From the Guidelines
For treating plantar warts in pediatric patients, I strongly recommend starting with salicylic acid (15-40%) topical paints or ointments, as this treatment has been shown to be effective with relatively low side effects 1. When treating plantar warts in pediatric patients, it's essential to consider the potential for spontaneous clearance, as warts in children are often relatively short-lived and may clear within a year or two 1.
Treatment Options
- Salicylic acid (15-40%) topical paints or ointments: This treatment is recommended as a first-line approach, as it has been shown to be effective in treating plantar warts with relatively low side effects 1.
- Cryotherapy: This treatment can be used for more stubborn warts, with a gentle freeze applied fortnightly for 3-4 months 1.
Important Considerations
- Painful treatments should be avoided in young children if possible, as they may not be well-tolerated 1.
- Treatment should aim to reduce discomfort, prevent spread, and address cosmetic concerns, rather than solely focusing on cure 1.
Additional Treatment Options
- Other treatments, such as dithranol, 5-FU, formaldehyde, glutaraldehyde, hyperthermia, laser, PDT, podophyllotoxin, and topical immunotherapy, may be considered for more extensive or resistant warts, but these should be used with caution and under the guidance of a healthcare provider 1.
From the Research
Treatment Options for Plantar Verrucae in Pediatric Patients
- Salicylic acid-lactic acid combination: This treatment method has been shown to be safe, painless, and effective for plantar warts in children 2.
- Cryotherapy: Although cryotherapy is a common treatment method, studies have shown that it may not be as effective as other treatments, such as salicylic acid-lactic acid combination or imiquimod 5% cream combined with a keratolytic lotion 3, 4, 5.
- Imiquimod 5% cream combined with a keratolytic lotion: This treatment method has been shown to be equally effective as cryotherapy and may be more effective for plantar warts 3.
- Cantharidin-podophylotoxin-salicylic acid: This topical formulation has been shown to be more effective than cryotherapy in the treatment of plantar warts 5.
- Salicylic acid-podophyllin-cantharidin product: This treatment method has been shown to be effective in 81 cases out of 100 patients with plantar warts in children 6.
Comparison of Treatment Methods
- A study comparing salicylic acid-lactic acid combination, cryotherapy, and imiquimod 5% cream combined with a keratolytic lotion found that the salicylic acid-lactic acid combination was the most effective treatment method 2, 3.
- Another study comparing cryotherapy and salicylic acid found that both treatments were equally effective for clearance of plantar warts 4.
- A study comparing cantharidin-podophylotoxin-salicylic acid and cryotherapy found that the topical formulation was more effective than cryotherapy 5.