The experts say: “Undoubtedly, the Podylas ™ laser is also a very effective treatment for plantar warts”

Interview with Spanish Podiatrist, Peña Martín. Complutense University of Madrid. (Spain)

After two years of using the Podylas™ system in her consulting room, the Spanish podiatrist, Peña García, says that she can achieve “very effective results after just one session” in the treatment of plantar warts. Her secret: the Peña technique, a revolutionary sublesional papule application system developed by herself, which enables her to remove warts in a single laser session.

What do you mainly use the Podylas™ laser for?

It’s difficult to choose one main use. I actually use it for numerous treatments to exploit its full potential. But if I had to pick one, I’d probably say for LLLT. The results of this laser in the treatment of onychomycosis are very satisfactory.

In your experience, is the same true for the treatment of plantar warts?

The laser is also, without doubt, a highly effective treatment for plantar warts. I use the two techniques that exist; the simplest technique is vaporisation and it is the one I use as my first choice. In cases where it is not possible to remove the lesion using this technique, and it is small or medium size, I use the sublesional papule method, or Peña technique, which has a 100% success rate.

What are the difficulties of treating this disorder?

There are certain factors that can cause the lesion to persist. A common factor is emotional, for example in patients suffering from stress or anxiety whose defences have been lowered, which often hinders the rapid resolution of this disorder. Because of this, in stubborn cases or in severe cases of papillomatosis, it is advisable to use medication to strengthen the defences.

What are the advantages of Podylas™ compared to conventional treatment methods?

Mainly its high effectiveness. It is also virtually painless and enables patients to get on with their normal lives during treatment.Yes, absolutely all of them. Provided, of course, that the most appropriate technique is used for each kind of wart.

It is suitable for all patients (adults, children)?

Yes, for everybody. The parameters of the Podylas™ laser can be set according to each patient’s level of tolerance. This is how we individualise laser treatment while maintaining the same effectiveness.

Is it necessary to use anaesthesia?

With the vaporisation technique, no. But, with the sublesional papule method, or Peña technique, it is.

What does treatment involve and how long does a laser session last?

For plantar warts, we perform two techniques, both with a 3 mm handpiece. The first technique is called vaporisation. This involves applying dye to the lesion and then cooling the treatment area before and after each laser shot. The cold is used as an anaesthetic as we penetrate deeper into the lesion with each shot. After laser treatment, we apply an occlusive dressing containing povidone iodine and, if necessary, unload the support area with adhesive felt. One treatment session with this technique usually lasts 15 to 20 minutes.

And what does the Peña technique involve?

The sublesional papule method, or Peña technique, takes a little longer because it is necessary to anaesthetise the area of the lesion. A small anaesthetic papule is injected under the wart and the laser is applied. The wart is separated from the healthy skin and debrided with a scalpel, leaving a clean ulcer in its place. We then help close the ulcer with the application of LLLT using the ulcer settings. We also help unload the area of the lesion with felt. One session is usually enough to resolve the patient’s dermal problem, with the skin normally taking around three weeks to heal.

What do patients feel?

With the vaporisation technique, they feel a burning sensation, which is rapidly relieved by applying cold. It only lasts while the laser is being applied and, at the end of the session, patients do not usually report any discomfort; they can normally put on their shoes and walk without pain. Similarly, with the sublesional papule method, or Peña technique, after the effects of the anaesthesia have worn off, patients do not usually report pain and can walk normally.

How long does it take to see the results?

With the vaporisation technique, sessions are every two weeks. The average number of sessions necessary to remove a plantar wart is three. With the sublesional papule method, or Peña technique, it is resolved quicker because the wart is removed in one session. The small ulcer produced usually closes up within three weeks.

What’s the success rate for plantar warts?

In my experience, it’s high – 70-80% with the vaporisation technique and 100% for cases treated with the sublesional papule method, or Peña technique. Podylas™ is also very useful as a tool for the treatment of pain in cases of fasciitis and trigger points, thanks to LLLT (low-level laser therapy) mode.

How does the laser help improve these disorders?

It does it very effectively and painlessly. Before having the Podylas™ system in my consulting room, I had to refer many patients to physiotherapist colleagues who applied effective but very painful techniques. Now, we have a system that benefits the patient, by offering very effective and painless treatment, and the podiatrist, by providing a remarkably rapid and efficient solution that precludes the need for referral. In the treatment of myofascial trigger points, the patient can leave the consulting room pain free.

How many LLLT sessions are necessary to achieve results?

One session is usually sufficient to treat trigger points. If two or more sessions are required, it is necessary to investigate why the disorder is persisting. I’ve had two cases, for example, in which a vitamin D deficiency was perpetuating the trigger points and causing the relief to be short-lived. By normalising the vitamin D levels in these patients, the effect of the laser treatment was ensured without relapse.

On the whole, what do you think of the Podylas™ laser platform?

INTERmedic’s Podylas™ laser therapy platform has become an essential tool for me in my consulting room. It provides simple and effective solutions to very common disorders among our patients that are difficult to tackle without the laser.