Plantar warts

Dear Footsie,

There are a number of 'natural' treatment options that may help rid your soles of stubborn warts, although evidence for their efficacy is limited. That being said, duct tape and zinc treatments have been found to help a bit (more on these later). Additionally, they may just go away on their own over time, but it may take a year or two. Although these types of warts can be pesky and painful, there are many different methods of treatment that have been shown to be effective in reducing the size and number of warts.

First, a quick primer on what they are: Plantar warts are a type of viral infection that cause hard, rough-surfaced skin areas to emerge on the soles of the feet. Often the warts appear with a black dot in the middle, sometimes referred to as "the seed." Plantar warts can be especially painful and tender due to their location, occasionally leading to back or leg pain. Infection with plantar warts most often comes from contaminated floors in swimming pool areas and communal showers.

The American Academy of Family Physicians recommends salicylic acid and cryotherapy with liquid nitrogen as the front-line therapies for wart treatment. Salicylic acid can take up to twelve weeks to be effective and cryotherapy has been shown to cure 50 to 70 percent of warts after three to four treatments. Salicylic acid treatments are available over-the-counter at pharmacies.

As for natural wart removal, there is less clinical evidence as to their effectiveness. That said, you might consider trying the following methods either on their own or in conjunction with clinically-recommended forms of treatment.

• Duct tape: The American Academy of Dermatology recommends applying a small piece of duct tape to the wart and removing it every few days until the wart goes away.
• Topical zinc ointments: Small-scale clinical trials have shown some promising evidence of efficacy of topical zinc for wart treatment.

To keep warts from spreading before or during treatment, avoid direct contact with the warts and don't pick at them. It's best for only health care providers to cut out warts, as there is a risk of bleeding, scarring, and infection. To relieve discomfort from the warts, some people have tried wearing a foam pad or donut in their shoe.

If plantar warts continue to plague these efforts, a visit to a health care provider may be warranted. Tell them if and which methods of treatment have already been tried, and discuss with them other types of treatments including drug therapy, cryotherapy ("freezing" the wart), laser treatment, or cutting out the wart, may be appropriate.

The good news about plantar warts is that they often disappear within two years on their own, which is called spontaneous remission. On the other hand, these warts, whether treated or not, can persist and recur at any time. To prevent getting plantar warts in the first place, try to keep your feet clean and dry by changing your shoes and socks frequently, and wear sandals or flip flops when walking in public showers, locker rooms, and pool areas.

Hope you'll be playing footsie again soon,