What are Plantar Warts?

Plantar warts are commonly known as verrucae.

These warts are found on the soles of the feet and around the toes. They are sometimes painful and itchy, and can become more so if they get bigger. They can grow larger than 1cm wide.

They appear as hard, grainy or fleshy growths, and often look like cauliflowers with small black dots.

Causes

Plantar warts are caused by an infection of the Human Papilloma Virus (HPV). The virus thrives in moist and wet areas such as communal showers, changing rooms and swimming pools.

While anyone can get plantar warts, children, teenagers and young adults are most commonly infected. It is possible to develop some immunity over time.

Are plantar warts contagious?

HPV is very contagious. You can catch plantar warts simply by walking on the same surface as someone who has the virus.

You should be especially careful if you have any cuts on your feet, as they make it much easier for the virus to penetrate.

While not a serious threat to your health, plantar warts can be very uncomfortable, and painful calluses can form over the warts.

They can look quite unsightly, and can spread to a large area of your feet.

Prevention

There are many simple steps you can take to prevent plantar warts:

Always wear thongs in communal showers, changing rooms and swimming pools
Don’t share towels, shoes or socks

Keeping your feet healthy to reduce the risk of cuts and abrasions is also important:

Dry your feet thoroughly after washing
Moisturise your feet if they often become dry
Make sure to treat any skin conditions such as athlete’s foot

The most effective way to prevent plantar warts is to get an HPV vaccine.

As plantar warts are caused by certain strains of the Human Papilloma Virus, getting an HVP vaccination is the best preventative method.

Vaccination will help your body make antibodies that will immediately recognise and kill the HPV virus in your body.

Treatment and prevention of its spread

While there are some plantar wart home remedies you can use, it’s also important to understand how to prevent spreading it to others.

Here are some steps you can take to stop the infection spreading:

Avoid touching or scratching plantar warts
Cover any warts with a plaster
Wear thongs in the shower and do not walk barefoot

Plantar warts may disappear of their own accord, though this can take several months or even years and is not guaranteed.

If plantar warts are painless, treatment may not be necessary. Some treatments may be painful, especially for children, and can cause side effects.

If the warts cause pain, are unsightly, or are spreading, treatment options are available.

Treatment options

While there are some home remedies for treating plantar warts, it’s best to see a podiatrist in the following circumstances:

If you have diabetes, poor circulation, are pregnant or have any other condition affecting your immune system or feet
If you have a lesion that is painful, large, spreading or unsightly

There are three categories of treatment based on the severity of the condition: First, Second and Third-Line Therapies.

First-Line therapy

First-line therapy consists of topically applied substances that help the body reject the warts.

These are usually keratolytic substances, which means that they cause the surface of the skin to peel and break.

Over-the-counter

Salicylic Acid is the mildest treatment used for warts that are just starting to form. It can be bought over the counter from pharmacies.

It is applied to the wart and surrounding areas until the wart disappears, which can take from weeks to months.

In-house

Your podiatrist may use a stronger acid-based treatment, in which an acidic medicine is applied to the top of the plantar wart. This is the most common and conservative treatment.

Your podiatrist will remove the hard skin covering the wart before applying an acid-based medicine. The surrounding skin will be covered and protected to reduce the likelihood of damage.

The procedure is safe and painless.

Multiple treatments over several weeks may be required to resolve the plantar wart.

Second-Line Therapy

These types of therapy are required when warts are large enough to cause significant discomfort.

Cryotherapy

This involves freezing the warts with nitrogen or carbon dioxide (dry ice).

The procedure is often painful and therefore often unsuitable for those sensitive to pain, such as young children and the elderly. Several treatments may be required.

Immunotherapy

This type of treatment involves medications that help your immune system fight the virus responsible for plantar warts.

Third-Line Therapy

These types of therapy are reserved for warts that have been present for a long time, warts that are unresponsive to other treatments, and warts that are painful.

Surgical Removal or Curettage

This is done under local anaesthetic and is not recommended for children, the elderly, or people with underlying diseases or compromised immune systems.

Microwave Therapy

This treatment uses medical microwave technology to remove the warts. 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

Scars are the number one concern of patients who undergo wart removal procedures.

Unfortunately, scars and depressions in the surface of the skin are often inevitable if surgery is required.

Development of Keloids

Keloids are very thick scars that sit above the skin. They do not often arise from wart removal procedures.

Recurrent Plantar Warts

Warts can sometimes recur after removal, especially if no further treatment is applied.

In instances of recurrent warts, the best available treatment is Microwave Therapy.

Final Words

Plantar warts, while not life-threatening, are highly contagious, painful, and unsightly.

If you notice warts on your feet, you should see your podiatrist as soon as possible to prevent plantar warts from spreading and to avoid infecting others.