Mittleman article

My twelve-year-old son has had plantars warts on both feet for some time. We have tried several over the counter remedies without success. Someone said they are caused by a virus, what can we do about it?

Plantars warts are common in adolescents and are caused by the human papiloma virus. This is similar to the virus that causes the common cold. They often appear as a thick painful callous growth on the sole and will frequently appear in different locations on both feet. Treatment for warts can be frustrating because they may be stubborn to resolve. Most current treatments employ the destruction of the wart tissue by use of chemical, freezing, or burning methods. There has been a lot of talk in the news about the treatment of warts with "duct" tape, but this alone does not appear to be effective.

There are many treatments that we employ in our practice for these stubborn viral growths. Most smaller warts can be resolved with local treatment with an agent called "Canthardin" which is a vesicant, causing a local irritation of the skin and blister formation around the warts. The warts "die" within the blister and are easily shaved away on a follow up visit. Many warts are resolved with on or two simple treatments of this chemical.

We also employ the use of an oral medication, Cimetidine (trade name Tagamet) this medication is known to help in stomach problems, but also is very effective at irradiating warts in children and adolescents by its action on histamine release. In recalcitrant cases we use the CO-2 (Carbon Dioxide) Laser which can be used to selectively destroy the wart tissue with minimal scarring of surrounding skin. There are other new and older agents available for wart treatment including Aldara cream, Bleomycin injections, and the old stand by Salicylic Acid, which is in most over the counter wart remedies. In summary, most warts respond to treatment, but it can take a variety of methods to resolve an individual case.

Marc G. Mittleman, D.P.M. Diplomate,
American Board of Podiatric Surgery Fellow,
American College of Foot and Ankle Surgery Member,
South Bay Independent Physicians Medical Group, Inc