Plantar warts are the hard, grainy warts that are typically found on the soles of the feet and toes. Because they are subjected to pressure in these areas, they may grow inward beneath a thick callus. They generally occur more frequently when the weather is warm, because the virus that causes these unsightly lesions, human papilloma virus, is most likely to thrive in warm and moist environments. This can include locker rooms, public showers, and the deck of your swimming pool. There are over 100 types of human papilloma viruses, but only a few types cause plantar warts and these strains are not highly contagious. It’s important to avoid areas where the virus flourishes, but it’s unlikely that you will transmit your wart to family members.
The human papilloma virus can enter your skin through a tiny break or cut on the surface. Once you have been infected, it is difficult to eradicate the virus entirely. Even if you treat the wart successfully, there is a good chance it will recur. It’s not a serious concern for your health, but it can be painful and even unsightly.
Plantar warts generally begin with a small black dot that grows to the size of a pencil eraser. This takes place beneath the surface of the skin and can be very uncomfortable. The small black pinpoint is known as a “wart seed,” but it is a small blood vessel that has clotted. You may develop a fleshy rough grainy lesion or, if the wart grows inward, you may develop an area of hard and thickened skin over the wart. Many people notice pain and tenderness when they are standing or walking.
Plantar warts can be treated with a number of over the counter topical wart removers. These products all contain salicylic acid in varying concentrations, including Compound W and Dr. School’s Wart Remover. If you decide to use a topical over the counter treatment, be sure to follow the package instructions so you don’t burn your skin. If you soak your foot in water for five minutes before applying a topical preparation, it will increase absorption and improve the effect of the medication. However, you will not see immediate improvement – it can take from weeks to months to achieve resolution.
Another over the counter remedy is duct tape, as odd as it may sound. If you apply duct tape to your wart, you should leave it on for 6 days them remove it for a half day before reapplying another piece of duct tape. Leave that piece on for 6 more days, remove for half a day, and repeat until your wart has resolved. This can also take weeks to months to resolve the wart.
Never cut a wart – you can cause an infection, bleeding, scarring, and increased pain. Warts will eventually resolve spontaneously, but it can take several years. With any treatment, no matter how successful, the wart is likely to reappear because the virus remains in the body.
Although it is not necessary to see your physician in every case, you should seek professional care and evaluation for any lesion that is painful or changes in color or appearance. You may also want to see a dermatologist if you have tried unsuccessfully to treat the wart or if it becomes larger or recurs. Individuals with a weakened immune system or with diabetes and poor sensation in the feet should see a physician for treatment. Your dermatologist will shave a small portion of the lesion, looking for dark pinpoint dots that represent the clotted tiny blood vessels. A small section of the lesion will be sent to the pathology lab for analysis.
A dermatologist can prescribe a stronger medication, usually salicylic acid in a higher concentration than over the counter remedies. Cryotherapy is also a useful approach, particularly when used with salicylic acid. This refers to freezing the wart with liquid nitrogen. It causes a blister to form around the wart and the dead tissue will slough off within 7-10 days.
Other treatment options are available in the event that your wart will not resolve with salicylates and cryotherapy. There are stronger acid solutions that your doctor can apply after shaving the surface of the wart.
Other treatments are available, but not as frequently utilized as they may result in scars and pain. Laser treatments can be used to cauterize the tiny vessels in the lesion, which will eventually die and fall off. In rare cases, the wart may be cut, but since this can result in a scar, it is not the treatment of choice. Finally, some people require immune therapy, to stimulate the immune system to fight the virus that causes the wart.
In most cases, plantar warts can be successfully managed with a combination of over-the-counter treatment and stronger concentrations of salicylic and other acids. If you are troubled by a plantar wart, call us today for an evaluation. If you are not certain about the type of lesion on your foot, or if it has changed color and appearance, it’s important to seek professional evaluation.