inward due to the constant pressure of walking and standing. This inward growth frequently causes pain and discomfort, making removal a desirable option for many individuals.
At-Home Treatment Options
The most widely available option for treating plantar warts at home is the use of over-the-counter (OTC) acid treatments, primarily containing salicylic acid. This acid is a keratolytic agent, meaning it works by gradually dissolving the protein that makes up the wart and the surrounding thickened skin. Salicylic acid is available in various forms, including liquids, gels, and adhesive patches, typically in concentrations up to 17%.
Consistency is necessary for this method, often requiring daily application over several weeks or months. Before each application, the skin covering the wart should be softened by soaking in warm water, followed by gently filing the dead tissue. This preparation allows the acid to penetrate the wart tissue more deeply, enhancing the treatment’s efficiency. Another self-administered method is the OTC freezing kit, which uses cooling agents to briefly freeze the wart. While these kits utilize the same cryogenic concept as a professional procedure, they offer lower efficacy for deeply embedded plantar warts.
Physician-Administered Destructive Methods
When at-home treatments prove insufficient, a physician can employ more potent destructive methods in a clinical setting to physically remove the wart tissue. Cryotherapy is a common procedure that involves applying liquid nitrogen directly to the wart. The extreme cold causes a blister to form beneath the wart, which lifts the infected tissue away from the healthy skin, causing the dead tissue to slough off over the next week or two. Multiple treatments, often spaced two to four weeks apart, are generally necessary for complete clearance, particularly for thick plantar warts.
Other destructive techniques include electrosurgery, which uses a high-frequency electrical current to burn away the wart tissue, and surgical excision, where the wart is physically cut out. Laser treatments, such as the Pulsed Dye Laser (PDL), target the tiny blood vessels supplying the wart. By destroying the feeder vessels, the blood supply is cut off, causing the infected tissue to die and eventually fall off. These procedures may require local anesthesia to manage pain and carry a risk of scarring, but they can be highly effective for stubborn lesions.
Prescription and Immune-Based Therapies
For warts that resist conventional destructive methods, physicians may turn to prescription-strength topical agents or therapies designed to stimulate the body’s immune response against the virus. Cantharidin is a blistering agent applied in the clinic, often in combination with podophyllotoxin and salicylic acid, and then covered with a bandage. This solution works by creating a blister under the wart, causing it to lift from the skin. It is notable for being painless upon application, though blistering discomfort may follow.
Immunotherapy techniques prompt the patient’s immune system to recognize and attack the HPV virus. This can involve intralesional injections of antigens, such as those derived from Candida or mumps, directly into the wart to provoke a localized immune reaction. Prescription-strength topical medications are also utilized, including 5-fluorouracil cream, which blocks viral DNA and RNA production, and topical retinoids, which interfere with the skin cell growth cycle. These prescription options are typically reserved for persistent or widespread warts and require careful application under medical guidance.
Post-Removal Care and Prevention
Following a removal procedure, proper wound care is necessary to promote healing and prevent infection. For procedures that cause blistering or open wounds, the area should be kept clean and covered with a sterile dressing, often requiring daily changes and sometimes a protective ointment. Patients may experience soreness or pain as the anesthesia wears off, for which over-the-counter pain relievers like ibuprofen are often suggested. Recovery time depends on the size and depth of the wart removed, but activities that put heavy pressure on the foot may need to be limited.
Prevention focuses on reducing the opportunity for the HPV virus to enter the skin. This involves avoiding walking barefoot in public, warm, and moist environments like communal showers, pools, and locker rooms. Maintaining good foot hygiene, including washing and thoroughly drying the feet, is also beneficial as the virus thrives in moist conditions. Individuals should also be careful not to touch or scratch existing warts, as this can transfer the virus and cause new warts to develop.