From the Guidelines
Formaldehyde solutions should not be used for treating plantar warts due to their potential toxicity and carcinogenic properties. According to the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1, formaldehyde is listed as a treatment option with a strength of recommendation of D, indicating a lower level of evidence and potential risks.
Treatment Options
Instead, the following treatment options are recommended:
- Salicylic acid (SA) with a strength of recommendation of A, which can be applied topically in concentrations of 15-26% after removing the thick keratin layer, with occlusion if possible, for 3-4 months 1.
- Cryotherapy with a strength of recommendation of B, which involves freezing the wart for 15-30 seconds, repeating every 2-4 weeks for at least 3 months or six treatments 1.
Risks of Formaldehyde
Formaldehyde solutions can cause skin irritation, chemical burns, and damage to healthy skin surrounding the wart 1. Additionally, formaldehyde has an unpleasant odor and can trigger respiratory issues.
Recommendation
Salicylic acid products or cryotherapy are safer and more effective options for treating plantar warts. If over-the-counter treatments fail after several weeks, it is recommended to consult a healthcare provider for professional treatment options like prescription-strength medications, laser therapy, or surgical removal.
From the Research
Treatment Options for Plantar Warts
- The treatment of plantar warts can be challenging, and various options are available, including cryotherapy, salicylic acid, and cantharidin-podophylotoxin-salicylic acid (CPS) formulation 2, 3, 4.
- Cryotherapy and salicylic acid are commonly used treatments, but they have been shown to have low cure rates for plantar warts, with cure rates of 45.61% and 13.6%, respectively 3.
- The CPS formulation has been shown to be more effective than cryotherapy in the treatment of plantar warts, with a cure rate of 97.82% 3, 4.
Formaldehyde Solution
- There is no mention of formaldehyde solution as a treatment option for plantar warts in the provided studies 5, 2, 6, 3, 4.
- However, glutaraldehyde is mentioned as a first-line therapy for cutaneous warts, which includes plantar warts 2.
Efficacy of Treatments
- The efficacy of different treatments for plantar warts varies, and the choice of treatment depends on the individual patient and the severity of the wart 2, 3, 4.
- A systematic review of topical treatments for plantar warts found that the average cure rates of different treatments were variable, ranging from 13.6% for salicylic acid to 97.82% for the CPS formulation 3.
- Another study found that topical CPS was more effective than cryotherapy in the treatment of plantar warts, with a significant difference in complete clearance rates between the two treatments 4.