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6 effective ways to eliminate plantar warts

Mar 25, 2022, 20:51 IST
Insider
Plantar warts are painful growths on the bottom of feet that will typically go away on their own but it can take over a year.Savanna Durr/Insider
  • Plantar warts are painful growths on the feet caused by HPV, but they are not an STI.
  • To get rid of stubborn warts try duct tape, cryotherapy, immunotherapy, topical acid, or surgery.
  • To prevent plantar warts wear shoes in public, wash and dry feet regularly, and wear breathable shoes.
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Plantar warts, caused by certain strains of the human papillomavirus (HPV), are small growths that typically appear on the bottom of your feet, especially the heels or underside of the toes.

Sometimes, these warts can cause pain or discomfort when you put weight on the foot while standing or walking. And if left untreated, they can grow bigger, more painful, and more prone to infection.

Despite being caused by HPV, plantar warts are not considered a sexually transmitted infection, as the specific strains that cause them are distinct from the sexually transmitted strains of HPV.

Still, HPV is contagious, so plantar warts can be passed from person to person through a surface or object carrying the virus or direct skin-to-skin contact.

According to Nelya Lobkova, DPM, a board-certified podiatrist with Step Up Footcare, plantar warts are fairly common, and most cases happen in children and teens. People who are immunocompromised are also at a higher risk.

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There are two overarching methods for getting rid of plantar warts:

  • Destructive therapy targets the wart (not the virus), removing it by peeling off the layers of skin using treatments like duct tape, salicylic acid, surgery, and laser therapy.
  • Immunotherapy is the most nondestructive approach and typically uses topical treatments to help your immune system fight the virus.

It's important to note that plantar warts will typically go away on their own, but it may take over a year for them to completely disappear. If you don't want to wait, first opt for a more gentle treatment like duct tape or cryotherapy before going for a more aggressive treatment that could lead to permanent scarring.

Below, podiatrists share six different treatments for plantar warts and which are most effective.

1. Duct tape

By applying a piece of duct tape directly on the wart, the adhesive may gradually remove the wart in layers, says Lobkova.

For this method, Lobkova recommends keeping the tape on for three days, removing it and scraping the skin with a pumice stone, and then applying fresh tape again 10-12 hours later.

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How effective it is: "Skin turns over every 28 days so that is the soonest one could expect to see changes with this method," Lobkova says. "However, duct tape alone has rarely been successful in treating plantar warts in my experience."

And research has found cryotherapy to be more effective.

2. Cryotherapy

Cryotherapy is a freezing technique that involves applying a solution that causes a blister to form around the wart. As the blister dries up, the wart may then fall off.

According to Lobkova, this can be done at home with over-the-counter kits like Compound W Freeze Off and Dr. Scholl's Freeze Away — or at the doctor's office.

At-home kits contain dimethyl ether combined with propane, which you apply directly to the wart. A doctor is more likely to use liquid nitrogen, which Lobkova notes is stronger and therefore may be more effective.

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Since cryotherapy with liquid nitrogen can be painful, a doctor will often numb the area with an anesthetic before cutting the skin and applying the freezing substance with a spray or cotton ball.

You can expect the area around the wart to be a little tender for a couple of days after treatment, says Lobkova.

How effective it is: It often takes several treatments to get rid of plantar warts with cryotherapy, says Lobkova, and most people won't see improvements for three to four weeks or more. Research has shown that cryotherapy has a 25% success rate for curing plantar warts.

3. Topical acids

Medications with salicylic acid, lactic acid, and trichloroacetic acid work by essentially dissolving and sloughing off the wart one layer at a time. These are available in both over-the-counter and prescription-strength forms.

Over-the-counter products are usually a patch or liquid, which you apply daily to the wart after soaking it with warm water to soften and loosen the skin.

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For best results, cover the wart with a sock or bandage after applying the solution, wash it off the next morning, and then exfoliate the area with an emery board or pumice stone. This method is not usually painful, but may sometimes cause some mild irritation or discomfort, says Bruce Pinker, DPM, a board-certified podiatrist and foot surgeon at Progressive Foot Care.

