Plantar warts, as the name suggests, are cutaneous neoplasms found on the soles of the foot. They’re often not painful but may cause discomfort if the warts grow to a certain size.
What are Plantar Warts?
Plantar warts, also known as verrucae are hard and often painful raised areas of skin that commonly occur on the soles of the feet or around the toes.
What do they look like?
They are hard, grainy or fleshy growths. The most common appearance is that of a small cauliflower-type growth containing tiny black dots. They can grow up to 1 or more cm in diameter and can form in clusters or spread to other parts of the feet. Sometimes they are painful when squeezed and can become painful if present over a weight-bearing area of the foot.
What causes Plantar Warts?
Plantar warts are caused by an infection of the Human Papilloma Virus (HPV). It is thought that the HPV thrives in moist and wet areas such as communal showers, change rooms, and swimming pools.
Who gets them?
Plantar warts can develop in anyone but are most commonly seen in children, teenagers, and young adults. It is possible to develop some immunity to warts over a period of time but most people are susceptible at some time during their life.
Are they contagious?
Yes, the HPV can be very contagious. It is possible to develop a verruca by simply walking on the same floor area as someone with a verruca. Cuts and abrasions make it easier for the virus to penetrate.
Are they serious?
Plantar warts do not represent a serious threat to your health but can cause a great deal of discomfort. Callus (hard skin) can form over the top of the plantar wart, causing pain. Plantar can also spread to different parts of your feet and can look unsightly.
How can I prevent myself from having plantar warts?
Always wear thongs in communal changing and showering areas and around swimming pools. Do not share towels, shoes, and socks.
Keep your feet in healthy condition to reduce the likelihood of cuts and abrasions. Dry your feet thoroughly after washing. Moisturise your feet if they are dry. Treat conditions such as Tinea (Athletes foot).
Get an HPV Vaccine
Since plantar warts are caused by certain strains of the Human Papilloma Virus, getting vaccinations for HPV would be the best preventive method.
Vaccinations help the body make antibodies against microorganisms.
If your body can create antibodies against HPV, your immune system will be able to immediately recognize the viruses. As soon as these viruses enter the body, they will be seized and killed, and will no longer produce physical manifestations such as warts.
What should I do if I have one?
Avoid touching or scratching plantar warts as this may cause the spreading of the virus. Cover it with a plaster. To prevent transferring the virus to other people, wear thongs in the shower and do not walk barefoot.
Plantar warts may disappear of their own accord. However, if plantar warts do resolve it may take several months or even years. The time it takes for plantar warts to resolve varies greatly from one person to the next and may never occur.
If plantar warts are painless, no treatment may be required. Some treatments may be painful, especially for children and can cause side effects.
For painful, unsightly and/or spreading verrucae there are several treatment options available. Self-treatment is not suggested in the first instance due to the likelihood of damaging the skin under your feet.
When should I visit a podiatrist?
If you have a lesion that is painful, large, spreading or unsightly, it is best to visit a podiatrist.
If you have diabetes, poor circulation, are pregnant or have any other condition affecting your immune system or feet, it is important to never attempt to treat a plantar wart yourself but instead visit a podiatrist.
Before commencing treatment, your podiatrist will assess your general health. A very focused assessment of your foot and ankle health is then performed.Only then can a treatment plan be developed.
What treatments are available for plantar warts?
Treatment for warts is classified into three categories based on the severity of the condition.
First-Line Therapy For Warts
The first line of treatment is made-up of topically applied substances that aim to help the body reject the warts. These are usually keratolytic substances, which mean that they induce peeling and breaking of the skin surface.
This is the mildest treatment used for warts that are just starting to form, and it can be bought over-the-counter from pharmacies.
Salicylic acid is applied to the wart and surrounding areas until the wart disappears. This often lasts from weeks to months.
Your podiatrist may use an acid-based treatment applied to the top of the plantar wart. This is the most common and conservative treatment.
The top surface of hard skin over the top of the plantar wart is painlessly removed then an acidic medicine is applied. The surrounding skin will be covered and protected to reduce the likelihood of damage.
The medicine used is often much stronger than the solutions available at your pharmacy.
Depending on the size of the lesion, topical treatment may take several treatments over many weeks to resolve the plantar wart.
Second-Line Therapy For Warts
Second-line therapy is done to warts that have become larger to the extent that they cause discomfort to the affected person.
This involves freezing the wart/s with nitrogen or carbon dioxide (dry ice). This procedure may be painful and generally will not be suitable for young children, people who are sensitive to pain and the elderly. Several treatments may be required and are usually more successful for warts on the hands, rather than the feet.
This type of treatment relies on immune boosters.
These medications enhance the ability of our immune system to kill the viruses that get inside the body. Without the viruses, the warts will not be able to grow and propagate, and will eventually expire.
Third-Line Therapy For Warts
The third-line therapy for removing warts is reserved for warts that have been present for a long time, are unresponsive to other treatments and may be causing pain to the affected person.
Surgical removal or curettage
This procedure will be done under local anaesthetic and not recommended for young children, the elderly or people with underlying disease states or compromised immunity.
This treatment uses medical microwave technology which is proven to be highly effective at resolving verrucae and is the best treatment to allow you to keep active.
It is a fast and convenient treatment and is a good option for stubborn, painful and large lesions.
With a few exceptions, most people are able to have this treatment.
What to Watch Out For After Plantar Wart Treatment
Scars are the number one concern of any patient who undergoes wart removal procedures.
When warts are directly removed using surgery, it is sometimes inevitable to remove the full thickness of the skin. The resulting damage may turn into scars or depressions in the skin surface.
Development of Keloids
Keloids are very thick scars that sit above the skin and do not often arise from wart removal procedures. Keloids, however, are a greater concern when they develop after surgery because they are more persistent and physically noticeable compared to normal scars.
What are Keloids?
Keloids are raised skin abnormalities that may grow even bigger compared to the actual wound that caused the scar. Some of them progressively grow for long periods, even years.
Recurrent Plantar Warts
It is not uncommon for warts to recur after removal, especially if no further treatment is applied.
In instances of recurrent warts, the best available treatment is Swift Microwave Therapy.
Plantar warts, while not life-threatening, are highly contagious, painful, and unsightly. It is best to see your podiatrist as soon as possible to prevent plantar warts from spreading and avoid infecting others as well. Contact us today for an appointment.