Best over-the-counter options for common warts and plantar warts

A keratolytic that dissolves the HPV-infected layer of skin a little at a time; the mild inflammation it causes may also help the immune system find the virus. The Drug Facts routine: wash the area, optionally soak the wart in warm water for 5 minutes (the label says "may soak" — it is not a required step), dry thoroughly, apply one drop at a time to cover just the wart, let it dry, and repeat once or twice daily. Between doses, rubbing off the softened white dead skin with a disposable emery board or pumice (never one you also use on healthy skin, and never shared) is standard practice, though it is not part of the label directions. This is the single best-evidenced OTC option and it works better on hands than on feet.

Cochrane 2012 (85 RCTs, 8,815 participants): "Trials of salicylic acid (SA) versus placebo showed that the former significantly increased the chance of clearance of warts at all sites (RR (risk ratio) 1.56, 95% CI (confidence interval) 1.20 to 2.03)." The effect was much larger on hands ("RR 2.67, 95% CI 1.43 to 5.01") than on feet ("RR 1.29, 95% CI 1.07 to 1.55"). Cochrane's own summary is deliberately modest: "The evidence remains more consistent for SA, but only shows a modest therapeutic effect." The Compound W 17% Drug Facts label sets the timeline: "repeat this procedure once or twice daily as needed (until wart is removed) for up to 12 weeks." AAD: "You usually apply salicylic acid once a day after softening the wart."

Caution: Treat one or two warts at a time. MedlinePlus: "do not apply topical salicylic acid to large areas of your body unless your doctor tells you that you should" — salicylic acid is absorbed through the skin, and covering a large area (a crop of hand warts, a mosaic plantar wart, or any large area on a child) can cause systemic salicylate toxicity. Multiple or spreading warts belong to a clinician, not a bigger box of acid. If you are allergic to aspirin or other salicylates, check with a pharmacist first — MedlinePlus advises telling your doctor and pharmacist "if you are allergic to salicylic acid, any other medications, or any of the ingredients in salicylic acid products." The label says do not use "on moles, birthmarks, warts with hair growing from them, genital warts or warts on the face or mucous membranes"; do not use "on irritated skin or on any area that is infected or reddened"; and do not use "if you have diabetes or poor blood circulation" — that last one has no anatomic exception, so it rules out a thumb wart as much as a foot wart. Twelve weeks is the labeled maximum — if the wart is still there, stop and see a clinician rather than continuing indefinitely. "Avoid contact with eyes. If product gets into the eye, flush with water for 15 minutes" and "avoid inhaling vapors." The collodion-type liquid is flammable — the label says "Flammable. Keep aware from fire and flame" — so let it dry before going near a stove, lighter, or candle. MedlinePlus warns that children and teenagers with chicken pox or flu "should not use topical salicylic acid unless they have been told to do so by a doctor because there is a risk that they may develop Reye's syndrome." Expect the surrounding skin to sting or peel — apply to the wart only, and consider ringing it with petroleum jelly.

The same drug at more than double the strength, because plantar warts sit under a thick callus that 17% liquid struggles to penetrate. The medicated pad or patch is trimmed to the size of the wart, stuck adhesive-side down, and left in place — with pads, you swap it every 48 hours rather than daily. The 40% stick is applied in a thin layer daily and covered with a clean bandage. Both labels make the warm-water soak optional ("may soak wart in warm water for 5 minutes"), which matters if you have any loss of sensation in your feet. Warts on the sole clear more slowly and less reliably than hand warts, so the 12-week label window is realistic, not pessimistic.

Compound W One Step Plantar Foot Pads Drug Facts: "Salicylic acid 40%," "for the removal of plantar warts on the bottom of the foot," with directions to "wash affected area," "may soak wart in warm water for 5 minutes," "dry area thoroughly," "remove medicated pad from backing paper by pulling from center of pad," "apply," "repeat procedure every 48 hours as needed (until wart is removed) for up to 12 weeks." Wartstick Plantar (salicylic acid 40% w/w) instead directs: "Keeping the product off the surrounding skin, apply a thin layer of the product to each wart. Cover affected area with clean bandage. Repeat procedure daily as needed (until wart is removed) for up to 12 weeks." Cochrane's foot subgroup still favored salicylic acid over placebo: "RR 1.29, 95% CI 1.07 to 1.55."

