Comparative study between microneedling alone and microneedling followed by topical bleomycin or topical green tea extract (polyphenone E) in treatment of plantar warts

Background Verrucae plantaris are benign proliferations that can last for many years. It can cause discomfort. Multiple treatment options are introduced for treatment of Verrucae, but the response is variable and unsatisfactory. Aim The authors aimed to evaluate the efficacy of microneedling alone versus microneedling followed by topical bleomycin or topical green tea extract (polyphenone E) in the treatment of plantar warts. Patients and methods Forty-five patients with plantar warts were included. The patients were randomly divided into three groups: each group comprises 15 patients. The first group was treated with microneedling alone. The second group was treated with microneedling followed by application of topical bleomycin, while the third group was treated with microneedling followed by application of topical polyphenone. Results There is complete clearance in 73.4% of the patients treated with microneedling combined with topical bleomycin versus 20.0% in patients treated with microneedling alone versus 26.0% in patients treated with microneedling combined with polyphenone E. Conclusions From this study, the authors conclude that microneedling alone and microneedling followed by topical bleomycin or topical green tea extract (polyphenone E) are effective and safe in the treatment of plantar warts, but a combination of microneedling with topical bleomycin is a more promising treatment for plantar warts. Topical polyphenone after microneedling did not enhance the effect of microneedling in plantar warts.