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Plantar warts
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Plantar warts

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INFECTIOUS DISEASE

Viral Illnesses

WOMEN'S HEALTH

Hair/Nails/Skin

Plantar warts are noncancerous skin growths on the soles of your feet caused by the human papillomavirus (HPV), which enters your skin through small or invisible cuts and abrasions. They're one of the most common warts seen by doctors.

Most plantar warts aren't a serious health concern, but they may be bothersome or painful, and they can be resistant to treatment. You may need to see your doctor to remove them.

Treatment

No wart treatment works 100 percent of the time. Most are aimed at destroying your warts or boosting your natural immune response to warts. Your doctor may recommend one or more of these therapies:

  • Freezing (cryotherapy). Freezing your wart with liquid nitrogen is one way to destroy it. Your doctor can apply liquid nitrogen with a spray canister or cotton-tipped applicator. The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. Freezing is the most common treatment for plantar warts and is usually effective, but may require multiple trips to your doctor every two to four weeks.

  • 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 use several types of lasers to eliminate warts. Carbon dioxide lasers emit a narrow beam of intense light that cuts away or vaporizes growths. Pulsed dye lasers emit a beam that vaporizes the blood vessels supplying the wart so that the wart dies. Some doctors also use the newer erbium: YAG laser, which can be precisely aimed to avoid damage to nearby tissue. These laser surgeries may be as painful as electrodesiccation and may take longer to heal.

  • Iontophoresis. Your doctor may deliver salicylic acid — the active ingredient found in many over-the-counter wart removers — into your skin using a technique known as iontophoresis (i-on-to-fuh-RE-sis). This method uses gentle electric current to draw the medicine into the tissue. This technique may be less painful than more invasive measures and may result in fewer scars.

  • Cantharidin. Doctors and healers have used cantharidin, a substance extracted from the blister beetle, to treat warts for centuries. This beetle juice, which is often mixed with other chemicals and painted onto the skin, is painless but causes the skin under the wart to blister, lifting the wart off the skin. Your doctor can then clip away the dead part of the wart in about a week. However, some doctors are hesitant to use cantharidin because it's not approved by the Food and Drug Administration for the treatment of warts.

  • Immunotherapy. This therapy attempts to harness your body's natural rejection system to remove tough-to-treat warts. This can be accomplished in several ways. 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. Your doctor may also apply a chemical to the skin to create a mild allergic reaction. When repeated over several weeks, this may help your immune system kill the warts. Finally, your doctor may inject your warts with interferon, a medication that boosts your immune system's instinct to reject warts.

  • Imiquimod. Available as a prescription cream (Aldara) that you apply directly to your wart, imiquimod is a promising, new immunotherapy medication that encourages your body to release immune system proteins (cytokines) to help ward off warts. Imiquimod is approved by the Food and Drug Administration for the treatment of genital and perianal warts but is also successful in treating common warts and plantar warts.

  • Other medications. 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 and can cause rashes or itching. They're not used if you're pregnant or breast-feeding or if you have circulation problems.

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