Laser surgery for plantars wart

[Dee]

After four unsuccessful acid treatments in the doctor's office the wart on the bottom of my big toe did not disappear. In fact the doctor has told me that I have a lot of little warts surrounding the two larger ones on my toe.  My doctor has now suggested that I see a dermatological surgeon for laser treatments on that toe.  I was told that it would be painful and leave open sores on my foot.  Can you tell me anything more about this surgery or whether I should seek a second opinion before choosing surgery as an option.

[Brian Miller]

I have had a plantars wart on the bottom of my foot for over 10 years. A G.P. diagnosed it and I've since gone to dermatologists and podiatrists for treatment. I've had liquid nitrogen treatments, laser surgery and I've tried acid applications many times in my ongoing battle with this one nasty wart.  It is  located right between the balls of my right foot and, as such, often causes me distress when I am unable to keep weight off of it.  If I inadvertently step on a pebble, I get a shooting pain up my right leg and a burning sensation for a few minutes afterwards.  It is ugly and I would love for it to go away on its own, but, I must tells you that your advice to ignore it suggests you yourself have never had one.  To be honest, I don't think I have rigorously followed the regimen prescribed on the box of acid and I plan to give it one more go and stick with it for months if need be to once and for all rid myself of this nightmare.  I was encouraged somewhat by your second point which says that the wart only involves the epidermis, no matter how deep it feels, because it feels DEEP.  But, they are contagious according to every other doctor I've talked to and every web-site I've checked out on the subject (over 50).  I think your answer was a little too, shall we say, casual, and I recommend you consider rethinking your advice to people who are in real pain and, if they are anything like me, want practical solutions.

Sincerely yours,

Brian Miller

[matia rankin]

I have 3 on my foot+1 on my hand I dont have a singel idea what to do about them! could you help me out at all.

[Alan Rockoff, MD]

Dee:

In general, I do not favor surgical approaches to warts, plantar or otherwise.  Your own description illustrates why: warts are a multifocal viral process; in other worss, the virus affects the epidermis in many different locations.  What good is it to blast away at little foci, only to have new ones reappear nearby?

Keep in mind the following:

1.  Warts generally do not behave in a contagious fashion (if they did, wouldn't washing your feet spread them all over the body?)
2.  Warts do not "grow into" the skin.  They only involve the epidermais, no matter how "deep" they feel.
3.  If you wait them out, warts nearly always disappear on their own, though it may take years.

Therefore, you have 2 choices:

Either get repeated gentle treatments like liquid nitrogen or acid application.  These will not incapacitate you for days or weeks.

OR

Ignore the warts!  True, they're ugly, but why go for a "cire" that isn't and is in any case worse than the disease?

Good luck.

Dr. Rockoff