Wart Treatment – Immune Therapy for Warts
HPV infection of the skin is a fascinating and complex disease that involves critical thinking amongst both patients and physicians. Wart treatment is more than just causing destruction to a skin lesion. Clinicians need to consider the host’s immune status, the type of HPV involved, the anatomical location and the tolerance for a certain procedure from a lifestyle perspective. The goal of therapy is to destroy the lesion in the fewest visits with the least pain.
At this time, there are a variety of well-studied as well as brand new wart therapies that one can use as monotherapy or in combination to create a positive therapeutic outcome for our patients dealing with plantar warts.
Looking At The Potential Of Microwave Therapy
Microwave therapy– The FDA approved microwave therapy in 2018 and Bristow and colleagues evaluated microwave therapy for 54 recalcitrant plantar warts. 94 percent of warts cleared in over 3 treatments with the device. Patients reported moderate discomfort but pain was resolved immediately post-treatment. This new method of treatment shows great potential and it continues to be researched for warts and skin conditions.
What About Surgical Treatment Options?
Excision of the verruca is common but there are no randomized controlled studies on this technique for the foot. Success rates are reportedly 65-85%, but the problem of these procedures are scarring and recurrence. Authors do not recommend excision of plantar warts as a first line therapy due to pain and possible recurrence and scar formation.
A Closer Look At Cantharidin
A blistering agent known as Cantharidin is derived from the beetle species Cantharis vesicatoria. It must be ordered from other countries since it is not approved by the FDA. After debridement, a thin layer of catharidin may be applied and covered with occlusive tape. Wash the affected area with soap and water anywhere between 6-24 hours, and a blister may form. Repeat once every two weeks. Catharidin is pain free, but may become very uncomfortble when blisters form. Some literature reports cure rates up to 80%, but there lacks randomized controlled trials on plantar warts.