Plantar Warts

What exactly is a plantar wart and how is it caused?

A plantar wart, also known as a verruca, is a form of the Human Papilloma Virus (HPV) that presents itself on the soles, or the bottom, of the foot. Plantar warts are caused by contact with the virus and they enter the skin through tiny cuts or scraps. Due to the fact that many of these viruses are microscopic they are usually present for a few weeks or months before they are noticeable. Many times warts get “pushed into the skin” and a new layer of tissue forms over the wart. This can cause pain with weight bearing, walking and exercise.  On the other hand, some patients have no pain whatsoever but notice a lesion on their feet.

How can a plantar wart be diagnosed?

A plantar wart is diagnosed via clinical exam.  Differentiating a wart from a corn is critical in treatment. Unlike a corn a wart will have small black dots in the center, which are capillaries or the blood supply to the wart. In addition the wart will have pain with direct pressure. Lastly, the skin lines that run on the bottom of the foot will wrap around the wart versus run through the corn.  

How can a plantar wart be treated?

There are many different treatment methods for plantar warts. Different physicians may have different techniques and protocols to treat warts. There are many different topical medications that can be used. Salicylic Acid is a common medication that can be purchased over the counter or prescribed by a physician. Canthrone, which is a beetle juice extract, can be used, which causes a blistering affect, and subsequent removal of the wart. There are different injectables that can be injected to the wart to eradicate the virus.

The warts can be removed via cryosurgery, or the freezing of the warts. Surgical excision, or removal of the warts, can be performed. Laser surgery, which has become more common lately, is another way to treat hard to cure warts.

In general, treating and curing warts is difficult due to the perseverance of the virus. Many of the options listed above take many weeks of treatment. Many physicians have a step wise approach to treating warts. I personally will use Cryotherapy on a younger patient, canthrone on an older patient. I will have the patient apply a medical strength Salicylic Acid during the 2 weeks between appointments. I will typically do 3-4 treatments. For the difficult to treat warts I reserve Laser therapy. Surgical removal of the wart has fallen out of favor due to the many different treatment options available. In addition, surgical removal would require an incision on the bottom of the foot, which is painful and takes a while to heal.

In conclusion, warts are very contagious, easy to contract but difficult to eradicate. Local care by a physician will close follow up and compliance is a great recipe to recovery. If you have a painful or non-painful suspicious lesion on your foot see a physician right away.

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