From the Guidelines
Removing dead skin over a plantar wart prior to cryotherapy is recommended, as it allows for better penetration of the treatment and can improve outcomes. According to the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1, paring, if used to remove excess skin from warts before treatment, should avoid damaging surrounding skin because of the risk of spreading infection. This suggests that removing dead skin, when done carefully, can be a useful step in preparing the wart for cryotherapy.
The importance of removing dead skin is highlighted by the fact that plantar warts have a thicker cornified layer, which can reduce the effectiveness of treatments like cryotherapy 1. By removing this dead skin, the liquid nitrogen used in cryotherapy can penetrate more effectively to the core of the wart, where the virus resides.
It's worth noting that the cure rates for plantar warts are generally lower than for other types of warts, and that cryotherapy may not be as effective for plantar warts as it is for other types 1. However, paring the wart to remove dead skin before cryotherapy can still be a useful step in improving outcomes, and can be used in combination with other treatments like salicylic acid to gradually remove the wart. Patients should avoid attempting to cut or dig out warts at home, and instead consult a healthcare professional for proper treatment and care.
Some key points to consider when removing dead skin from a plantar wart prior to cryotherapy include:
- Using a scalpel or pumice stone to carefully remove the thickened, dead skin
- Avoiding damage to surrounding skin to reduce the risk of infection
- Using salicylic acid products between professional treatments to gradually remove dead skin and help expose the wart
- Repeating the cryotherapy process every 2-3 weeks until the wart resolves
- Consulting a healthcare professional for proper treatment and care.
From the Research
Removal of Dead Skin Prior to Cryotherapy
- There is no direct evidence in the provided studies that specifically addresses the removal of dead skin over a plantar wart prior to cryotherapy 2, 3, 4, 5, 6.
- However, some studies suggest that combining cryotherapy with other treatments, such as salicylic acid, may be effective in treating plantar warts 2, 3, 5, 6.
- One study found that a combination of cryotherapy and 70% salicylic acid treatment resulted in an 89.2% rate of eradication of verrucae in 86.2% of patients 6.
- Another study compared the effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts and found no significant difference between the two treatments 3, 5.
- A study that compared the efficacy of topical cantharidin-podophylotoxin-salicylic acid versus cryotherapy in the treatment of plantar warts found that the topical treatment was more effective than cryotherapy 4.
Treatment Outcomes
- The studies suggest that cryotherapy may not be more effective than other treatments, such as salicylic acid, in treating plantar warts 2, 3, 5.
- The combination of cryotherapy with other treatments, such as salicylic acid, may be a more effective approach in treating plantar warts 6.
- The choice of treatment may depend on various factors, including the patient's preferences and the specific characteristics of the wart 3, 5.