Warts, Corns, Calluses, and Ingrown Toenails

Warts

-any area of the skin

-rough cauliflower like appearance

-usually not painful unless area undergoes repeated pressure

-may grow to ~1 inch

-HPV infection

-prevention of spread w/ salicylic acid/cyrotherapy

Corns

-over bony prominences of the feet (Knuckles)

-raised, sharply demarcated hyperkeratotic lesions with central core

-painful

- few mm to 1 cm

- friction

-alleviation of causative factors

-tx with salicylic acid

Calluses

-weight bearing areas of the feet

-raised, yellowish, thickening of the skin, normal skin pattern

-usually not painful

-few mm to several cm

-friction

-alleviation of causative factors

-tx with salicylic acid

What warts can you treat OTC?

- Verruca vulgaris

-Verruca planaus

Warts Treatment

-Salicylic acid: liquid, plaster

-Cryotherapy: liquid nitrogen, DMEP/propane

-Duct Tape: small children in combo therapy, seal/suffocates growth, leave on for long periods

Salicylic Acid Plasters, Pads, Strips, Sticks

-wash hands before and after

-soak affected area in warm water for 5 min

-wash and dry affected area

-trim a plaster to fit wart, apply it, and cover with an occlusive tape or bandage, make sure not on healthy skin

-remove the plaster, pad, strip, or stick after 48 hours

-repeat the procedure until the wart resolves

-these products can be used for up to 12 weeks

Salicylic Acid Liquid/Gel

-wash hands before and after

-soak affected area in warm water for 5 min

-wash and dry affected area

-apply one drop at a time to cover the wart

-protect healthy skin with petrolatum

-cover the wart with self adhesive or occlusive tape

- repeat the procedure 1-2 times a day until the wart resolves

-product may be used for up to 12 weeks

Cyrotherapy

-wash hands before and after

-soak affected area in warm water for 5 min

-wash and dry affected area

-a file or pumice stone may be used to lightly abrade the surface of plantar warts

-prepare device, activate, apply to wart until halo appears around it

- ~20 sec for common warts

- ~ 40 sec for plantar warts

-discard single use applicators after one use

-repeat after 2 weeks if needed, product may be used for up to 3 treatments

Exclusions to Self Treat Warts

-salicylic products: <3

-cryotherapy: <4

-pregnancy/breastfeeding

-mental/physical condition that limits the patient from following directions

-chronic, debilitating conditions that affect sensitivity or poor blood circulation to hands/feet

-immunocompromised

-large or mult. in one area

-bleeding, painful, discolored

-warts located on the face, breasts, armpits, fingernails, anus, genitalia, or mucous membranes

-warts that have not resolved after 12 weeks of self treatment

-salicylic acid products: immunosuppressive medications, or salicylate allergy

Exclusions to Self Treat Corns and Calluses

-diabetes, peripheral circulatory disease, or other medical conditions that contraindicate the use of foot care products

-lesions hemorrhaging or oozing purulent material

-anatomic defect or fault in body weight distribution

-extensive or painful, debilitating

-proper but unsuccessful self medication

-history of rheumatoid arthritis

Salicylic Acid in Collodion like Vehicle

-apply product no more than twice daily for up to 14 days

-morning and evening

-no not let adjacent area in contact, use petroleum jelly

-apply one drop at a time directly onto area

-allow the drops to dry and harden

-cap the container

-store product in amber/light sensitive container

Salicylic Acid Plasters/Pads for Corns/Calluses

-remove after 48 hours

-after rubbing off the softened skin, reapply every 48 hours as needed

-do not treat longer than 14 days, no more than 7 applications

Ingrown Toenail prevention

-bump out nails so grow straight

-cut toenail straight

Treatment of Ingrown Toenail

-educate to prevent it from happening

-warm water soak (10-20min x multiple/day)

-relieve pressure: insertion of small cotton wisps or dental floss under nail

-ibuprofen/Tylenol for pain relief

Exclusions for Ingrown Toe Nails

-diabetes, peripheral circulatory disease, arthritis

-malformations of foot

-physical or mental impairment that makes self tx difficult

-pus or oozing discharge at site or inflammation, redness, or pain beyond site

Dr. Scholl's Ingrown Toenail Pain Reliever

-sodium sulfide: softens nail

-very expensive

-not worth it at all