Tackling the Plantar Wart
By Darrel Arthurs, ARNP, DCNP
Warts that form on the sole of your feet are called plantar warts. Essentially, they are the same as warts that are found on the hands and knees except this strain forms on the bottom of the feet. The human papillomavirus (HPV) is the cause of these growths, and they thrive in warm and moist environments such as public showers and locker rooms. These warts can be painful since they grow up into the foot and put pressure on the nerves. Warts start life as tiny black dots and grow larger, usually about to the size of a pencil eraser. They are very tenacious and difficult to treat, frequently reoccurring despite your best efforts to eradicate them.
Over the counter topical wart removers can be purchased relatively inexpensively and applied on a regular basis. Gels, pads, or liquids can be utilized. My personal favorite is Duofilm 17.5% SA, which costs around $9.00 per bottle. Some brand names include Dr. Scholl's wart remover, Compound W, and Wart-Off. Be sure to follow the directions for whichever brand you choose since these medications' mechanisms of action are to burn the skin. To improve treatment, soak the feet in warm water for approximately 5 minutes prior to applying the medication.
Duct tape can be used to treat warts, but it leaves a terrible, sticky residue and takes months of treatment to reach clearance. However, it is economical and can easily be done as a home treatment. Just apply the duct tape to the wart and ensure that the entire lesion is covered with no air reaching the wart. Leave the tape in place for 6 days without removing it. Then remove for only a short period of time to clean off the surrounding skin then immediately re-apply the tape. Continue with the tape until the wart is completely gone with no bumps felt across the area. It would not be unusual for this treatment to take months—possibly up to 9-12 months of treatment to completely clear the wart.
Cryotherapy is a safe and effective treatment as well but must be performed by a qualified healthcare provider. This treatment is still covered by most insurances and is the most common treatment in the dermatology office. The drawbacks include multiple treatments as well as pain at the time of treatment. Liquid nitrogen is an immediate frostbite to the skin, and it can sting quite a lot at the time of application. Afterwards, a blister will form and may cause some further discomfort depending on the amount of walking the patient has to do.
Most importantly in treating warts is to always be persistent in application. Missing one day of treatment can allow the wart to regenerate and start to grow again, so persistence is the key to success. As you can see from the methods utilized we are not actually killing the virus with treatment but instead destroying the surrounding tissue that allows the virus to grow and replicate. Therefore, daily treatment or very frequent treatment without breaks is the key to success.
Darrel Arthurs's passion for dermatology developed while he was serving in active duty in the U.S. Navy. Since then he has accumulated over 11 years' experience in medical and surgical dermatology. Currently he works independently in a small city in northeastern Oklahoma. Arthurs is on the NADNP Board of Directors.