How To Treat Plantar Warts

Plantar warts are warts that appear on your feet when the body comes in contact with human papillomavirus (HPV). Plantar warts occur on the bottom of your feet, and are most commonly caused by HPV 1, 2, and 4.

Plantar warts can make walking and standing painful. Warts on the heel and ball of the foot can be especially sensitive since you apply a lot of pressure to those areas. Therefore, treatment goals often include removing the wart and reducing pain. 

Often, plantar warts go away without treatment, especially in children. In adults, they may take a little longer to disappear. You can treat plantar warts at home or visit a podiatrist.

Treatments may include topical medications or procedures to burn, scrape off, or excise the wart. A podiatrist may also provide laser treatments or injections for stubborn plantar warts.

Medications

Often, plantar warts go away on their own without treatment. In fact, they often go away within two years.

Still, if your plantar wart causes pain or won't go away, consulting a dermatologist may help. For example, a dermatologist may recommend or prescribe topical medications to get rid of the wart. 

Salicylic Acid

Salicylic acid is one of the most common topical treatments, available over-the-counter (OTC) or by prescription. Typically, dermatologists advise removing the plantar wart with salicylic acid at home. 

Salicylic acid removes excess keratin, a protein that forms your skin's outermost layer. Also, salicylic acid generates an inflammatory response that reduces the plantar wart.

Usually, you'll need to apply salicylic acid to the affected area daily for several weeks to months. In some cases, plantar warts do not respond to at-home treatment. A dermatologist may prescribe a more potent salicylic acid or advise other remedies if that happens.

Also, research has found that people with health conditions affecting the nerves, like diabetic peripheral neuropathy, should not treat plantar warts at home.

Cryotherapy

Often, cryotherapy is the second line of treatment if salicylic acid fails. With cryotherapy, a dermatologist applies a topical liquid nitrogen solution to the affected area. The solution freezes off the plantar wart, which induces cell damage. Like salicylic acid, cryotherapy generates an inflammatory response.

You'll need to visit a dermatologist to receive cryotherapy since liquid nitrogen is not available over the counter. There are some OTC freezing solutions, like dimethyl ether and propane. However, those are less effective than liquid nitrogen.

One of the most common side effects of cryotherapy is pain. In some cases, pain may cause limited mobility. Also, people with darker skin tones may notice dark spots on the affected area.

You'll need multiple office visits for this treatment. For example, you may receive cryotherapy once every two to three weeks for as long as three months.

Cantharidin

Cantharidin is a topical treatment that requires an office visit. A dermatologist applies the medication to the plantar wart. Then, a blister will develop under the wart. 

This medication works faster than salicylic acid and cryotherapy. After one week, the dermatologist will remove the destroyed wart.

Chemical Peels

Some people develop multiple plantar warts in the same area. In those cases, a dermatologist may prescribe a topical chemical peeling medication that you'll apply daily. Often, those medications include a potent salicylic acid, tretinoin, and glycolic acid.

Bleomycin

Bleomycin is an anti-cancer medication typically reserved for stubborn plantar warts. A dermatologist injects bleomycin into the affected area. The injection may be very painful.

Immunotherapy

If no other medications work, a dermatologist may try immunotherapy. Those medications employ your immune system to get rid of the plantar wart.

A dermatologist may apply diphencyprone (DCP), a chemical, to the wart. DCP induces an allergic reaction that gets rid of the wart. Or a dermatologist can inject interferon that boosts your immune response to fight HPV and get rid of the wart.

Surgeries and Procedures

In some cases, a dermatologist may use different types of surgeries and procedures to remove plantar warts.

Some of the most common surgeries and procedures to remove plantar warts include:

• Electrosurgery and curettage: Electrosurgery is when a podiatrist burns off a plantar wart. Curettage is when a podiatrist cuts or scrapes off a wart. In some cases, a podiatrist uses a mix of both procedures. 
• Excision: This is when a podiatrist cuts out the plantar wart.
• Laser treatment: This treatment uses a laser beam to heat and damage the plantar wart. Before using the laser beam, a podiatrist will numb the affected area with a shot. 
• Pulsed dye laser treatment: This laser treatment heats and damages the vessels delivering blood to the plantar wart. By doing so, the skin cells stop growing.
• Erbium YAG laser: This laser treatment uses stronger heat than others. A podiatrist will use the laser beam to damage the plantar wart's cells for short periods.
• Panacos surgery: This procedure is generally used in severe cases, or cases where there are multiple warts. It involves surgically removing the wart and transplanting it into the abductor hallucis muscle of the unaffected foot to stimulate an immune response to the HPV strain causing the warts.

Complementary and Alternative Medicine

Besides traditional medications, surgeries, and procedures, there are possible complementary and alternative ways to remove plantar warts. Still, know that the efficacy of those methods is inconclusive. 

Some of those methods include:

• Duct tape: Some people use duct tape to remove plantar warts. Research has found that duct tape may work if you use it with salicylic acid. Apply duct tape to the wart every four to seven days. Then, remove the tape and cleanse the wart with soap and water. Get rid of any dead skin using a nail file. After 12 hours, apply a new piece of duct tape.
• Herbs: Zijinding is a traditional Chinese medicinal herb. Some evidence suggests that Zijinding, prepared with white vinegar, may remove plantar warts. In one study, researchers found that, among three people, the herb-and-vinegar mix reduced warts within five months.
• Iodine: One study found that iodine may help remove plantar warts. Specifically, the researchers found that applying a topical povidone-iodine solution twice daily might be a safe plantar wart treatment.
  

Living With and Managing Plantar Warts

Often, plantar warts go away on their own. Still, you can speed up recovery and prevent transmitting the virus to other body parts or people. 

Covering your plantar wart is key to not spreading the virus. For example, if you have a plantar wart and exercise barefoot, the virus can transfer to the gym mat or floor. The next person to come along with bare feet will also be at risk for developing a plantar wart.

Also, wash your hands after treating a plantar wart. If you touch a plantar wart, then touch another body part, you risk spreading the virus to a new area.

Lastly, keep your feet dry as much as possible. HPV spreads easily in warm, moist environments. People with hyperhidrosis, which causes excessive sweating, may need to consult a healthcare provider about treating plantar warts.

A Quick Review

Plantar warts can be uncomfortable and painful. Fortunately, you may find relief and expedited healing from OTC medications and at-home remedies. Consult a healthcare provider if you have a painful plantar wart or are unsure if it's a wart or other skin condition.