Nobody's perfect. And Loretta Smith loved her husband, warts and all. But then he gave his Verruca Plantaris - plantar warts - to her.
Most warts are just blemishes, but warts on the feet need prompt medical treatment. Tom Smith, 32, waited a year until one wart grew to a multitude of painful eruptions. For another two years, the Elk Township resident saw a podiatrist who tried everything he knew - two invasive surgeries, acid peeling, injections, and other painful techniques, including an early laser technique called CO2 vaporization. Nothing cured the warts or relieved his excruciating pain.
The plantar wart virus enters the foot through microscopic cuts or scratches to cause the warts and soon Loretta Smith had them too.
Found on the bottom of the foot, between the toes or under the toenails, the warts are actually pea-sized tumors. Unlike common warts, when the plantar warts are cut, they bleed in multiple pinpoints.
In 16 years of practice, Woodbury podiatrist, Dr. David Zuckerman has seen thousands of plantar warts. He says conventional treatment often works, especially if a plantar wart is caught in its early stages. Some patients dismiss an eruption as a corn or callous, until crippling pain drives them to a podiatrist, and entrenched warts can defy as many as fifty conventional treatments.
"A neglected wart's root grows deep into the foot", says Zuckerman. "The virus spreads and causes multiple warts, which form large mosaic patterns. And nothing worked on mosaic warts."
Lucky for the Smiths, a new technology called the Flashlamp Pulsed Dye Laser came on the scene. Zuckerman says many plantar warts need only one or two 5-second laser pulses from the new laser, but by the time Tom Smith sought Dr. Zuckerman's help, his wart required a hopping 600 pulses.
Zuckerman performed the procedure in his office. No anesthetic or pain killers were needed and, because the laser does break the skin, there was virtually no risk of infection. Each pulse felt like the snap of a small rubber band against the skin and, after that first marathon treatment, Smith walked out, pain-free and cured. The laser procedure also cured 30-year-old Loretta Smith.
Zuckerman says he is astounded at the pulsed dye laser's overall success rate - about 93 percent. Even with recurring plantar warts that defy every other treatment, it succeeds about 85 percent of the time.
"This laser is safer and more effective than earlier devices", he said, "because it employs photothermolysis to selectively treat only the wart, without affecting surrounding tissue."
The laser seeks and destroys only red targets. The Flashlamp emits powerful pulses of light directly to the wart's red blood cells and, when this light energy is absorbed, it is converted to heat. The heat coagulates the abnormal capillaries, cuts off the wart's blood supply and kills it. The laser also obliterates the virus. The treated growth gradually separates from the skin and sloughs off, leaving healthy skin and tissue completed unaffected.
Zuckerman demonstrates the laser's selectivity on inflated balloons. He inflates a red balloon inside a white balloon and, when he applies the pencil-like wand to the balloons, the laser energy passes through the white balloon, leaving it undisturbed, but bursts the blood-colored red balloon inside.
The pulsed dye laser also can remove or greatly reduce vascular lesions, such as port-wine and other red birthmarks, stretch marks, scars, and conspicuous veins on the nose, chin and cheeks.
Zuckerman says the new laser procedure is more affordable than older methods. "First, it solves the problem in on to five sessions, rather than ten to fifty," says Zuckerman. "Also, I didn't buy the equipment, I lease it only on days when I schedule plantar wart removal."
At $100,000, the pulsed dye laser device is too steep for most surgeons, dermatologists and others who offer outpatient laser therapy. "Laser technology changes rapidly," says Zuckerman. It's more economical to lease the latest equipment than to replace it every two to three years." Medical Alliance, a national provider of medical laser equipment, leases the advanced technology to physicians who treat warts and vascular lesions in their offices.
Health insurance and Medicare cover the doctor's fee, but not all companies pay for use of the new laser. Medicare and some managed care insurers cover the average $130 pulsed dye laser treatment charge only after less advanced methods fail.
Life is good for Tome and Loretta Smith these days. Before his plantar warts were removed last July, Tom's job as a production manager was misery. "I just got through it every day," he says. "Then, at home, I just stayed off my feet." Now, thanks to new laser technology, the couple walk together, go shopping, and enjoy active, pain-free lives.
This is a reprint from an article in "The Gloucester County Times"
Flashlamp Pulsed Dye Laser for the effective
Every year 3.5 million people in the United States are treated for verrucae, or warts. Clinical studies have proven that laser treatment or recalcitrant (resistant) warts is successful where treatment with acids, cryogenics, chemical agents, and surgical excision have failed. In one study, over two-thirds or patients treated had their warts successfully removed in as few as two treatments. Because there is no open wound and minimal pain following the procedure, patients can resume their active lifestyles immediately.
How this treatment works
Treatment works by selective absorption of laser energy by the blood supply which feeds the wart. The treated area then separates from the dermis and gradually sloughs off. Depending on the size and type of wart, some conditions will respond to the very first treatment. However, most will require additional treatment sessions. Your physician will assess whether further treatment is necessary.
What to expect after treatment
There may be minor discomfort after the treatment,
however, most patients are able to return to normal daily activities
almost imediately. You will experience some temporary discoloration
of the skin at the treatment site. Over the 24 hours following laser
exposure, the gray discoloration will darken and persist for up
to 2-3 weeks.
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