Getting rid of plantar warts could prove very difficult due to the high recurrence rates of the HPV infection of the soles. The principles and various modalities of treatment for plantar warts are discussed here. A step-by-step physician assisted treatment plan for resistant types of plantar warts is also outlined for the benefit of the sufferers of this painful foot condition.
Principles of Treatment of Plantar Warts
Aggressive and potentially scarring types of intervention are not advisable in the treatment of plantar warts.
- The idea that all types of plantar warts will disappear by themselves is a misconception. A spontaneous cure depends upon formation of a neutralizing antibody by the immune system of the patient and is not always reliable. Most untreated plantar warts continue to increase in size and number, making walking a painful experience for the patient.
- It is advisable to treat all different types of plantar warts as early as possible. Though self limiting, there is no guarantee that the warts will go away by themselves. In addition to the pain (which is excruciating at times) to the sufferer, there are chances of family and the community contracting the warts through carpets, a shared toilet, foot wear or showers.
- Patients should always wear loose fitting, soft, comfortable footwear. Any footwear, especially high heels, which puts direct pressure on the warts, should be avoided.
- If the warts are on the pressure points, the patients are advised to put on corn cushions or corn rings either on the footwear or on the warts during the treatment period and a few weeks thereafter to prevent recurrence of the plantar warts.
How to Get Rid of Plantar Warts
Topical applications containing salicylic and lactic acid (16.7% each) daily gets rid of most superficial warts, if used in the earlier stages.
Other effective treatments for the plantar warts:
- Salicylic acid 15-40% plaster with weekly pairing of the macerated wart tissue.
- 20% Podophyllin with 20% Linseed oil in lanolin or 25% podophyllin in soft paraffin under occlusive dressing.
- Formalin 3% soaked cotton wool application and weekly pairing is effective in extensive superficial plantar warts. Gluteraldehyde 2% is also effective, but causes brown stains.
- Cryotherapy with liquid nitrogen or carbon dioxide snow is effective in some cases of plantar warts, but recurrence rate is quite high with cryo.
- Electro-desiccation may be done in superficial plantar warts but is best avoided in deep plantar warts due to concerns of scar formation.
- Laser treatment is a comparatively painless treatment modality for plantar wart removal.
- Surgical excision is best avoided in plantar warts as recurrence and painful scarring is quite common following this mode of treatment.
A Step by Step Physician Assisted Treatment Plan to Get Rid of Resistant Plantar Warts
The cure rate of dermatologist assisted graded pairing (scraping off the dead wart tissue) is quite high, making this the treatment of choice in resistant and persistent types of plantar warts.
- During the first visit, a soft pairing (scraping off the superficial tissue) with a # 10 scalpel blade is done until bleeding points appear. Any bleeding is stopped by the application of 30-50% trichlor-acetic acid (TCA).
- At home, the patient covers the warts with cotton balls soaked in warm salt water for 10 to 15 minutes. Immediately after drying, a thick coat of anti wart solution is applied.
- A solution containing 5-Flurouracil (FFU) 0.5%, Salicylic acid 10%, dimethyl sulphoxide 8% is quite effective for this procedure as the antiviral FFU helps reduce the recurrence rates in treated warts.
- The anti-wart solution is applied at bedtime for 4-5 days. There is no need for occlusive plasters as the solution dries up quite fast.
- The warts are deep paired at the clinic after 4-5 days till bleeding points appear, followed by application of 30-50% TCA.
- This procedure is repeated every 4-5 days. Most patients get rid of their warts with 5-6 sessions.
- In the final stages, application of imiquimod 5% cream (aldara) helps reduce recurrence rates of the foot warts.
- A close watch is kept to look out for any new growths for the next two months or so. In case of recurrence, the same protocol is followed at the earliest to get the best results.
This wart removal procedure is comparatively painless and non-scar forming. For very thick and deep plantar warts, cryo-freezing and/or lasers can be combined with the above protocol for faster results. In a limited number of thick, hyperkeratotic types of plantar warts, salicylic acid plasters may be used in the initial stages before starting the application of the wart solution.
Reference
Disclaimer
The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or Suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
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