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Treatments and drugs
By Mayo Clinic staffPlantar warts don't require treatment, but you may want to treat them if they're painful or to prevent their spread. Home treatment is often effective in curing plantar warts. Salicylic acid, an over-the-counter medication, or even duct tape and patience may be enough to resolve plantar warts.
If you have stubborn plantar warts and home treatment isn't helping, your doctor may suggest one of the following approaches. Doctors generally start with the least painful, least destructive methods, especially in young children.
- Freezing (cryotherapy, or liquid nitrogen therapy). Your doctor can apply liquid nitrogen with a spray canister or cotton-tipped applicator to freeze and destroy your wart. This treatment isn't too painful and is often effective, although you may need repeated treatments. The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. Freezing therapy may be painful so isn't typically done on young children.
- Cantharidin. Your doctor may use cantharidin — a substance extracted from the blister beetle — on your plantar warts. Typically, the extract is paired with salicylic acid, applied to the plantar wart and covered with a bandage. The application is painless, but the resulting skin blister can be uncomfortable. Your doctor clips away the dead part of the wart in about a week.
- Minor surgery. This involves cutting away the wart or destroying the wart by using an electric needle in a process called electrodesiccation and curettage. This treatment is effective, but may leave a scar if not done carefully. Your doctor will anesthetize your skin before this procedure.
- Laser surgery. Doctors can use several types of lasers to eliminate stubborn warts. Laser surgery is expensive and painful and may require multiple sessions to treat the warts.
- Immunotherapy. This therapy attempts to harness your body's natural rejection system to remove tough-to-treat warts. This can be accomplished in a couple of ways. Your doctor may inject your warts with interferon, a medication that boosts your immune system's instinct to reject warts. Or your doctor may inject your warts with a foreign substance (antigen) that stimulates your immune system. Doctors often use mump antigens, because many people are immunized against mumps. As a result, the antigen sets off an immune reaction that may fight off warts.
- Imiquimod (Aldara). This prescription cream is an immunotherapy medication that encourages your body to release immune system proteins (cytokines) to help ward off warts. You can apply this cream directly to your warts. Imiquimod is approved by the Food and Drug Administration for the treatment of genital and perianal warts, but it's also successful in treating common warts and plantar warts.
- Bleomycin (Blenoxane). In severe cases that haven't cleared with other therapies, your doctor may inject each wart with a medication called bleomycin, which kills the virus. This medication is given systemically in higher doses to treat some kinds of cancer. The injections for wart treatment can be painful. They're not used if you're pregnant or breast-feeding or if you have circulation problems.
References
- Habif TP. Warts, herpes simplex and other viral infections. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/121280969-6/806516417/1195/75.html#4-u1.0-B0-323-01319-8..50014-5--cesec21_1286. Accessed Feb. 19, 2009.
- Lichon V, et al. Plantar warts: A focus on treatment modalities. Dermatology Nursing. 2007;19:372.
- Gibbs S, et al. Topical treatments for cutaneous warts. Cochrane Database of Systematic Reviews. 2006:CD001781.
- Goldstein BG, et al. Cutaneous warts. http://www.uptodate.com/home/index.html. Accessed Feb. 23, 2009.
- Aldara. Food and Drug Administration. http://www.fda.gov/medwatch/SAFETY/2004/mar_PI/Aldara_PI.pdf. Accessed Feb. 23, 2009.
- Focht DR 3rd, et al. The efficacy of duct tape vs. cryotherapy in the treatment of verruca vulgaris (the common wart). Archives of Pediatric and Adolescent Medicine. 2002;156:971.
- Your guide to diabetes: Type 1 and type 2. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/type1and2/YourGuide2Diabetes.pdf. Accessed Feb. 23, 2009.
