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Verrucae are extremely common and are experienced by most people at some time during their lives. Although most verrucae will spontaneously disappear without treatment, many patients seek treatment, often because they have persisted for many years, are unsightly or painful, or prevent them from doing sports or other activities
Treatment options include:
Verrucae needling: first described by Falknor in 1969 Falknor G.W. Needling—a new technique in verruca therapy. A case report. J. Am. Podiatry Assoc. 1969;59:51–52. [PubMed] [Google Scholar]. This method works by the successfully controlled inflammatory response that will prompt your immune system to destroy the HPV.
• No treatment: Up to 65% of viral warts including plantar warts resolve by themselves without any treatment within two years of appearing. Plantar warts that are not causing any adverse symptoms such as pain should be left alone.
• Salicylic acid paints and gels: These are available in different strengths. Salicylic acid works by removing the outer dead layers of skin and triggering the immune system into clearing the virus. Before applying the paint, the feet should be soaked in warm water and thickened skin filed away with a pumice stone or emery board. Care should be taken not to scrape the surrounding normal skin to avoid spreading the virus. Treatment should be daily for at least 12 weeks and is usually most convenient at bed-time. The paint /gel should be applied carefully to the wart, not the surrounding normal skin. If the wart becomes too sore, treatment should be stopped for a few days, then resumed.
• Cryotherapy. (See patient information leaflet on Cryotherapy). Freezing warts with liquid nitrogen (a very cold gas), may be available at your doctor’s surgery or podiatrist. Thick warts need to be shaved before freezing to allow the cold to get into the skin. Ideally, cryotherapy should be repeated every three to four weeks. It is painful and may cause blisters and burns, and because of this is not usually recommended in children. Several freezes may be needed to clear warts and it does not always work. Using a salicylic acid preparation in between freezes may improve the effectiveness.
• Duct Tape: Although there is conflicting evidence regarding the effectiveness of duct tape in the treatment of cutaneous warts, it might still be well worth trying, especially in children. The wart should be occluded with duct tape for six days, and if the tape falls off it should be replaced with a fresh piece. The tape should then be removed and the affected area soaked in luke-warm water and the wart pared down to remove any dead skin cells. The wart should then be left uncovered overnight and the duct tape reapplied once again in the morning. This can be continued for up to two months.
• Other approved topical treatments for plantar warts include formaldehyde gel, glutaraldehyde, and silver nitrate caustic pencils.