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Verrucas or plantar warts normally go away on their own in a year or two in most people. In around half individuals the warts resolve in a year. In two thirds the warts resolve within two years. In the remaining one third however the warts may persist and may be resistant to treatment. 1-5
Treatment for verruca is recommended in only some special cases. For the rest prevention of recurrence and spread are the only measures that are adopted.
Treatment is recommended in:
Those with suppressed immunity like after a kidney or liver transplant and those with diseases like AIDS that causes suppression of immune functions.
Those in which the warts have become painful and have led to difficulty in walking and bearing weight necessitating treatment
Patients who desire therapy
Verrucae are curable but no single treatment can be guaranteed to be effective in every case. In addition not all verrucae need to be treated.
The highest cure rates are in young people with recent onset of symptoms or warts.
Self-care and treatment may be begun at home. The wart is first pared down, or filed with sandpaper and then the foot is soaked in warm water for at least 5 minutes. This softens the wart and helps treatment. This is to be repeated every night for at least 12 weeks and the surrounding normal skin should also be treated. Treatment is stopped for a day or two if the skin becomes tender.
Those with mosaic warts may also begin treatment with a salicylic acid of formaldehyde containing gel. If there are a large number of small verrucae the area is soaked for 10 minutes at night in a weak formaldehyde solution.
Medications like salicylic acid preparations can be used to treat verrucas. These are available as gels, paints, plasters, colloidion etc. These may be combined with podophyllum resin.
Other preparations contain formaldehyde, glutraldehyde, tretinoin (Retinoic acid) or bezoyl peroxide.
This is done by freezing the affected area with liquid nitrogen, using either a cotton wool swab or a spray. The podiatrist usually pares or sandpapers off the art before this therapy and freezes it with this technique. This therapy may be combined with a salicylic acid preparation.
The treatment is performed once at least three weekly for better cure rates. This therapy is usually painful and may lead to formation of blisters and is thus not used in children.
If there is no change or improvement after 7 or 8 visits of freezing, the treatment is considered to be a failure and is discontinued.
Resistant plantar warts may be removed under a local anaesthetic. The technique involves scraping the verrucae with a sharpened spoon-like instrument called a curette. The remaining raw area is cauterized with electrically heated points. This is also a painful procedure.
Sometimes after removal or scraping some medications might be used to stop recurrence or growth. These include interferons, 5- flurouracil, bleomycin etc.
Laser treatment may be used in multiple or mosaic warts in some patients who have failed to respond to other forms of therapy. This therapy may lead to pain and formation of scars.