How effective it is: A 2019 review found that salicylic acid was just as effective as cryotherapy for treating plantar warts. It will usually take at least two weeks and up to several months to see results with this method, according to Lobkova.

4. Surgery

Surgery is only recommended for plantar warts if they still persist after several months of trying other conventional treatments, says Pinker.

Surgery involves cutting out the wart, says Lobkova, and while your doctor will typically numb the area first, she notes that the injection of local anesthesia can be painful. In some cases, you may be sedated for the procedure.

Additionally, she says that sometimes cutting into the dermis layer of the skin can cause scarring which may lead to pain for a period of time after surgery when you put weight on it.

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In most cases, the skin needs to be stitched up with sutures afterward, says Pinker, and the healing process is monitored through several follow-up visits.

"Surgical excision is not a typical treatment for plantar warts anymore, since so many other effective, less invasive options exist these days," says Lobkova.

5. Immunotherapy

Immunotherapy involves topically applying or injecting a chemical, like candida antigen, meant to stimulate an immune response that targets and eliminates plantar warts.

Some of the most common solutions, according to Lobkova, include imiquimod and fluorouracil. All of these medications require a prescription — but whereas injections must be administered in a doctor's office, topical creams may be used at home.

Treatments are spaced two weeks apart, and it may take two to three months to see results, says Lobkova.

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Immunotherapy is usually only considered in severe cases where other treatments haven't worked, says Pinker. Additionally, experts note that it's usually combined with acids, lasers, or other treatments to speed up results.

How effective it is: A small 2017 study found that immunotherapy was more effective than cryotherapy for treating plantar warts: 76.7% of patients were cured by the former, whereas 56.7% of patients were cured by the latter.

One advantage of immunotherapy is that it may help ward off future outbreaks in recurring plantar warts.

6. Laser treatment

If you're dealing with a large, stubborn wart that's not responding to other methods, laser treatments can also be used to burn off the top layer of the wart, says Lobkova. Since these treatments can be painful, they're almost always done under local anesthesia.

While Lobkova says the cost will vary depending on the type of laser used, size of the wart, and whether or not your insurance covers it, it's important to note that this is one of the more expensive options at about $360 for three sessions. Lobkova says you can expect results in about three to four weeks after treatment.

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How effective it is: A small 2018 study found that with a laser, fewer sessions were needed to clear up plantar warts compared to cryotherapy. Note, however, that there is a slight risk of scarring with these treatments.

Prevention

Keep in mind that you have a higher risk of experiencing plantar warts if you already have a history of them, says Pinker.

Once your plantar warts are gone, podiatrists say there are several things you can do to prevent them from returning, like changing your shoes and socks daily to keep your feet clean and dry to prevent infection.

Here are a few more tips:

  • Wear shoes in public places: Lobkova says it's important to always wear something on your feet when walking around public pools, gyms, locker rooms, and showers. This is not only because they're contagious, but also because you're more prone to infection when your skin is moist and soft.
  • Wash your hands after handling warts: Since you can reinfect yourself by touching warts and then another part of your foot or body, always wash your hands after handling them.
  • Wash and dry the feet regularly and thoroughly: Consider washing your feet every night, and always after physical activity or sweating. Since the virus that causes plantar warts thrives in moisture, Pinker recommends applying a superabsorbent powder to your feet after washing and towel drying them. Don't forget to dry in between your toes.
  • Wear breathable shoes: Shoes that have a breathable upper layer allow your feet to breathe so sweat doesn't get trapped inside, says Lobkova. Whenever possible, Lobkova also advises removing the insoles, particularly inside athletic shoes, to allow them to dry out before putting them back in.

Insider's takeaway

Plantar warts are hard growths caused by the HPV virus that appear on the bottoms of the feet — while they can be a nuisance and sometimes painful, they aren't generally serious and may even clear up with over-the-counter remedies.

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Duct tape, topical acids, and cryotherapy are several common methods that can all be used at home.

"If home treatments are not successful after a few applications, seek the advice of a medical professional," says Pinker.

Immune therapy and laser treatments are two options for stubborn plantar warts that must be prescribed by a doctor. Surgery to remove plantar warts is usually a last resort.

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