The human papillomavirus (HPV) is responsible for a wide variety of skin conditions and infections—plantar warts are one of them. These pesky growths are often treated at home, but occasionally they stick around. After making a trip to the doctor and weighing your options, you might find that surgery is your best bet.
What to Consider
It’s true that most plantar warts are able to go untreated. Within a two-month to two-year time frame they usually disappear. Every now and then you have your outliers, though: the wart that causes extreme discomfort and just wont go away.
Many over-the-counter medicines will zap away the wart in no time but always leave the possibility of an unwanted return. Treating the wart surgically removes that possibility and makes it less likely for the wart to come back.
Most doctors recommend surgery as the last and final option of wart removal. It’s more expensive than traditional methods and can leave a scar. There are two surgical options: electrosurgery with curettage or laser removal.
As with any surgery, the risk of infection and discomfort is a possibility. Some methods require more downtime than others. Regardless, the doctor will choose the method that's best for the patient.
Electrosurgery and Curettage
Electrosurgery and curettage are two surgical techniques combined to remove a plantar wart. The procedure begins with an electric shock and ends with the wart tissue being scraped out. Not to worry, though—a local anesthetic is given prior to surgery to numb the pain. This method can only be used on a single or very few warts. It's ineffective when performed on mosaic or clustered plantar warts.
The joint-procedure begins with electrosurgery. A needle is given an electric charge that burns off the first few layers of skin tissue. It’s then followed up by curettage, or the scraping and actual removal of the wart. A scalpel or small tool is used to dig out the remainder of the plantar wart. When performed together, this surgery has a 65% to 85% success rate. However, the viral nature of HPV always leaves the possibility another wart will return.
Laser Surgery
Laser surgery is in the same ballpark as the previous method. There’s no guarantee that the wart won’t return, but it’s undoubtedly more reliable than over-the-counter methods. There are two types of lasers that can be used: a pulsed-dye laser or carbon dioxide laser.
During pulsed-dye laser surgery, excess skin is removed to get closer to the internal layers of the wart. A numbing agent is applied then the laser sends a series of pulses to the foot. The pulses successfully cut off the blood supply feeding the wart and the wart eventually falls off.
Carbon dioxide laser surgery is far more aggressive. The recovery time for can be four to five weeks and the days after surgery can be extremely painful. It involves using the laser to burn and cut the skin around the wart. The base of the wart is targeted to remove all signs of infection. Stitches are sewn in the foot to close the wound and are taken out weeks later.
