Bleomycin has been successfully used to treat resistant warts since the 1970’s.³ Bleomycin is a chemotherapeutic agent which is used in dilute formulation with minimal systemic toxicity. Its safety has been confirmed in a number of scientific studies. Bleomycin is administered through intralesional injection and can be quite painful requiring pretreatment with local anesthetic. After injection, swelling and redness develops followed by a black crusted scab with occasional sterile pustule. Cure rates with Bleomycin injections are high. A recent study demonstrated success with microneedling Bleomycin into recalcitrant plantar warts.4 The pain associated with microneedling tends to be less than that with injection. Bleomycin should be used with caution in patients who have Raynaud’s phenomenon, connective tissue disease, and peripheral arterial disease.