Treatments and drugs

By Mayo Clinic Staff

Plantar warts often don't require treatment. Most warts resolve on their own without treatment within a couple of years. However, if they are causing pain or spreading, they should be treated. It's much easier to treat a few small warts than several large warts.

Plantar warts can stubbornly resist treatment. Therefore, most treatments require patience, persistence and multiple interventions.

People with diabetes, nerve damage in their feet or weakened immunity need treatment under a doctor's supervision. Your doctor will closely monitor the treatment effect and the quality of wound healing.

Treatments provided by your doctor

If home remedies aren't working, your doctor may recommend other treatments. Doctors generally start with the method that is least likely to result in pain, side effects and scarring. Scarring on the sole of the foot can be painful and is usually irreversible. Treatments often need to be repeated, and warts may return at a later time.

Treatment options include the following:

  • Freezing (cryotherapy). Your doctor can apply liquid nitrogen with a spray canister or cotton-tipped applicator to freeze and destroy your wart. The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. The application itself can be painful, and cryotherapy can result in painful or tender blisters that resolve on their own.
  • Cantharidin. Your doctor may use cantharidin — a substance extracted from the blister beetle — on your plantar warts. Typically, the extract is paired with salicylic acid, applied to the plantar wart and covered with a bandage. The initial application is painless, but the subsequent blister that forms can be quite painful. Your doctor clips away the dead part of the wart in about a week.
  • Immunotherapy. This therapy attempts to harness your body's immune system to remove tough-to-treat warts. This can be accomplished in a couple of ways. Your doctor may inject your warts with interferon, a medication that boosts your immune system's instinct to reject warts. Or your doctor may inject your warts with a foreign substance (antigen) that stimulates your immune system. Doctors often use mump antigens, because many people are immunized against mumps. As a result, the antigen sets off an immune reaction that may fight off warts. Interferon treatment may result in flu-like symptoms for a few hours after treatment. Both treatments may cause pain.
  • Imiquimod (Aldara). This prescription cream applied directly to a wart is an immunotherapy medication that encourages your body to release immune system proteins (cytokines) to attack HPV. This treatment can result in severe inflammation near the site and damage to the tissues beyond the wart. If this occurs, the treatment is dropped. The drug may also result in flu-like symptoms that may lessen with a lower dosage.
  • Minor surgery. This involves cutting away the wart or destroying the wart by using an electric needle in a process called electrodesiccation and curettage. Your doctor will anesthetize your skin before this procedure. This treatment is avoided if possible with plantar warts because of the risk of scarring.
  • Laser treatment. A type of laser treatment called pulse dye laser treatment burns closed (cauterizes) tiny blood vessels. The infected tissue eventually dies, and the wart falls off. This treatment can cause pain and scarring.

With each of these treatments, your doctor will provide instructions about how to cover a wart or wound, remove dead tissue between appointments, clean the site, and change a dressing if needed.

Your doctor may also direct you to use over-the-counter wart treatments along with these treatments or between visits to the office. He or she may also recommend the use of an antibiotic cream to protect the site from common infections after a wart has been removed or after a treatment-related blister has broken.

May. 03, 2011