Adult Skin Problems Slideshow Pictures Quiz: Can You Identify These Skin Conditions? Gallery of Skin Problems and Images Collection

Medical Author:

Gary W. Cole, MD

Gary W. Cole, MD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Treatment

Doctors may choose from several different techniques for removing plantar warts.

• Acid: One of the most common methods is to burn warts off with a mild acid applied topically to the wart. Many applications may be required over the course of several weeks to achieve this, but the technique is highly successful. Salicylic acid and dichloroacetic (or trichloroacetic) acid are useful.
• Other acid methods may be used.
• Upton's paste: A piece of thick adhesive tape (such as Leukoplast), with a hole cut in the middle for the wart, is applied to the sole to isolate the wart. Upton's paste is applied to the wart, and the whole area is covered with a second piece of tape. This is kept dry and intact for one week. The wart is then pared (shaved down) and the paste reapplied until clearance occurs. Upton's paste consists of six parts salicylic acid and one part trichloroacetic acid in glycerin, mixed to a stiff paste (ordered by prescription).
• Salicylic acid in white soft paraffin: A mixture of 40%-60% salicylic acid in white soft paraffin is applied daily after showering and covered with waterproof tape. You pare the wart once a week with a sharp blade.
• Efudex (5-fluorouracil), although not an acid, is another topical ointment that can destroy wart tissue in a manner similar to chemotherapy for skin cancer.
• Laser treatment: New technology has enabled doctors to use lasers to destroy the wart. The procedure, performed in the physician's office, is expensive and is likely to result in some scarring. Its efficacy in comparison to other destructive approaches in unproven.
• Cryotherapy: Freezing warts with liquid nitrogen is frequently successful. This causes the wart to turn black and eventually fall off within a few days. If used properly, there should be no scarring.
• Curettage and desiccation: After injecting a local anesthetic, the physician uses an electrical or ultrasonic device to destroy the wart, the remainder of which is removed with a curette. This technique is likely to cause a scar. (Note: The excision of warts is not recommended since the surgery may leave a painful scar and it is common for warts to return in the scar tissue.)
• Oral medication: No oral medication has proven effective in the treatment of warts.
• Immunotherapy: For plantar warts that are resisting treatment, you may be referred to a dermatologist for immunotherapy in which your body is taught to reject foreign substances.
• There are many other treatments available for the treatment of plantar warts. No single therapy is so effective that it has eliminated the use of all others. Ultimately, all treatments rely on the patient's immune system to recognize the wart virus proteins and to produce an immune response that will rid the body of this annoying problem.