Updated: Apr 6
Plantar warts (aka verrucas) are skin lesions that develop along the toes or bottoms of the feet. They are caused by the human papilloma virus (HPV) and often look like a callus or corn. Depending on the size and location, they may be painful. If the wart is not tender, oftentimes treatment is not necessary. If it does become tender and at-home, or over-the-counter, remedies do not work, it is important for the lesion to be evaluated and treated by a healthcare professional.
Below are 10 different treatment options for plantar warts, including at-home & over-the-counter remedies, prescription topical medications, and in clinic procedures. There are also multiple research studies attached for those interested in the success rate of certain treatment options.
At-Home & Over-The-Counter Remedies
Occlusion with duct tape or other non-porous tape
The area should be filed down with an emory board first. Then the acid is applied and covered with non-porous tape. The area should be washed with soap and water between treatments to avoid accumulation of residual acid. If OTC strength acids are not working, prescription strength medications can be prescribed by a physician (2).
Prescription Treatment Options
Used as an off-label treatment for plantar warts
Good for multiple warts
May take several weeks to months to have results
Check out this study on its use for plantar warts
5-fluorouracil cream (e.g. Efudex)
Used as an off-label treatment for plantar warts (4).
Inhibits viral replication at the cellular level by inhibiting DNA & RNA synthesis (4).
In-Office & Surgical Treatment Options
Cantharone (“aka beetle juice”)
A liquid solution that is applied after debridement of the wart. A blister usually forms within 24 hours and days later, the blister will dry up and start to fall or flake off. Follow-up appointments are typically done 2-3 weeks later, at which time the area is debrided again, removing any non-viable tissue. If there is residual wart, another treatment can be done at this time.
Immunotherapy with intralesional injections
Warts are superficial skin viruses that the body does not recognize, which makes them difficult to treat. Therefore, the purpose of injecting the wart with something is to cause an immune response that the body will respond to and hopefully heal/get rid of the virus (1).
What is the wart injected with?
Candida – study & results
Bleomycin – case report
Tuberculin-PPD & Zinc sulfate 2% – study & results
The wart can easily be frozen in the clinic using liquid nitrogen. In my observation, the success rate is low.
There are various types of lasers and each can destroy the wart virus differently (2).
Multiple treatments may be necessary, but laser can also be done in conjunction with other treatments.
If other conservative treatment options fail, needling of the wart or complete surgical excision can be considered. By needling the wart, virus particles can be pushed into the body, which causes an immune response (2,3). The procedure involves numbing up the area first, followed by several punctures of the wart with a needle (3).
Complete surgical excision of the wart can usually be done right in the office. After the foot is numbed with local anesthetic, the wart is removed. There should be no open wound afterwards, but scarring can occur if the dermal layer of the skin is traumatized with removal of the wart.
HOW LONG DO WARTS LAST?
The duration warts last varies. Some warts can resolve on their own; however, with treatment, the wart may resolve even sooner. You and your doctor can discuss the details of the above treatment options, but many of them may require multiple treatments spaced weeks apart from one another.
PREVENTING PLANTAR WARTS
Avoid touching the wart – Warts are often called “kissing lesions”, meaning that a wart on one side of the toe can spread to the adjacent toe just from rubbing against it. Therefore, you should prevent things from coming in contact with the wart.
Avoid walking barefoot and use shoes/sandals while in public places
DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. Should you have questions or concerns related to your health, please contact the doctor or your own healthcare professional.
1. Cole, G.W. Plantar Warts. emedicinehealth. Retrieved from http://www.emedicinehealth.com/plantar_warts/page5_em.htm#what_are_treatments_for_plantar_warts
2. Fishco, W. (2010, December). Current Concepts In Managing Plantar Warts. 23(12). Retrieved from http://www.podiatrytoday.com/current-concepts-managing-plantar-warts
3. Needling – an effective treatment for warts and verrucas. Retrieved from http://www.betternowhealthcare.co.uk/news/26-needling-an-effective-treatment-for-warts-and-verrucas
4. Salk, R., Grogan, K., Chang, T., D’Costa, W. (2004, May). Exploring Alternative Treatment For Resistant Warts. 17(5). Retrieved from http://www.podiatrytoday.com/article/2598