Edited by Lauren Dayes
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Ouch! You feel a painful pinch from the bottom of your left foot while walking. You take off your sock to check – a small and rough bump has emerged from the skin of your foot. You start to panic as this may be a plantar wart. Fear not, this article will go through what plantar warts are and how to treat them effectively and safely with products you can buy without a prescription.
What are plantar warts?
Plantar warts are common benign lesions on the bottom of the foot caused by the human papillomavirus (HPV). There are over 150 strains of HPV, some of which are known to cause severe complications in humans. However, it is important to note that having plantar warts does not put you at risk for genital warts or HPV-related cancers.
Plantar warts are characterized by the development of small, skin-coloured hard growths with rough surfaces. They can occur as a singular wart or in clusters (known as mosaic warts). Generally, transmission of HPV occurs through direct skin contact and exposure to contaminated surfaces. Additionally, small cuts or scrapes on the skin can provide a point-of-entry for the virus, making the individual more susceptible to infection.
Risk factors for developing plantar warts are similar to those for athlete’s foot, including:
Being barefoot in public areas where contamination may be more frequent (e.g., communal showers)
Weakened immune system
Sharing of personal items such as socks and shoes
Open wounds on the foot
Poor personal hygiene
How are plantar warts treated?
Lifestyle modifications are a vital part of treating plantar warts, as well as preventing re-infection and transmission to others. These changes include wearing appropriate footwear in communal areas, such as swimming pools and gym showers, changing into clean socks and shoes every day, and avoiding touching the warts.
While most warts are generally self-resolving and only produce pain upon pressure in most individuals, untreated warts may be uncomfortable. Leaving plantar warts untreated may increase the risk of spreading to other body parts or other people.
There are a few options when it comes to treating plantar warts, and some of them can be accessed without a prescription! In this article, we will be going over the two most used first-line options for the initial treatment of plantar warts.
Topical salicylic acid is used as an effective treatment for managing plantar warts and is available over the counter. It works by exfoliating the affected areas of the foot while stimulating local immunity to help combat the infection. Salicylic acid can be self-administered with minimal pain and risk of side effects. However, the treatment time is lengthy and often requires 6 to 8 weeks (sometimes up to a maximum of 12 weeks) for full resolution. Thus, it is important to closely adhere to the treatment schedule.
Some over-the-counter salicylic acid preparations include:
Dr. Scholl’s – available as 40% medicated discs
Other strengths and formulations of salicylic acid may be available by prescription at a compounding pharmacy.
Cryotherapy with liquid nitrogen is another first-line treatment for getting rid of plantar warts, and it is provided at some primary care clinics and administered by trained clinicians. It works by freezing the wart and destroying it. Compared to salicylic acid, cryotherapy may be more convenient with treatments every 2-3 weeks (up to a maximum of 6 treatments). A disadvantage associated with liquid nitrogen is the post-treatment pain and blistering that can be mobility-limiting. Due to the risk of side effects, cryotherapy is generally not recommended in young children with plantar warts.
There are also over-the-counter options for cryotherapy, however these products tend to be less effective than liquid nitrogen:
Dimethyl ether propane – available as Compound W Freeze Off
Nitrous Oxide – available as Compound W Nitro Freeze
When should I see a doctor?
You should see a doctor if you do not see any improvement in the lesions after an adequate trial of a treatment (e.g., 12 weeks for salicylic acid and 6 treatments for cryotherapy) as you may need to try a different therapy. You should also seek medical attention if you noticed any damage, pain, discharge or inflammation of the skin around the plantar warts.
Plantar warts are common skin growths affecting many people. Due to the contagious nature of plantar warts, it is crucial to wear proper footwear when walking in public areas to prevent the infection and spreading of warts. Over-the-counter products can be effectively and safely used to treat plantar warts. When in doubt, consult with your family doctor or local community pharmacist about your foot health.
Mallin A. Plantar Warts. In: Compendium of Therapeutics for Minor Ailments. Canadian Pharmacist Association. Updated September 30, 2018. Accessed August 12, 2022. https://www.myrxtx.ca/
Goldstein BG, Goldstein A, Morris-Jones R. Cutaneous warts (common, plantar, and flat warts). In: Post T, ed. UpToDate. UpToDate; 2022. Accessed August 12, 2022. www.uptodate.com
Burgess P. Cryotherapy for Warts. HealthLink BC. Updated March 3, 2021. Accessed August 12, 2022.