Plantar Warts and Curettage

[Bronan the Barbarian]

This morning I went to the dermatologist for my third freezing treatment for plantar warts. I have (had?) a fairly large one on the bottom of my foot and one very large one covering the outside of my little toe, so not technically "plantar" I guess. The latter is really a mosaic wart consisting of many small warts. Dermatologist looked at them and decided that the freezing/acid/duct tape/filing/paring treatment is not producing good results, primarily because these things regenerate at a rate that would make Wolverine jealous. So it was time to move on to the next level of aggressiveness: That's right, curettage. This consists of numbing the area and then scraping/digging/scooping out the wart tissue with a curette (which is best described as a tiny melon baller), and then freezing the resulting wound for good measure. This is what I wanted him to do two months ago when I first went in. Oh well. So now I have a crater in the bottom of my foot, and a much larger one on the little toe. I am surprised the one on the toe is expected to heal without a skin graft. And he only did half of the little toe today because he didn't want to create too big of a wound. Next round in three weeks. Good times.

Anyone else dealt with these? Let's hear your war(t) stories.

PS: I was dismayed to hear at least a couple of dermatologists/podiatrists on Youtube refer to them as "planter's warts."

PPS: I'm always impressed by medical personnel who can simultaneously perform procedures and carry on a conversation.

[Culican]

I had one on my foot that wasn't bothering me too bad. I mentioned it during a regular checkup and he offered to freeze it off with liquid nitrogen. As I am on my feet all day, I passed. A month or so later I was researching a medication prescribed by my dermatologist for sun-damaged skin, (5-fluorouracil cream or 5-FU for short). I came across several articles about treating plantar warts with it so I tried it. Wart went away.

(The dermatologist had told me apply it as needed to sun-damage spots so I figured it wouldn't be too dangerous to try it on the wart.)

Here is one study, Google will give several more.

http://www.ncbi.nlm.nih.gov/pubmed/16703777

Topical 5% 5-fluorouracil cream in the treatment of plantar warts: a prospective, randomized, and controlled clinical study.
Salk RS, Grogan KA, Chang TJ.
Source

Northern California Foot and Ankle Center, San Francisco and Santa Rosa, CA, USA. drsalk@yahoo.com
Abstract

Topical 5-fluorouracil (5-FU) is an antineoplastic antimetabolite that inhibits DNA and RNA synthesis, thereby preventing cell replication and proliferation. This mechanism of action may allow topical 5-FU to be utilized in the treatment of human papilloma virus (HPV). We conducted a study comparing 5% 5-FU cream under tape occlusion versus tape occlusion alone in 40 patients presenting with plantar warts. Nineteen out of 20 patients (95%) randomized to 5% 5-FU with tape occlusion had complete eradication of all plantar warts within 12 weeks of treatment. The average time to cure occurred at 9 weeks of treatment. Three patients (15%) had a recurrence at the 6-month follow-up visit; accordingly, an 85% sustained cure rate was observed. It is concluded that use of topical 5% 5-fluorouracil cream for plantar warts is safe, efficacious, and accepted by the patient.

PMID:
16703777
[PubMed - indexed for MEDLINE]

[tertius]

Had a girlfriend with a big multi-wart on the outside of her little toe. Actually, most of her little toe.

She eventually murdered it by keeping her toe wrapped in duct tape, and starving it of air.
This was slow (as in, it took months), but was the only thing that actually got rid of it. This is also apparently the technique the military uses.

[Bronan the Barbarian]

Culican, thanks. I thought that I had read about every method of getting rid of warts.

Tertius, I think the duct tape method is disputed. How can you be sure of causation when plantar warts are known to disappear spontaneously? In any case, I've tried it several time over the years for months at a time to no avail.

[Philbert]

I had one on my heel for a few months, tried the acid, duct tape, freezing, shaving, bleach. Finally went to a dermatologist, she prescribed imiquamod ointment. After applying it for a few weeks the wart blistered off. Imiquamod is wildly expensive at retail, if insurance had not paid for it I would have gone for a third opinion.

[tertius]

Tertius, I think the duct tape method is disputed. How can you be sure of causation when plantar warts are known to disappear spontaneously? In any case, I've tried it several time over the years for months at a time to no avail.

I suspect there are varieties of warts that it works on, and some that it doesn't.

[Culican]

I had one on my heel for a few months, tried the acid, duct tape, freezing, shaving, bleach. Finally went to a dermatologist, she prescribed imiquamod ointment. After applying it for a few weeks the wart blistered off. Imiquamod is wildly expensive at retail, if insurance had not paid for it I would have gone for a third opinion.

Interesting. Imiquamod is another, newer, medication used for sun-damaged skin (just like 5-fluorouracil). There must be a similarity between warts and the skin sun-damage lesions.

[MattJ.D.]

I had two warts on my hand (over 4 years thought they were callouses) and i tried digging them out myself, the very core was extremely sensitive. Bought that freeze away shit didnt work at all. Then one day I noticed they were extremely brittle and litterly picked it off like a scab and my skin was normal again underneath...weird shit

[brettd]

I had one on my foot that wasn't bothering me too bad. I mentioned it during a regular checkup and he offered to freeze it off with liquid nitrogen. As I am on my feet all day, I passed. A month or so later I was researching a medication prescribed by my dermatologist for sun-damaged skin, (5-fluorouracil cream or 5-FU for short). I came across several articles about treating plantar warts with it so I tried it. Wart went away.

(The dermatologist had told me apply it as needed to sun-damage spots so I figured it wouldn't be too dangerous to try it on the wart.)

Here is one study, Google will give several more.

http://www.ncbi.nlm.nih.gov/pubmed/16703777

Topical 5% 5-fluorouracil cream in the treatment of plantar warts: a prospective, randomized, and controlled clinical study.
Salk RS, Grogan KA, Chang TJ.
Source

Northern California Foot and Ankle Center, San Francisco and Santa Rosa, CA, USA. drsalk@yahoo.com
Abstract

Topical 5-fluorouracil (5-FU) is an antineoplastic antimetabolite that inhibits DNA and RNA synthesis, thereby preventing cell replication and proliferation. This mechanism of action may allow topical 5-FU to be utilized in the treatment of human papilloma virus (HPV). We conducted a study comparing 5% 5-FU cream under tape occlusion versus tape occlusion alone in 40 patients presenting with plantar warts. Nineteen out of 20 patients (95%) randomized to 5% 5-FU with tape occlusion had complete eradication of all plantar warts within 12 weeks of treatment. The average time to cure occurred at 9 weeks of treatment. Three patients (15%) had a recurrence at the 6-month follow-up visit; accordingly, an 85% sustained cure rate was observed. It is concluded that use of topical 5% 5-fluorouracil cream for plantar warts is safe, efficacious, and accepted by the patient.

PMID:
16703777
[PubMed - indexed for MEDLINE]
where do you get this stuff?

[drlvegas]

I was treated with a bunch of different things for two nasty ones for close to a year before the doc said the last available treatment was a shot of something or another into each once a month for 3 months. He told me they hurt.

I went for my first shot, and the nurse immediately started building up how bad it was going to hurt. She then whipped out the smallest hypo I've ever seen--like a 1/2 inch long hair. The doc is a friend of mine, so, when I saw it, I thought they were busting my chops.

The most painful shot I've ever had--avoid at all cost.

It did actually work.

[melody]

I am giant hippie with this type of shit, but this one worked for my husband at my reccomendation. Take a small piece of cotton ball and soak it in raw apple cider vinegar. keep it on with a bandage. Do this 24/7 for 2 weeks, changing 2-3 times a day.

[Bronan the Barbarian]

I am giant hippie with this type of shit, but this one worked for my husband at my reccomendation. Take a small piece of cotton ball and soak it in raw apple cider vinegar. keep it on with a bandage. Do this 24/7 for 2 weeks, changing 2-3 times a day.

Apple cider vinegar--is there anything it can't do? I haven't tried this one yet. When the current treatment inevitably fails, I'll pull this thread up and work my way through all of these.

Here's a question for any MDs reading this thread: Is there a tactful, non-obnoxious way to tell your doctor, "Hey, I read about such and such drug on the internet. How about we try that?" (I'm referring to the stuff Culican and someone else mentioned in this thread.) I know that WedMD-educated patients can be a source of annoyance to doctors, and I'm sensitive to that, but is there any way to do this right?

[Culican]

where do you get this stuff?

5-fluorouracil cream requires a prescription (at least in the US).

[Culican]

Apple cider vinegar--is there anything it can't do? I haven't tried this one yet. When the current treatment inevitably fails, I'll pull this thread up and work my way through all of these.

Here's a question for any MDs reading this thread: Is there a tactful, non-obnoxious way to tell your doctor, "Hey, I read about such and such drug on the internet. How about we try that?" (I'm referring to the stuff Culican and someone else mentioned in this thread.) I know that WedMD-educated patients can be a source of annoyance to doctors, and I'm sensitive to that, but is there any way to do this right?

That's how I did it in the first place. I was having an actinic keratosis frozen with liquid nitrogen almost every visit to my doctor (too much sun when I was younger) and told my doctor that I had read about a cream to get them all at once. He said, "I'll refer you to a dermatologist and let him decide." Dermo examined me for 5 min, gave me a quick reason why he was prescribing 5-FU instead of the other cream mentioned in this thread, and then whipped out his rx pad.

Neither doctor was upset that I asked about it.

[OCG]

Asking a doctor for his opinion on a treatment is hardly a bad thing. At least it shows you're putting some thought into it and asking first.

[Michele Knaub]

"I thought I'd inquire if I was a candidate for (drug x/treatment x)" is the way I've done it. Straightforward and not mealy-mouthed.

[Michael Grantham]

I was treated with a bunch of different things for two nasty ones for close to a year before the doc said the last available treatment was a shot of something or another into each once a month for 3 months. He told me they hurt.

I went for my first shot, and the nurse immediately started building up how bad it was going to hurt. She then whipped out the smallest hypo I've ever seen--like a 1/2 inch long hair. The doc is a friend of mine, so, when I saw it, I thought they were busting my chops.

The most painful shot I've ever had--avoid at all cost.

It did actually work.

Was it Candida antigen? I've heard that this worked really well, and better yet, it can lead to the resolution of warts that aren't injected.