What is a plantar wart?

Plantar_WartPlantar warts (or verrucae) are warts that occur on the bottom of your feet. They generally appear as hard lumps in the skin with thick skin surrounding it. They are often mistaken for corns but can be differentiated by the appearance of small black dots in the middle of the wart and with the lack of skin striations (skin lines on the feet, like fingerprint lines) through the wart.

Plantar warts can occur at any age but are particularly common in school-aged children. [1] They are contagious and can be spread when using communal facilities such as change rooms and showers.

Plantar warts are sometimes painful, depending on their location on your foot and how big or how deep they are. The decision to treat them is usually dependent on whether they are painful.

What causes plantar warts?

Plantar warts, like any wart, are caused by the Human Papilloma Virus (HPV). There are over 100 different strains of HPV, with only a few causing warts on your feet. The virus enters the body through a small break in the skin surface [2], however, the virus can remain dormant in the body and become evident months, if not years later.

Pain associated with warts is due to the pressure applied to the soft tissue underneath the wart, as the wart and surrounding callus gets thicker.

How can plantar warts be treated?

Often warts will resolve on their own without any treatment, but this may take years to do so. Treatment options for plantar warts are quite varied. They range from doing nothing at all, to home remedies such as ‘over the counter’ wart treatments and duct tape, to more advanced treatments such as salicylic acid and cryotherapy (freezing). Surgical removal is also an option. Whatever the treatment, care must be taken to avoid scarring which can sometimes lead to long term painful callus formation.

Research has suggested the best form of treatment for warts is the use of salicylic acid and/or cryotherapy.

Salicylic acid, as the name suggests, is an acid which softens the wart tissue, and with the aid of manual removal of dead skin, will gradually reduce the wart tissue. It is also thought that partially-damaged cells expose the immune system to HPV to stimulate your body’s immune system into reacting to the wart too.[1] Care must be taken only to apply the acid to the wart tissue, hence this is often done by your Podiatrist or doctor who may also mask the surrounding area with tape or dressings to protect the healthy skin.

Cryotherapy utilises liquid nitrogen to freeze the wart tissue, and like salicylic acid, will eventually decrease the wart size as well as stimulating your body’s immune system to respond. It can be painful and also requires care taken to ensure only wart tissue is treated.

Silver nitrate has also been shown to have some good results for treating warts. It is also a topical treatment which is painted on to the wart.

All of these non-surgical wart treatments require several applications, and may take weeks or  months to resolve, so patience and persistence is key. As they all cause tissue damage, these treatments must be used with great caution in people who have poor circulation or sensation e.g. diabetes or those who have poor immunity. In some of these cases no treatment may be the best option.

At FootMotion, we use our extensive clinical experience and state-of the-art technology to properly diagnose your skin condition, carry out a thorough vascular and neurological examination to accurately assess your foot health and create an evidence-based treatment plan to effectively manage your condition.

References:

  1. Kwok, C.S., et al., Topical treatments for cutaneous warts. The Cochrane Database Of Systematic Reviews, 2012(9): p. CD001781.
  2. Leung, L., Treating common warts – options and evidence. Australian Family Physician, 2010. 39(12): p. 933-937.