Treating Plantar Warts in Children
Plantar warts are a fairly common occurrence in children the argument has always been do we treat them or leave them alone in the hope that they will spontaneously resolve. Well our take on this subject is 1 wart is OK in a child however if it multiplies or gets larger then the parent must take the child for treatment of the plantar warts. There are many ways of treating a plantar wart in a child however most are not that successful. Freezing that is done by many GP’s is very painful and in most cases has little effect on the wart. Then I read articles such as the one below and the last paragraph suggests to pumice the wart down this is in fact the WORSE thing you can do as it will often spread the wart.
Warts are skin lesions caused by the human papillomavirus and occur in almost fifty percent of children at some time. The common wart is a small, hard, rough bump that usually occurs on the hands and fingers. The virus that causes warts can be spread to other parts of the body and to other people who have contact with the wart.
Another type of wart is the plantar wart that occurs on the soles of the feet. These types of warts may resemble calluses or corns, but you can tell the difference because plantar warts disrupt the natural lines of the skin and may have small black dots on their surface, which are tiny blood clots in blood vessels.
Flat warts are another type of wart that usually are found on the face.
Warts usually don’t cause any symptoms and do not require treatment, although plantar warts may be painful. Although there is no specific cure for warts and most will disappear on their own in a few years, if the warts are painful or causing cosmetic problems, there are steps you can take to remove them.
There are many over the counter medications that contain salicylic acid that may work if used daily for an extended period of time.
You can also see your doctor about freezing the warts (cryotherapy) to destroy the virus. This will cause a blister to form around the wart and hopefully, when this blister falls off, the wart and virus will come off with it. Paring down the wart before freezing, using several freeze-thaw-freeze cycles, and freezing for extended periods of time (perhaps up to a minute) may help this treatment work better.
Cantharidin is another treatment that can help to treat warts. It is similar to freezing in that it destroys the skin around the wart, but it is less painful when it is applied. It may hurt a little once the blister forms though.
Neither of the above treatments actually kills the virus that causes warts, they just kill the skin in which the virus is growing.
Aldara (imiquimod) is a newer, non-destructive treatment for warts. It is a cream that was first used to treat anogenital warts, but is now being used more to treat other types of warts and molluscumcontagiosum. It is applied to the warts three times a week, either with or without an occlusive dressing. You might need to soak and then pare or trim down the wart and then apply Aldara for it to work well.
Other treatments may include using a pulsed dye laser, injection of bleomycin or interferon, application of Retin-A liquid, or taking oral cimetidine.
Update: The newest treatment recommendations are to cover the warts with duct tape for 6 out of 7 days at a time. You then soak and pare down the wart and then reapply the duct tape the next morning. In one recent study, this treatment worked 80% of the time after about two months, while freezing only worked less than 60% of the time.
Many other ‘treatments’ are also often tried and sometimes work, such as rubbing the warts with a dime or placing raw potato slices on them.
Plantar warts are more difficult to treat. You can soften the warts by soaking them and then paring them down with an emory board or pumice stone and then apply an over the counter medicine with salicylic acid. Persistent or very painful plantar warts may need to be surgically removed.
At Brighton Podiatry we have been using lasers to successfully treat plantar warts in children for over 2 years now, some can even be treated with a “cold” laser that causes very little pain to the child. The Photo below shows the result of treating plantar warts in children using a cold laser.