Houston podiatrist discusses using OTC treatments and conventional office treatments for plantar wartsWelcome back. Today, I'm continuing my video series on plantar warts. In the previous videos, I explained what plantar warts are, what they're caused by and how they're diagnosed. I also discussed what differentiated a wart from a corn or a callus. In today's video, I'll discuss over the counter treatments and do they work? I'll also discuss traditional treatments done in the office to destroy the wart tissue. Welcome, I'm Houston podiatrist, Dr. Andrew Schneider 

Plantar warts are very common and people tend to ignore them until they cause pain or they spread. And their first stop is usually the foot care aisle of the pharmacy. There are lots of home remedies and over the counter treatments to treat plantar warts. Some work for some people, but usually they're not very effective. One treatment is using salycilic acid. This comes as liquid or patches, and you apply the salycilic acid to the wart. Here's the problem. Often the body reacts to the acid and it sees it as a threat and it builds up callus to defend against it. So realistically, the acid never really makes it through the callus into the wart. There's also no way to protect the healthy skin from being damaged by the acid. And by damaging the wart, but by not destroying it, it can cause the wart to spread.

Another over the counter treatment is cryotherapy, which is using cold to destroy the wart. The over-the-counter products are not as powerful as the liquid nitrogen used in a podiatrist or dermatologist's office. And it's not usually strong enough to penetrate the thick skin on the bottom of the foot to fully reach the wart, to take care of it.

Finally, another common home remedy is duct tape. Some people swear by this method, but it's never really been proven to work. It involves putting duct tape patches over the wart and changing it every few days. In between applying the duct tape, you use a pumice stone or a file to remove the dead skin. I've seen a lot of people who have tried this method. It just doesn't work.

In the office, there are many treatments that are available for plantar warts. All of these are focused on destroying the wart tissue. Because of this, it can take many uncomfortable treatments to finally get the wart to resolve. One way, is using a stronger acid treatment. This is similar to the salycilic acid treatments that you used over the counter. You'll need to come into the office every few weeks for me to remove the dead skin that forms over it, so the acid can actually reach the wart. And the drawback is there's damage to the healthy skin, as well as damage to the wart. And again, if you damage the wart, but you don't kill it, it can spread.

Another treatment is with cryotherapy. Again, similar to the freezing that you may have tried over the counter, but with a much stronger liquid nitrogen. This is a painful treatment and it often causes a painful blister afterwards. And even though it's stronger, we still have trouble with the liquid nitrogen penetrating deep enough to resolve the wart. That's because the skin on the bottom of the foot is so much thicker. 

Another treatment for plantar warts is Canthridin. It's originally the extract of a blood beetle, but now I have this medication compounded in the pharmacy to make it pretty strong. A small amount of medication on the wart will cause a large painful blister that lasts about a week. The blister puts pressure back on the wart's blood vessels, causing them to shut down. Typically we have to treat about every two weeks until the wart is gone. In my opinion, this is the best of the conventional solutions that work, but they still have drawback in that it's painful.

Another treatment for plantar warts is using a laser. We use a pulse dye laser, and that targets the tiny blood vessels of the wart and helps to shut them down. You need to repeat the treatment about every three or four weeks. Also a painful procedure, and it may cause scarring. And when we have scarring on the bottom of the foot, that can become as painful or more painful than the wart was in the first place. 

So finally I'm often asked "Can't you just cut it out?" And surgical removal certainly is an option. I can cut it out, but in order for it to be successful, I would have to go not just to the wart tissue, but all the way into the dermis of the skin. And when you go into dermis of the skin, that's going to lead to a scar. And as I just mentioned, the scar can end up becoming more painful than the wart ever was to start with. I save surgical removal of plantar warts as an absolute last resort. I recommended it rarely.

So, if one of these treatments work and takes care of your wart...Great, right? Well, warts have a very high rate of return. That's one of the most frustrating things about them. Not to worry. I've a better solution, which we will discuss in next week's video, which we will discuss an innovative new treatment on using immunotherapy to treat plantar warts. If this video provided value to you, please like, comment, subscribe, and share on social media. That will help other people find the information they need to take care of their plantar warts. If you identified with anything we discussed today, contact us at the office and we'll get you in for an immediate appointment. Thanks so much for watching and have a great day. 

Dr. Andrew Schneider
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A podiatrist and foot surgeon in Houston, TX.