Plantar Wart

Warts are benign (noncancerous) growths of the outer skin layer. They can occur at any time in life but are most common during childhood and the teen years. Warts can occur on many skin surfaces of the body. When they occur on the underside (sole) of your foot they are called plantar warts. They often emerge in groups with several small warts encircling a larger growth.

CAUSES

Human papillomavirus (HPV) is the cause of plantar warts. HPV attacks a break in the skin of the foot. Walking barefoot can lead to exposure to the wart virus. Plantar warts tend to develop over areas of pressure such as the heel and ball of the foot. Plantar warts often grow into the deeper layers of skin. They may spread to other areas of the sole but cannot spread to other areas of the body.

SYMPTOMS

You may also notice a growth on the undersurface of your foot. The wart may grow directly into the sole of the foot, or rise above the surface of the skin on the sole of the foot, or both. They are most often flat from pressure. Warts generally do not cause itching but may cause pain in the area of the wart when you put weight on your foot.

DIAGNOSIS

Diagnosis is made by physical examination. This means your caregiver discovers it while examining your foot.

TREATMENT

There are many ways to treat plantar warts. However, warts are very tough. Sometimes it is difficult to treat them so that they go away completely and do not grow back. Any treatment must be done regularly to work. If left untreated, most plantar warts will eventually disappear over a period of one to two years.

Treatments you can do at home include:

  • Putting duct tape over the top of the wart (occlusion), has been found to be effective over several months. The duct tape should be removed each night and reapplied until the wart has disappeared.

  • Placing over-the-counter medications on top of the wart to help kill the wart virus and remove the wart tissue (salicylic acid, cantharidin, and dichloroacetic acid ) are useful. These are called keratolytic agents. These medications make the skin soft and gradually layers will shed away. Theses compounds are usually placed on the wart each night and then covered with a band-aid. They are also available in pre-medicated band-aid form. Avoid surrounding skin when applying these liquids as these medications can burn healthy skin. The treatment may take several months of nightly use to be effective.

  • Cryotherapy to freeze the wart has recently become available over-the-counter for children 4 years and older. This system makes use of a soft narrow applicator connected to a bottle of compressed cold liquid that is applied directly to the wart. This medication can burn health skin and should be used with caution.

  • As with all over-the-counter medications, read the directions carefully before use.

Treatments generally done in your caregiver's office include:

  • Some aggressive treatments may cause discomfort, discoloration and scaring of the surrounding skin. The risks and benefits of treatment should be discussed with your caregiver.

  • Freezing the wart with liquid nitrogen (cryotherapy, see above).

  • Burning the wart with use of very high heat (cautery).

  • Injecting medication into the wart.

  • Surgically removing or laser treatment of the wart.

  • Your caregiver may refer you to a dermatologist for difficult to treat, large sized or large numbers of warts.

HOME CARE INSTRUCTIONS

  • Soak the affected area in warm water. Dry the area completely when you are done. Remove the top layer of softened skin, then apply the chosen topical medication and reapply a bandage.

  • Remove the bandage daily and file excess wart tissue (pumice stone works well for this purpose). Repeat the entire process daily or every other day for weeks until the plantar wart disappears.

  • Several brands of salicylic acid pads are available as over-the-counter remedies.

  • Pain can be relieved by wearing a doughnut bandage. This is a bandage with a hole in it. The bandage is put on with the hole over the wart. This helps take the pressure off the wart and gives pain relief.

To help prevent plantar warts:

  • Wear shoes and socks and change them daily.

  • Keep feet clean and dry.

  • Check your feet and your children's feet regularly.

  • Avoid direct contact with warts on other people.

  • Have growths, or changes on your skin checked by your caregiver.