From the Guidelines
Occlusion therapy is a recommended treatment for plantar warts, and it works by covering the wart with an airtight, waterproof material to soften the skin and stimulate the immune system, with salicylic acid (15-26% strength) being a suggested treatment option, applied daily after removing the thick keratin layer, with occlusion if possible, as stated in the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1.
How Occlusion Therapy Works
Occlusion therapy increases skin hydration, softening the wart and enhancing penetration of any applied medication. The irritation caused by the occlusive material and medication stimulates a local immune response against the human papillomavirus (HPV) that causes the wart.
Treatment Approach
The most common approach involves applying salicylic acid directly to the wart, then covering it with duct tape, waterproof adhesive bandages, or plastic wrap for 24-48 hours at a time. This process is repeated for 3-4 months until the wart resolves, as suggested in the guidelines 1.
Additional Considerations
Between applications, patients should soak the affected area in warm water for 5-10 minutes and gently debride the dead skin with a pumice stone or emery board. Occlusion therapy can be combined with other treatments like cryotherapy for stubborn warts, and patients should keep the area clean and dry between treatments to prevent bacterial infection.
Key Points to Consider
- Salicylic acid (15-26% strength) is a recommended treatment option for plantar warts, applied daily after removing the thick keratin layer, with occlusion if possible 1.
- Occlusion therapy should be done consistently for 3-4 months until the wart resolves.
- Patients should keep the area clean and dry between treatments to prevent bacterial infection.
- Occlusion therapy can be combined with other treatments like cryotherapy for stubborn warts.
From the Research
Occlusion Therapy for Plantar Warts
Occlusion therapy is a treatment method used to manage plantar warts, which involves covering the wart with a dressing or tape to occlude it. The following points highlight how occlusion therapy works to treat plantar warts:
- Occlusion therapy can be used in combination with other treatments, such as topical agents, to enhance their effectiveness 2, 3.
- The application of an occlusive dressing can help to soften the wart, making it more susceptible to treatment 2.
- Topical agents, such as adapalene, can be applied under an occlusive dressing to treat plantar warts 3.
- Duct tape occlusion has been studied as a potential treatment for plantar warts, with mixed results 4.
- While occlusion therapy may not be as effective as other treatments, such as cryotherapy or CO2 laser, it can still be a useful option for some patients 4, 5, 6.
Mechanism of Action
The exact mechanism of action of occlusion therapy for plantar warts is not fully understood, but it is thought to involve:
- Softening of the wart due to increased moisture and warmth under the occlusive dressing 2.
- Enhanced penetration of topical agents into the wart 3.
- Possible immune system stimulation, leading to increased inflammation and eventual resolution of the wart 4.
Efficacy of Occlusion Therapy
The efficacy of occlusion therapy for plantar warts varies depending on the study and the specific treatment protocol used. Some studies have reported: