Thursday, January 1, 2009

How I killed a very stubborn plantar wart

This blog is intended as a one-time-post detailing the process by which I successfully rid myself of a very stubborn and durable plantar wart. The purpose of this blog isn't to dole out medical advice, but rather to describe what did and didn't work in my particular scenario.

I discovered that the internet held a wealth of information with regards to treatments for plantar warts and ultimately I suppose that this blog is just another example of this. Regardless, if you've come here you either have a strange fascination with skin growths, or you're looking for advice on how to rid yourself of one of these pesky little critters. Here's my success story -- may it provide hope to you.


Your comments and tips are welcome - others may benefit from your advice.


--


Me: Male, 33, Canadian


Background:

I first discovered that I had a new foot friend midway through 2007. Having dealt with plantar warts in my childhood, I suspected immediately that I had another one. I wasn't surprised at having "caught" one since I spend an awful amount of time in public change rooms and showers and have never bothered to wear sandals. At first, I didn't think too much about the wart; I'd have to treat it like my parents did for me when I was a kid which meant nightly soaking sessions and parring away the skin. This process would last a few days, maybe a week, and then the wart would be gone. No problem I thought, I'd get around to treating it and it would be gone in no time. I procrastinated and didn't treat it immediately. A month probably passed before I started treatment.


Lessons learned: Wear sandals in public showers. Start treatment ASAP.


Treatment Attempt #1: Soak, Dig and Hack

A month passed and unbeknownst to me my little friend had rooted himself in nice and deep. From a visual perspective, my wart was about the size of the eraser head on a regular pencil. It was painless to me, but I would occasionally feel it while walking. I could feel that the skin was slightly elevated and hardened over the wart.

So I began the treatment process of digging and hacking. This consisted mostly of soaking my foot in warm water so that the skin would become soft. I would then cut away dead skin around the wart with nail clippers. It was always a personal challenge to see just how far I could dig without it becoming too uncomfortable. I figured a few days of this and I'd have the little bugger completely excavated. A couple of weeks passed and it finally donned on me that these things couldn't just be hacked out of your foot.

Lesson learned: Plantar warts are cellular based. Unless you dig out every single cell from the growth, there's not point in digging at all.

Treatment Attempt #2: Salicylic acid pads

So I headed out to the local drug store in search of an over-the-counter remedy to help me out. I found plantar wart treatment pads which looked nice and easy to use. These pads come with a medicated core that is mostly a salicylic acid based mix. The idea here is that the acid slowly kills the skin around the wart, and the wart itself. The medication causes your skin to turn white (which is dead skin), and you can then peel/cut some away before applying a fresh pad. It's a little messy, but would gradually lead the killing the wart... or so I thought.

I used these pads for about two months. Each night I'd peel off the used pad, clean the skin, and cut and file away as much dead skin as possible. It did look like I was getting closer to the root of the wart, but unfortunately there was a lot of collateral damage to the skin around the wart. My eraser head sized wart was being treated, but so was a quarter-sized area of skin around the wart. The pads slid around under my sock and would require re-centering during the day. You might have more success taping the pads down a little more to prevent movement, but ultimately for me the wart and surrounding skin became quite painful. Not a harsh pain, but more of a throbbing type of pain when I'd walk on it. Of more concern was that I couldn't tell if the wart was dying or not; the skin had become so messy around the wart. I continued to use this treatment for a couple of months, and eventually had had enough and stopped, not really knowing if the wart was dead or not. After a couple of weeks, my skin returned to normal color and it became clear to me that warty was still there.

Lesson learned: it is difficult, if not impossible, to tell if the wart is actually dead.

Treatment Attempt #3: Salicylic pastes

I turned to using Salicylic acid pastes next, after discovering that warty wasn't dead. Duoplant was the brand I bought. The two advantages the paste had over the pads were that it was cheaper, and it had a slightly higher concentration of acid, which I thought would be helpful. Over the course of another couple of months, I applied the cream, covered the wart, removed the bandage, soaked the foot, parred away skin and repeated the process daily. Ultimately, the effect of the pastes is the same as that of the pads. There was a lot of collateral damage, and my foot became painful. I endured this for another couple of months and actually felt that progress was being made. It was taking a lot longer than I thought, but on a daily basis I was able to hack out a good chunk of dead skin. I felt that if I kept this up I'd have this thing beat. Again, another problem with the paste is that the skin became so messy and raw around the wart that it became difficult to tell whether the thing was dead or not. After another month of this, I thought it was dead.

Lesson learned: to kill a wart, you've got to kill every single cell of the virus. If you can't tell whether you've accomplished this, then you're wasting your time.

Treatment attempt #3.5: A visit to the physiotherapist?

Ok ,I'll admit that this has little to do with the treatment of my plantar wart, but it's a funny aside that I'll mention. Over the course of the past few months I'd developed a sore hip/groin muscle. I couldn't figure out what was causing it, but thought it was probably the result of the biking I do, or the hockey I play. I ignored it, figuring it would go away as these things generally do. It didn't. I decided to go and see my physiotherapist who helped me treat it with a variety of stretches and exercises. This helped a little, but the nagging pain was still there.

Only months later did it occur to me that the pull was being caused by the stretched position I'd assume when treating my plantar wart. Sitting on the side of the bathtub, with my foot pulled up over my other leg's knee and my back hunched over was causing a strain on my hip/groin!

Lesson learned: stretch before you pull your body into uncomfortable positions. :-)

Treatment attempt #4: Duct tape

A few weeks passed during which time the skin on my foot healed and returned to a normal looking state, not the gnawed up white mess that was caused by the acid paste and my digging. And when things cleared up .... lo and behold, I still had a wart. I donned on me that I had probably under-estimated the durability of this thing and I started to wonder just how deep it was rooted. As luck would have it, I had a regular Dr. appointment scheduled. I asked my Dr about the wart, her response after examining it and parring away some dead skin was that "it looked quite small, and was almost gone. I mentioned to her the failed attempts with pads and paste. She suggested two things: 1) using liquid nitrogen to freeze the wart, and 2) using duct-tape to cover the wart.

The theory behind duct tape is referred to as occlusion therapy whereby you cover a wart for an extended period of time which triggers stimulation of the immune system to fight the wart. She mentioned I'd have to come back multiple times for the freezing therapy and suggested I give the duct tape a try. Before I left, she did apply liquid nitrogen to the wart and suggested that this "might just do it", but to use the duct tape in case it re-appeared. A week later, I examined my foot and was frustrated to see that the freezing hadn't worked. But hey, I had duct tape to look forward to, so I wasn't all that down on it. And so began my "experimental" treatment phase of my plantar wart. I mean hell, she's a Dr., and must know what she's talking about. This duct-tape has got to work, right?!

Lesson learned: Don't mess around with these things and experimental treatments... go to the Dr consistently until it is dead.

Duct tape... what could be easier... simply cut away a small piece of tape that covers the wart, tape it on, and wear it... all day. Change tape as needed. So simple... so easy.... so painless... so... so.... so.... useless. I wore freakin' duct tape for over three months and nothing ever happened. The wart did begin to look "agitated", but it never disappeared.

After three months I became impatient. I decided to start applying salicylic acid paste under the duct tape and resorting to a combination of tape and soaking/digging/hacking. My foot became a bloody mess, but I didn't care at this point, this was all out war. Another month of this and I gave up. My foot was constantly in pain from the collateral damage of the acid paste, my socks were all ruined from duct tape stickiness and I was really back to square 1. Again, it became difficult to tell if the wart was dead. I held a faint glimmer of hope that it might be, but after stopping tape/paste treatment the skin healed over and revealed that warty was still there.

Lesson learned: There are tonnes of people who swear by this treatment, or a variety of other ones. Google "duct tape wart" if you want proof. I'm sure people have had success with pads, paste and freezing too. However, what I was quickly learning was the not all treatments worked for everyone.

Treatment Attempt #5: Home Freezing Kits

Back to the drugstore I went, looking for another option. Having been to the Dr. who tried freezing, I decided to try the home freezing remedy kits. They are fairly easy to use, and I found them to be quite painless. By this time, however, my pain tolerance threshold for my foot had increased somewhat. Freezing kit instructions say to apply the freezing tip to the wart for roughly 20 seconds, and to repeat in a week or so. I kicked it up a notch - I applied multiple "freezes" to the wart and surrounding skin, and did so every other day. Between freezes I would cut/dig away skin. At first I though the results I was seeing were positive. I was able to hack out pieces of warty skin and thought I was getting to the root. It was cleaner than the creams, and more controlled in the application. I had hope...

After burning through a couple of freezing kits, I was left with a painful foot ... and a wart. It turns out I just couldn't get to the root of the thing without it being too uncomfortable.

Lesson learned: The roots on plantar warts can be quite deep.

For what its worth, OTC freezing kits are not nearly as powerful as the liquid nitrogen administered by a Dr. One treatment I never tried was the consistent application of liquid nitrogen.

The Spread:

I spent a good amount of time worrying about spreading my plantar wart to my wife. She warned me daily saying "If I get one of these on my feet...(insert random threat here)". I was careful enough not to walk around barefoot, and to ensure that I cleaned up my "surgery" area after treating the wart, but we did sleep in the same bed after all. Luckily we did not share a shower.

And then the spread happened. Not to my wife, but to my other foot. Yup, old warty had a new friend, in roughly the same place on my other foot.

Lesson learned: Plantar warts spread. I knew this already, but I'll reiterate it here because anyone dealing with these should know that they are contagious.

Treatment Attempt #6: The Chiropodist and Beetles

So here I was. Several month of treatment later and not only did I still have the wart, it had also managed to spread to my other foot. My original wart looked battle hardened. I knew now that it was deeply rooted and seemed to have some sort of magical power for healing itself. With everything I had tried, I just couldn't get to the bottom of it.

My new wart was much smaller and looked more manageable. Still, I wasn't about to try the same series of treatments on it. It was time to see an expert. I found a local chiropodist. I'm not sure these guys are actually experts in warts, but the one I saw definitely made a good business treating them. Over the course of the next 8 months I visited him roughly 14 times. Each visited lasted about 3 minutes, and cost $40. That's good business.

My chiropodist's recommendation was to use some sort of cantharidin based cocktail he had. Cantharidin is a blistering agent that is apparently secreted by some species of beetles. I thought, hey why not, I wore duct tape on my foot for 3 months, so why not give beetle juice a shot.

My chiropodist applied a very small amount of the beetle juice to the warts (both of them), cover it with medical tape, and send me home. About 3-4 hours later, things would become very uncomfortable. About 5-6 hours later, I couldn't walk on my feet and just sitting around was painful. The best thing to do was to go to bed. In the morning, I would remove the tape (which wasn't fun) and then lance the huge blister that had formed over the wart and surrounding skin. There was definitely a lot of collateral damage to using this method. After lancing the blister, it would drain, and thing would be more comfortable again. Over the course of the next couple of days, the blister would require more draining, and on the fourth day I was able to peel the blister. That's when things got interesting. Peeling the blister really allowed you to get a good view of the wart. Mine was lighter in colour, and really stood out set against the pink fleshyness of the surrounding skin. After peeling the blister, the foot would be uncomfortable again for a day or two, so really it may have been better not to peel the blister. But I couldn't help it - I had to see what was going on under there... and I was willing to put up with the discomfort.

After my first application of beetle-juice, my "new" wart was gone. My original wart definitely required another application. But hey! This worked! It had destroyed one of my warts! And so I returned two weeks later - filled with hope - for what I thought would be the final application to old warty - the killing blow, the coup de grace.

After peeling that blister, I knew it was a no-go. Warty would require another application.

Application #3 came and went. We needed another.

This went on for a total of 5 applications, spaced by two weeks. I deduced that old warty was just being giving too much opportunity to heal in between applications. I requested that we up the application to every 7 days. And so we did this, for 3 more consecutive weeks. Applying this stuff every 7 days was uncomfortable. Each time I'd return for an application, my skin was hardly healed from the previous week. Peeling the blister on day 4 became important, if not just to allow the skin to harden a little before the next beetle juice application.

After the third consecutive week application, my chiropodist concluded that we had killed the wart, except for a very tiny speck left to which he applied liquid nitrogen freezing. I said "Are you sure?", he said probably. I didn't feel good about it, but trusted his recommendation... somewhat. On the way out I bought a home freezing kit and drained the thing into the speck that was left, just for good measure.

I then had a glorious wart free life ... for 4 weeks.

I was carefully monitoring the wart spot, and sure enough the wart started to grow back and returned to it's good old self. I was fed up. To make matters worse, another bump had started to form about a quarter of an inch from the initial wart. I didn't think much of this at the time, but later came to realise that it was an entirely new root that had spawned. Regardless, I decided to take some time off treating it - it was summer and I was sick of spending all my time limping around. I didn't want to think about it for some time.

Lesson learned: "Specks" are dangerous. Treat the last little speck like you would a brand new wart.

Treatment Attempt #7: The Internet

Ah the Internet - a perfect source of medical information. My chiropodist visits had turned out to be fruitless, and I'd maxed out my work benefits for paying for the appointments. I turned to the internet for help.

And that's when things got funky... home remedies for plantar warts were everywhere. Two that stood out for me were Apple Cider Vinegar and banana peels.

Apple Cider Vinegar: oh how I hate thee

After doing a lot of "internet research", I decided to try the ACV approach. The approach was simple. Soak a cotton ball in ACV and tape it to your foot overnight. Some people complained of mild "burning" pain, others said they felt nothing. Being the seasoned plantar wart warrior that I was, I decided that I would continue hacking/digging in between ACV applications. I figured anything I could do to expose the root would be beneficial. The first night I applied ACV, I examined the wart the following morning, and IT HAD TURNED BROWNISH IN COLOR. Holy cow - this is exactly what the internet said would happen! I was definitely on my way to a cure! I continued to hack out bits of brown and to apply the ACV. I did this for about 1.5 months... at which point in time I gave up. The main reason I gave up was that ACV applied to my pulpy hacked up foot was BLOODY PAINFUL. I can recall waking up in the night and limping to the bathroom to tear the cotton ball off. It throbbed, it burned, and it was just plain and simple too uncomfortable for me, even after diluting the ACV with water. After enduring it for a month and a half I'd had enough.

Some may argue that had I stuck it out this treatment would have worked. I'm not sure I agree. 1.5 months seems like long enough to have tried. My personal opinion is that the ACV was good at killing the surface area of the wart, but that the underlying root remained unaffected.

On an unrelated side note, I used the ACV application in parallel on a wart I had on my finger... and it worked like a charm. The thing dried up and fell off. My plantar wart, on the other hand, just seemed to drink the stuff. Your mileage may vary.

Lesson learned: The internet can lie to you, especially when it comes to medical advice. Who knew!?

Banana peels... rock bottom

Next I tried taping banana peels to the wart, as suggested on many "credible" internet sites. I'm not going into details of this treatment, but let's just say I tried this only because I was freakin' desperate. I was a pesimistic trying the "treatment" and sure enough it had the results I expected; a gooey foot.

Lesson learned: Banana peels really aren't the slippery to walk on. :-)

I'd hit rock bottom. For the love of god, I'd just spend a week with banana peels taped to my sole! I could still try garlic as others suggested on the internet, or my personal favourite which consisted of rubing a potato on the wart and then burying it in your backyard. Yes, google it, it's really out there as a wart cure...