Caution: Everything in the 17% caution applies here with more force, because the concentration is higher: treat one or two warts at a time (MedlinePlus: "do not apply topical salicylic acid to large areas of your body unless your doctor tells you that you should"), which rules out blanketing a mosaic plantar wart, and check with a pharmacist first if you are allergic to aspirin or other salicylates. Wartstick's label is blunt about who must not use it: do not use "if you are a diabetic," "if you have poor blood circulation," "on irritated, infected, or reddened skin," "on warts with hair growing from them," "on moles or birthmarks," or "on face, genitals, or mucous membranes." A 40% product will chemically burn healthy skin, so cut the patch to the wart's exact outline and keep the stick off surrounding skin. Make sure it is actually a wart: AAFP notes that "Plantar corns are more sensitive to direct pressure of the lesion, while a plantar wart is more sensitive on lateral compression of the lesion," and that "Warts, unlike mechanical lesions, tend to bleed on sharp debridement. If small black or brown dots are visible after removal of the hyperkeratotic tissue, thrombosed blood vessels have become entrapped." A corn or callus has skin lines running through it and no black dots — treating one with 40% acid just burns a hole in a pressure spot. Stop and ask a doctor if discomfort persists.

An aerosol cryogen is discharged into a foam applicator or metal tip that you hold on the wart for a set number of seconds; a blister forms and the frozen tissue sheds over roughly one to two weeks. These are marketed as home versions of what a dermatologist does, but a dermatologist uses liquid nitrogen and these cans do not contain it — Compound W Freeze Off's stated contents are "Dimethyl ether and propane." The manufacturer's own limits are narrow and specific: not on children under 4; not in pregnancy or breastfeeding; "Hold the foam applicator on common warts for 20 seconds or less"; on the sole, up to "40 seconds or less" only on "areas with thicker or calloused skin, such as the ball of the foot or the heel," while plantar warts "occurring on less calloused areas of the foot, such as the arch of the foot or the toes" get "20 seconds or less" — the same ceiling as a hand wart; and "Do not treat each wart with this product more than three times in total." Those are hard ceilings, not suggestions — there is no fourth attempt, and 40 seconds is not a blanket permission for the whole foot.

Nguyen NV and Burkhart CG, a 2011 Journal of Drugs in Dermatology case report and literature review on DMEP versus liquid nitrogen: "Manufacturers have substituted liquid nitrogen with dimethyl ether and propane (DMEP), and marketed these new preparations to be safe and effective alternatives to in-office cryotherapy with liquid nitrogen. However, data from in vitro studies and comparative studies in humans refute manufacturers' claims that these products reproduce in-office cryotherapy." Cochrane found even clinic cryotherapy unimpressive: "A meta-analysis of cryotherapy versus placebo for warts at all sites favoured neither intervention nor control (RR 1.45, 95% CI 0.65 to 3.23)," and "Meta-analysis did not demonstrate a significant difference in effectiveness between cryotherapy and SA at all sites (RR 1.23, 95% CI 0.88 to 1.71)." The one genuine add-on finding: "Two trials with 328 participants showed that SA and cryotherapy combined appeared more effective than SA alone (RR 1.24, 95% CI 1.07 to 1.43)" — that was clinic liquid nitrogen, not a drugstore can. The dwell-time limits are the Compound W Freeze Off Plantar Wart Removal Kit's own directions: "Hold the foam applicator on plantar warts on areas with thicker or calloused skin, such as the ball of the foot or the heel, for 40 seconds or less. Treat plantar warts occurring on less calloused areas of the foot, such as the arch of the foot or the toes, for 20 seconds or less."

Caution: Do not use these on a child under 4. Compound W's own label says "Do not use on children under the age of 4 years," and the stated reason is injury: "If this product is not used exactly as instructed or if you mistakenly use it on conditions that are not warts, it may cause serious burns and permanent scarring on the skin." A wart on a child under 4 is a pediatrician or dermatologist visit, not a drugstore can. Do not use it in pregnancy either — this exclusion is on the freeze kit specifically, not on the salicylic acid labels: "Do not use if you are pregnant or breast-feeding." Respect the seconds, and do not read "40" as the plantar number: 20 seconds or less on a common wart, 20 seconds or less on a plantar wart in a less calloused area "such as the arch of the foot or the toes," and up to "40 seconds or less" only on "areas with thicker or calloused skin, such as the ball of the foot or the heel" — doubling the dwell time on thin foot skin is how you get a deep blister and a scar on a surface you have to walk on. Three treatments per wart in total. More freezing is not more clearance, it is more burn. Never point or discharge the can toward anyone's face: the label says "Avoid Contact with Eyes. Contact with eyes may cause blindness." The same label gives the first aid, and it is to flush: "Do not rub or touch eyes with hands if Compound W Freeze Off® Wart Removal System has been applied to them. If product gets into eyes, flush with water for 15 minutes and call medical help right away." The label also says "Do not Swallow. Content is toxic and may cause serious internal damage," which is reason enough to keep the can out of the hands of the children it is marketed for. The label also bars breathing it: "Do not inhale vapour/spray and use only in well-ventilated areas. Breathing vapour/spray may be toxic." Use it in a ventilated room — and treat a pressurized hydrocarbon can as an inhalant-abuse risk to keep away from teenagers, not only a burn risk. The propellant mix is highly flammable — no lighters, candles, gas stoves, or smoking during or right after use. Freezing is painful and can leave a permanent pale mark, which matters on visible skin. Do not use these on the face, on genital warts, on moles or birthmarks, or if you have diabetes or poor circulation — a blister on a neuropathic foot is how ulcers start. If you want the real thing, ask for in-office liquid nitrogen, which is what the combination-therapy evidence actually studied.

