From the Guidelines
The best remedy for a plantar wart is over-the-counter salicylic acid treatments, which are available as liquids, gels, or adhesive pads, as they have shown a cure rate of 33% compared to 30% for cryotherapy and 23% for no treatment, according to the study by Bruggink et al. 1. Apply the product daily according to package instructions, typically for 2-3 months, making sure to soak and file down the dead skin between applications. For faster results, consider combining this with duct tape occlusion therapy by covering the treated wart with duct tape for 6 days, removing for 12 hours, then repeating for up to 2 months. If self-treatment doesn't work after 3 months, see a healthcare provider who may recommend cryotherapy (freezing with liquid nitrogen), prescription-strength treatments, or minor surgical procedures.
Some key points to consider when treating plantar warts include:
- The cure rate for salicylic acid treatment is around 33% for plantar warts, as shown in the study by Bruggink et al. 1
- Cryotherapy has a cure rate of 30% for plantar warts, as shown in the same study 1
- Combination therapies, such as cryotherapy and salicylic acid, may have a higher cure rate, with a reported clearance rate of 86% in a retrospective analysis of cases treated with both cryotherapy and salicylic acid 1
- However, the evidence for combination therapies is not as strong, and more research is needed to confirm their effectiveness
It's also important to note that plantar warts are caused by human papillomavirus (HPV) entering through tiny breaks in the skin on the bottom of the foot, creating a rough, grainy growth with tiny black dots (small blood vessels). While many plantar warts resolve on their own within 1-2 years, treatment can relieve pain and prevent spreading to other areas of your body or to other people. The guidelines for treatment of cutaneous warts, including plantar warts, are outlined in the British Association of Dermatologists' guidelines for the management of cutaneous warts 2014 1.
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% is a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders, including verrucae plantares (plantar warts). The best remedy for plantar wart, according to the drug label, is topical preparations of 6% salicylic acid, which can be used as an adjunctive therapy 2.
- Key points:
- Salicylic Acid 6% is used for dermatologic and podiatric use
- It is a topical aid in the removal of excessive keratin
- It is useful for treating verrucae plantares (plantar warts)
From the Research
Treatment Options for Plantar Warts
- Cryotherapy with liquid nitrogen: This method involves freezing the wart using liquid nitrogen, and it has been compared to salicylic acid application in several studies 3, 4.
- Salicylic acid application: This involves applying a salicylic acid solution or ointment to the wart, and it has been shown to be effective in treating plantar warts 3, 4, 5.
- Combined cryotherapy and salicylic acid treatment: This approach involves combining cryotherapy with daily application of salicylic acid, and it has been shown to be effective in treating plantar warts 5.
- Cantharidin-podophylotoxin-salicylic acid (CPS) treatment: This is a topical treatment that combines cantharidin, podophyllotoxin, and salicylic acid, and it has been shown to be more effective than cryotherapy in treating plantar warts 6.
Efficacy of Treatment Options
- Cryotherapy: The efficacy of cryotherapy in treating plantar warts has been shown to be similar to that of salicylic acid application in some studies 3, 4, but less effective than CPS treatment in another study 6.
- Salicylic acid application: The efficacy of salicylic acid application in treating plantar warts has been shown to be similar to that of cryotherapy in some studies 3, 4, and it has been recommended as a first-line treatment option 7.
- Combined cryotherapy and salicylic acid treatment: This approach has been shown to be effective in treating plantar warts, with a reported cure rate of 89.2% 5.
- CPS treatment: This treatment has been shown to be more effective than cryotherapy in treating plantar warts, with a reported cure rate of 53.8% compared to 41.7% for cryotherapy 6.