I gave up on internet "cures".

Treatment Attempt #8: Salicylic Gel

I was out of ideas. The only thing in the drugstore I hadn't tried was the salicylic acid that came in a gel form. I convinced myself that if I just stayed persistent with this stuff, the wart would be gone. This was a mistake really, and I'm not sure why I decided this. I'd tried salicylic acid cures for about half a year with no success, still, I naively managed to convince myself that the gel would be different. Over the course of two months I emptied a bunch of gel tubes into the wart, and continued with the dig and hack approach. All of this amounted to little more than another couple of months with an uncomfortable foot.

Lesson learned: Gels are not magical. Surprisingly, they behave much the same way as the pastes (granted, they are a little less messy).

Treatment Attempt #9: Return of the Beetle Juice (Cantharidin)

I reviewed my (non) progress thus far. I had been battling this plantar wart for about 1.5 years now, including the "timeOff" I took from treatments. The very thought of this made me want to both laugh and cry. I concluded that the limited success I'd had was with the use of cantharidin. I returned to the chiropodist. He laughed when I told him all the internet remedies I had tried. I swore at him for not finishing the job the first time. He told me that all a wart required to survive was a single skin cell. He then went on some rant about plantar warts being viruses, and that viruses would take over the world someday, and blah blah blah. Very reassuring, I told him.

With that in mind, I told him that I wanted consecutive weekly treatments of beetle juice. I knew what to expect, but was willing to put up with the discomfort. I knew that I would go at least 4 treatments, which is one more than I did initially.

And so that is what I did. After peeling the blister after treatment #1, I got a clear look at the wart. It looked bigger. Meaner. And more defiant. It also became clear to me that the secondary bump I had noticed earlier was in fact a new wart root. Luckily both warts were close enough to treat with a single cantharidin application. And so treatment continued.

After the second treatment the wart looked injured, but determined... the smaller wart looked almost gone.

After the third treatment, the wart was barely noticeable, and the smaller wart was gone. Having learned my lesson once already, I requested a fourth treatment.

At this point in time, the chiropodist suggested taking a week off. The treated portion of my foot had become quite raw, and a number of skin layers had been peeled off. Another treatment would be the 4th administered in a 22 day span. The recommended treatment period, he told me, was every 7-10 days. I knew better than to stop now - taking a week off would allow old warty to regroup and build up his defenses. I ordered the treatment.
When 4 days later I peeled the blister, I was fairly confident the war was over. There was nothing but pink skin, and everything felt correct to my touch. The wart root area that always felt different, now felt like other parts of my foot. I debated going for a 5th treatment, but decided against it. I suspect the chiropodist may not have administered it anyway, given the rawness of my foot.

Several weeks passed and the layers of skin regrew. I kept a close eye on the new skin, looking for signs of the wart, but none appeared. On a few occasions I was a little suspect because of skin coloration, but this proved to be only the incoming skin pigmentation.

Now, 3 months later, I remain wart free. Thankfully the battle is over. From time to time my foot feels a little tingle in the wart area (not painful, but like an old reminder), and I suspect this is related to any scarring that may have been caused by the beetle juice applications. I expect this sensation to disappear eventually.

And that concludes my plantar wart story and lessons learned. I hope that this blog helps you if you are trying to get rid of one of these buggers. May you learn from my mistakes.

Lesson learned: Be persistent and overtreat the wart if you think it's dead.

Summary:

Time spent treating wart: 1.5 years.

Money spent treating wart: chiro ~= $500, OTC treatments ~= $200

Professionals seen: 1 family Dr., 1 chiripodist

Most painful treatment: short term=Apple Cider Vinegar. Longer term = cantharidin.

Most destructive treatment: cantharidin.

Final recommended treatment: cantharidin. Doses= 4 total, 1/week, consecutive weeks.