From the Guidelines
The most effective treatment for plantar warts is salicylic acid (15–40%) topical paints or ointments, or cryotherapy, fortnightly for 3–4 months, as recommended by the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1. When treating plantar warts, it is essential to consider the location and the potential for scarring.
- Paring, if used to remove excess skin from warts before treatment, should avoid damaging surrounding skin because of the risk of spreading infection 1.
- Combination treatments, such as salicylic acid and cryotherapy, can be undertaken, but care is needed with worse side-effects 1.
- Other treatments, including dithranol, 5-FU, formaldehyde, glutaraldehyde, hyperthermia, laser, PDT, podophyllotoxin, and topical immunotherapy, may also be considered 1. It is crucial to note that plantar warts can be contagious, and precautions should be taken to avoid spreading the infection, such as avoiding walking barefoot in public areas and keeping feet clean and dry.
- The treatment should be chosen based on the individual patient's needs and the severity of the warts, and a healthcare provider should be consulted for persistent or severe cases.
From the FDA Drug Label
For Dermatologic Use: Salicylic Acid 6% is a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders including verrucae, and the various ichthyoses (vulgaris, sex-linked and lamellar), keratosis palmaris and plantaris keratosis pilaris, pityriasis rubra pilaris, and psoriasis (including body, scalp, palms and soles). For Podiatric Use: Salicylic Acid 6% is a topical aid in the removal of excessive keratin on dorsal and plantar hyperkeratotic lesions. Topical preparations of 6% salicylic acid have been reported to be useful adjunctive therapy for verrucae plantares.
Salicylic Acid 6% can be used as a solution for plantar warts (verrucae plantares) as an adjunctive therapy 2.
- It aids in the removal of excessive keratin on plantar hyperkeratotic lesions.
- The drug is used topically for the treatment of verrucae plantares.
From the Research
Treatment Options for Plantar Warts
- Cryotherapy: a common treatment method that involves applying liquid nitrogen to the wart to freeze it off 3, 4, 5, 6
- Salicylic acid: a topical treatment that can be applied daily to help dissolve the wart 3, 4, 5, 6
- Monochloroacetic acid: an alternative treatment to cryotherapy that has shown comparable effectiveness for plantar warts 7
- Cantharidin-podophylotoxin-salicylic acid: a topical formulation that has been shown to be more effective than cryotherapy in some studies 5
- Combined cryotherapy and salicylic acid: a treatment approach that combines the use of cryotherapy with daily application of salicylic acid, which has been shown to be effective in some studies 6
Effectiveness of Treatment Options
- Cryotherapy has been shown to be effective in treating plantar warts, with cure rates ranging from 39% to 54% 3, 4
- Salicylic acid has been shown to be less effective than cryotherapy in some studies, with cure rates ranging from 15% to 24% 3, 4
- Monochloroacetic acid has been shown to be an effective alternative to cryotherapy, with comparable cure rates 7
- Cantharidin-podophylotoxin-salicylic acid has been shown to be more effective than cryotherapy in some studies, with a cure rate of 89.2% 5, 6
Comparison of Treatment Options
- A study comparing cryotherapy and salicylic acid found no significant difference in effectiveness for plantar warts 4
- A study comparing monochloroacetic acid and cryotherapy found that monochloroacetic acid may be preferred over cryotherapy due to comparable effectiveness and less treatment pain 7
- A study comparing cantharidin-podophylotoxin-salicylic acid and cryotherapy found that the topical formulation was more effective than cryotherapy 5