Conway McLean, DPM, Journal columnist

Health care can be a frustrating experience for many Americans. Diagnosing some medical conditions can be a challenging process. In contrast, various problems are easily diagnosed but difficult to treat, the therapy painful or even potentially disabling. Falling into this latter category is the dreaded plantar wart.

The following is the history of an individual afflicted with this pathology, a viral infection of the skin on the bottom of the foot. This is the story of John, a relatively normal fellow, hard-working, well into middle age. John was mildly hypertensive, with no serious health concerns (other than a gradually expanding middle), and was employed in a lumberyard, a physical job, it was a demanding position requiring extensive time on his feet.

Several years ago, this level of activity became more challenging due to some pressure he was experiencing from his right foot. Initially, this occurred only occasionally and was, at most, mildly uncomfortable. Over the months, the pain became more consistent. His personal evaluation revealed a small spot of callus on the bottom of his foot, which didn’t look particularly concerning to his untrained eye. Regular application of a moisturizer produced some slight softening of the callus, but no change in symptoms which were becoming more significant, with sharp pain now experienced at times.

At his next visit to the primary care office, John asked about the lesion. The provider seemed uncertain of a definitive diagnosis but guessed that it was likely a plantar wart. Thus began John’s warty saga of his dealings with the treatment of a simple plantar wart, this common, symptomatic infectious skin lesion, afflicting the young and old alike.

The physician’s assistant appeared none too excited about the prospect of treating this ugly painful spot. They trimmed some of the callus but admitted this would not resolve the issue. A recommendation was made to treat it at home with a topical acid application, which he purchased at the local pharmacy.

Although labor-intensive, he performed the regimen with surprising consistency, per instructions. The therapy itself became a source of discomfort, not surprising since the “medicine” was eating a hole in his foot. Eventually he recovered from the treatment and the skin in the area healed. John was hopeful that he was cured, and the wart gone, despite the warnings he had received from well-meaning family regarding the recurrence rate of these persistent lesions. But his bout with plantar warts would be different!

When the wart reappeared two months later, John was aghast….he had been so certain it was gone. His wife encouraged him to get serious about the wart and go to a specialist. The doctor declared definitively he froze warts; that was his treatment of choice. Consequently, John proceeded to have a series of painful visits for application of liquid nitrogen.

Once again, the skin in the area of the wart was looking abused and unhappy. And was tender as a result, for most any weight bearing. He kept a close eye on the spot, only to be disappointed once again, as the wart reappeared weeks later.

A visit to another specialist led to a blistering treatment, requiring extensive bandaging and significant pain for days afterward. Although this approach will often kill the wart eventually, the idea of walking on a painful blood blister for weeks was intimidating. There had to be a better way. And there are numerous others including the injection of a cancer drug, and various surgical methods. But the latter choice too often leads to a painful scar as a result of the procedure, a wholly separate problem.

Some internet research led to the discovery of the Swift, a radically new approach, which he received. This technology, in use over a decade, caused John’s immune system to recognize the wart as foreign tissue. The treatment doesn’t attempt to kill the affected skin cells unlike all the previously mentioned methods. Instead, the body does the work, and the wart disappears or falls off.

The Swift protocol required three sessions in John’s case but can range anywhere from one to four to resolve warts. Amazingly, there was no downtime for John, no restrictions on his activity, and no pain afterward. Even better, no bandaging was needed as there was never an opening in his skin. After John’s prior experiences with wart treatment, discovering the recurrence rate with the Swift is less than one percent was welcome news. This is the result of the release of viral proteins from the Swift treatment, educating the sufferer’s immune system.

Not only are warts ugly, when they are on the bottom of the foot, they can be seriously painful. The mass of callus and wart is a lump of “not you,” and you’re walking on it. It turns out, these common growths have been afflicting mankind forever. And for the longest time, our therapies had all the subtlety of a sledgehammer, attempting to bludgeon the infected skin cells into submission.

Finally, there is a completely new approach, the result of advances in medicine and engineering. Although the exact number of treatments with the Swift cannot be ascertained prior to, it’s not a question of “if” but when. And best of all, with the Swift device, they almost never come back. Not all new technologies work, but the Swift is a grand success, destined to be here for the long haul. Finally, an elegant solution to the ancient problem of plantar warts.

EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.