Zeehan S. Husain, DPM
Charles G. Kissel, DPM
Michael S. Schey, DPM
Angela
Stoutenburg, DPM
Board
certified by the
American Board of
Podiatric Surgery.
Plantar Warts
What
is a Plantar Wart?
A
wart is a
small growth on the skin that develops when the skin is infected by a
virus. Warts can develop
anywhere on the foot, but typically they appear on the bottom (plantar
side) of the foot. Plantar
warts most commonly occur in children, adolescents, and the elderly.
There
are two types of plantar warts:
 |
A solitary wart is a single wart. It often increases in size and may eventually multiply,
forming additional satellite warts. |
|
Mosaic warts (picture) are a cluster of several small warts growing closely together in one area. Mosaic warts are more difficult to treat than solitary warts. |
Signs
and Symptoms
The
signs and symptoms of a plantar wart may include:
|
Thickened skin— Often
a plantar wart resembles a callus because of its tough, thick tissue. |
|
Pain— A plantar wart usually hurts during walking and standing,
and there is pain when the sides of the wart are squeezed. |
|
Tiny black dots— These often appear on the surface of the wart.
The dots are actually dried blood contained in the infected
capillaries (tiny blood vessels). |
Plantar
warts grow deep into the skin. Usually
this growth occurs slowly where the wart starts off small and gets larger
over time.
Identification Problems
Most warts are harmless, even
though they may be painful. They
are often mistaken for corns or calluses which are layers of dead skin
that build up to protect an area which is being continuously irritated.
The wart, however, is a viral infection.
It is also possible for a variety of more serious lesions to appear on the
foot, including malignant lesions such as carcinomas and melanomas.
Although rare, these conditions can sometimes be misidentified as a
wart. It is wise to consult a
podiatric physician when any suspicious growth or eruption is detected on
the skin of the foot in order to ensure a correct diagnosis.
Plantar warts tend to be hard and flat, with a rough surface and
well-defined boundaries; warts are generally raised and fleshier when they
appear on the top of the foot or on the toes.
Plantar warts are often gray or brown (but the color may vary),
with a center that appears as one or more pinpoints of black.
It is important to note that warts can be very resistant to
treatment and have a tendency to reoccur.
What
Causes a Plantar Wart?
Plantar
warts are caused by direct contact with the human papilloma virus (HPV). This is the same virus that causes warts on other areas of
the body. Typically, the
plantar wart virus is acquired in public places where people go barefoot,
such as locker rooms, swimming pools, and karate classes.
It can also be acquired at home if other family members have the
virus.
Tips
for Prevention
|
Avoid walking barefoot, except on beaches |
|
Change shoes and socks daily |
|
Keep feet clean and dry, do not put lotion/creams between toes |
|
Check children’s feet periodically |
|
Avoid direct contact with warts- from others or another part of the
body |
|
Do not ignore growths on your skin |
|
Visit your podiatric physician as part of your annual health
checkup |
Self-Treatment
Self-treatment
is generally not advisable. Over-the-counter
preparations contain acids or chemicals that destroy skin cells and it
takes an expert to destroy abnormal skin cells (warts) without destroying
surrounding healthy tissue. Self-treatment
with such medications especially should be avoided by people with
diabetes, cardiovascular, or circulatory problems.
Never use them in the presence of an active infection.
Diagnosis
and Treatment
To
diagnose a plantar wart, the foot and ankle surgeon will examine the
patient’s foot and look for signs and symptoms of a wart.
Treatment
Options
Topical or oral medications
Laser ablation (pulse dye or CO2 laser)— done in Laser
Center or operating room
Cryotherapy (freezing)— done in office
Surgical excision— done in office or operating room
Regardless
of the treatment approach undertaken, it is important for the patient to
follow the surgeon’s instructions, including all home care and
medication that has been prescribed and making follow-up visits.
Warts may return which warrants further treatment.
If
there is no response to treatment, further diagnostic evaluation may be
necessary. In such cases, the
surgeon can perform a biopsy to rule out other potential causes for the
growth