The internet protocol is to cover the wart with duct tape for about six days, remove it, soak and file the wart, leave it uncovered overnight, then reapply — the theory being that occlusion and irritation provoke an immune response against HPV. It is free and it will not hurt you. It also did not beat placebo when it was actually tested, and the original positive 2002 study has not held up in the trials that followed.

Cochrane 2012: "Two trials of clear duct tape with 193 participants demonstrated no advantage over placebo (RR 1.43, 95% CI 0.51 to 4.05)." The confidence interval crosses 1, meaning the result is compatible with no benefit at all. Cochrane's Authors' conclusions repeat it plainly: "Two trials of clear duct tape demonstrated no advantage over placebo." By contrast the same review found salicylic acid "significantly increased the chance of clearance of warts at all sites."

Caution: The real cost is time — six weeks of taping is six weeks you did not spend on salicylic acid, and Cochrane's own tape trials ran that long or longer. Skin under continuous occlusive tape gets macerated, itchy, and prone to secondary infection, especially between toes or on a sweaty foot. Do not tape over a lesion on the face or genitals, and do not use occlusion on a foot lesion if you have diabetes, neuropathy, or poor circulation without having it looked at first — you cannot feel a problem developing under the tape. Adhesive allergy is common; stop if the surrounding skin turns red or weeps. If you want to combine, tape is at best an adjunct to salicylic acid, never a substitute for it.

There is no over-the-counter product you may safely use in any of these situations. Genital and anal warts need a clinician's diagnosis and prescription treatment or provider-administered removal; facial warts need a treatment that will not leave a chemical burn scar on visible skin; freeze kits are barred outright under age 4; and anyone with diabetes or peripheral vascular disease needs a clinician, because self-inflicted acid or freeze injuries can become non-healing ulcers. A dermatologist can also confirm the growth is a wart at all rather than a corn, a callus, a molluscum lesion, or a skin cancer that has been mistaken for one.

Most wart-remover Drug Facts labels carry the same exclusions, and the major brands all do. Compound W 17% liquid and gel: do not use "on moles, birthmarks, warts with hair growing from them, genital warts or warts on the face or mucous membranes"; do not use "if you have diabetes or poor blood circulation" — the same two lines appear on Compound W One Step Plantar 40%, and Wartstick Plantar 40% bars use "if you are a diabetic," "if you have poor blood circulation," and "on face, genitals, or mucous membranes." But not every store-brand label does: the CVS 40% plantar patch ("PLANTAR WART REMOVER- salicylic acid patch") bars use "on genital warts and warts on the face," "on moles, birthmarks and warts with hair growing from them," and "on mucous membranes" — and says nothing at all about diabetes or circulation. Do not assume the box will stop you. MedlinePlus on topical salicylic acid: "Topical salicylic acid should not be used to treat genital warts, warts on the face, warts with hair growing from them, warts in the nose or mouth, moles, or birthmarks." MedlinePlus on genital warts: "Genital warts are a sexually transmitted infection (STI) caused by the human papillomavirus (HPV)," and it is a health care provider who treats them. Compound W Freeze Off: "Do not use on children under the age of 4 years." AAD lists when to see a dermatologist, including "Warts on your face or genital area," "A wart that is changing, hurts, itches, burns, or bleeds," "Many warts," "A weakened immune system (e.g., cancer, HIV, organ transplant)," "Diabetes," and having "Tried at-home treatment and cannot get rid of the wart(s)."

Caution: Do not improvise. Acid or freezing on genital or perianal skin causes severe chemical burns and ulceration, and it does not treat the internal or cervical HPV that matters most; genital warts also require a conversation about partners and cervical screening that no drugstore box provides. On the face, a 17% or 40% acid burn or a freeze blister can leave a permanent hypopigmented scar in the exact spot you were trying to fix. If you are immunosuppressed, treatment is both more necessary and harder — Merck notes that immunosuppressed patients are "at particular risk of developing generalized lesions that are difficult to treat" and that "Treatments are less successful in immunocompromised patients." A lesion that bleeds, ulcerates, grows fast, or changes color is a dermatology appointment, not a wart product.