From the Guidelines
Plantar warts can be effectively treated with salicylic acid (15–40%) topical paints or ointments, or cryotherapy, fortnightly for 3–4 months, as these methods have shown to be effective in reducing discomfort and preventing spread. The treatment of plantar warts should prioritize methods that balance efficacy with minimal risk of side effects and scarring, considering the location and potential for discomfort 1.
Treatment Options
- Salicylic acid (15–40%) topical paints or ointments are recommended as a first-line treatment, applied daily after soaking and filing down the wart.
- Cryotherapy with liquid nitrogen is another common treatment, usually requiring multiple sessions spaced 2-3 weeks apart.
- Combination treatments, such as salicylic acid and cryotherapy, may be more effective but require careful consideration of potential side effects 1.
Considerations
- The treatment of plantar warts should take into account the potential for spontaneous clearance within 1-2 years, as well as the risk of spreading the virus to other areas or people.
- Home remedies, such as duct tape occlusion, may be considered, but their effectiveness is less well-established 1.
- It is essential to avoid walking barefoot and keep the wart covered when using communal facilities to prevent spreading the virus.
Recommendations
- For most patients, salicylic acid (15–40%) topical paints or ointments are a suitable first-line treatment, due to their ease of use and relatively low risk of side effects.
- Cryotherapy may be considered for patients who do not respond to salicylic acid treatment or have more severe cases, but it should be performed by a healthcare provider to minimize the risk of scarring and other complications.
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 can be used as a topical aid in the treatment of plantar warts (verrucae plantares). The treatment is used to remove excessive keratin on plantar hyperkeratotic lesions. Key points include:
- Salicylic acid 6% is used for this purpose
- It is used as an adjunctive therapy for plantar warts 2
From the Research
Plantar Wart Treatment Options
- Various treatment options are available for plantar warts, including cryotherapy, salicylic acid, and cantharidin-podophylotoxin-salicylic acid (CPS) formulations 3, 4, 5, 6, 7
- The effectiveness of these treatments can vary depending on the individual and the specific type of wart
Comparison of Cryotherapy and Salicylic Acid
- Studies have compared the effectiveness of cryotherapy and salicylic acid for the treatment of plantar warts, with some finding no significant difference between the two treatments 4, 6
- However, one study found that cryotherapy was more costly and no more effective than salicylic acid 4
- Another study found that cryotherapy was the most effective therapy for common warts, but not for plantar warts 5
Efficacy of Cantharidin-Podophylotoxin-Salicylic Acid (CPS) Formulations
- One study found that a topical CPS formulation was more effective than cryotherapy in the treatment of plantar warts 3
- This formulation consisted of 1% cantharidin, 5% podophyllotoxin, and 30% salicylic acid
Over-the-Counter Treatment Options
- Over-the-counter treatments, such as 17% salicylic acid with lactic acid in a collodion base, can be effective for the treatment of plantar warts 7
- However, treatment must be sustained for several months to achieve optimal results