Updated: Aug 13, 2018
Plantar Warts: Background
Plantar warts (aka verrucae) are superficial, benign skin lesions caused by the human papilloma virus (HPV). Warts on the feet can result with breaks in the skin, and those with a suppressed immune system are at increased risk of becoming infected (2). They usually present along the toes and the soles of the feet. If they are on weight-bearing surfaces, they may be painful. They can also have social implications as people may become embarrassed by their appearance.
Because the virus resides along the outer layer of skin, the body does not always recognize it as a pathogen. This makes warts difficult to treat and likely contributes to why there are several different treatment options available (2).
Many treatments are aimed at creating trauma to the affected area in order for the body to create an immune response, which will then get rid of the wart. In a previous blog, I discussed 10 different ways in which warts can be treated. Salicylic acid is probably the most commonly used over-the-counter option with varying percentages of acid, depending on the product. If you were to see a primary doctor or a dermatologist, they may recommend cryotherapy (freezing it), while other specialists may offer laser therapy, topical medications, or various injectables (1). There is another way, though, that does not involve radiation or the use of chemicals (excluding local anesthetic). It is the Falknor’s Needling Method (no relation to me).
Falknor’s Needling Method
In 1969, Falknor was the first to describe his needling technique for warts. After numbing the area, a needle was used to pierce the wart “in dart fashion, so as to penetrate the full depth of the verruca and exiting through the base of the capsule into the fat”. Of the treated 126 lesions, Falknor noted only two recurrences (2). Since his publication, the largest known study to date (at the time of its publication) was in 2013 out of the UK, in which 69% (31/45) of patients had resolution of their wart by their 8-week follow-up, even though 7 patients did have multiple needling procedures performed (2).
If you decide to undergo the procedure, here is what you can expect:
1. If there is a callus overlying the wart, it will be trimmed (2).
2. The area around the wart will be anesthetized so that you do not feel the needling procedure.
3. Once the area is numb, a needle will be used to penetrate the wart several times. If you have multiple warts, only the largest (aka “mother” wart) needs to be needled (3).
4. The area is then covered with a dressing, which should be left in place and kept dry for 24 hours (2). Further at-home aftercare instructions will be dispensed to you.
5. Follow-up appointments are done around 7-10 days after the procedure and again at 6-8 weeks.
Click here to see the results of the UK study published in 2013.
Contact the doctor to schedule your appointment or to discuss other treatment options for getting rid of your plantar wart(s).
Disclaimer: The above information is meant for educational purposes only and should not be construed as medical advice. Please contact the doctor, or your own healthcare professional, should you have questions or concerns related to your health.
1. Fishco, W. (Dec 2010). Current Concepts In Managing Plantar Warts. Podiatry Today, 23(12):40-46. Retrieved from https://www.podiatrytoday.com/current-concepts-managing-plantar-warts
2. Longhurst, B., & Bristow, I. (2013). The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases. Journal of Clinical Medicine, 2(2), 13–21. http://doi.org/10.3390/jcm2020013.
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.