From the Guidelines
The most effective treatment for plantar warts is a combination of salicylic acid and cryotherapy, with a clearance rate of 86% reported in a retrospective analysis of cases treated with both therapies 1.
Treatment Options
- Salicylic acid products (like Compound W or Dr. Scholl's) are first-line treatments, applied daily to the wart after soaking and filing down dead skin, typically for 12 weeks.
- Cryotherapy using liquid nitrogen, performed by healthcare providers every 1-3 weeks, freezes and destroys the wart tissue.
- For stubborn warts, prescription options include stronger salicylic acid formulations (up to 40%), cantharidin application, or immunotherapy treatments like Candida antigen injections.
- Surgical removal through curettage or laser therapy may be used for resistant cases.
Important Considerations
- 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 can be undertaken, but care is needed with worse side-effects.
- Other treatments, such as dithranol, 5-FU, formaldehyde, glutaraldehyde, hyperthermia, laser, PDT, podophyllotoxin, and topical immunotherapy, may be considered, but the evidence is limited.
Treatment Goals
- The goal of treatment is to remove the wart and prevent recurrence.
- Treatment should be individualized based on the patient's symptoms, medical history, and preferences.
- A combination of salicylic acid and cryotherapy is the most effective treatment for plantar warts, with a high clearance rate and minimal side effects 1.
From the FDA Drug Label
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 is an effective treatment for plantar warts, as it aids in the removal of excessive keratin on plantar hyperkeratotic lesions.
- It is used as an adjunctive therapy for verrucae plantares, which are plantar warts.
- The recommended concentration is 6% salicylic acid 2.
From the Research
Effective Treatments for Plantar Warts
- The treatment of plantar warts can be challenging, but several options have shown effectiveness in various studies 3, 4, 5, 6, 7.
- A cantharidin-podophyllin-salicylic acid (CPS) formulation has been found to be effective in treating plantar warts, especially in cases where other treatments have failed 3, 4, 5.
- Cryotherapy is another common treatment for plantar warts, but its effectiveness compared to other treatments is still debated 4, 6.
- Salicylic acid has also been shown to be effective in treating plantar warts, either on its own or in combination with other treatments 5, 6, 7.
Comparison of Treatments
- A study comparing CPS formulation with cryotherapy found that the CPS formulation was more effective in treating plantar warts 4.
- Another study comparing salicylic acid with cryotherapy found that the two treatments were equally effective in clearing plantar warts 6.
- The effectiveness of a treatment may depend on various factors, such as the location, number of lesions, HPV biotype, and the patient's health condition 3.
Treatment Outcomes
- The CPS formulation has been shown to have a high success rate in treating plantar warts, with complete eradication of the warts in 95.8% of patients in one study 5.
- Salicylic acid has also been found to be effective in treating plantar warts, with a success rate of 81% in one study 7.
- Cryotherapy has been found to be effective in treating plantar warts, but its success rate may vary depending on the study and the comparison treatment 4, 6.