Plantar Warts – Veruccae

What are plantar warts?

Warts are localized thickening of the skin and term plantar warts is used for those formed on foot.  A special type of warts can be found on the soles of the feet. Because of pressure these warts have a flat surface and often occur in groups. Commonly found in locations with the greatest pressure such as the heel or toe, so they cause pain when walking or running. They are called plantar warts (verrucae plantares), flat warts and also verrucae.

flat warts - plantar warts

What causes plantar warts?

Warts are a form of infection with human papilloma virus. There are different types of this virus and plantar warts are usually the result of just a few of them. Infection of cells of the outer layer of the skin with this virus results in growth and its thickening thereby to form non-cancerous growths on the skin or wart. Plantar warts are obtained by skin contact that is infected with a virus

Human papillomavirus (HPV) strains that are most common cause of plantar warts are HPV type 1 and 2. These strains are contagious and spread from person to person by direct contact with the virus. HPV virus which causes plantar warts can easily spread in warm and humid environments such as shower stalls and swimming pools. The virus enters the skin through tiny cracks in the surface of the skin while moisture and maceration of the skin of the foot probably facilitate the infection.

Are plantar warts contagious?

Yes. However, the virus is not highly contagious, and it remains unclear why some people get flat warts while others do not.

What are the symptoms of plantar wart?

Some plantar warts are unpleasant especially if they occur on the sole of your feet when you can have the feeling like you have a little stone in your shoe.

How do plantar warts look like?

Plantar warts can appear on any part of the foot and toes. Sizes range from a few millimeters to more than one centimeter. Each plantar wart have a rough surface which is slightly convex surface of the skin. Most often flat warts commonly seen on the skin can be found in places of the greatest pressure such as the heels or toes.

In the early stages they look like little bites, but in time as flat warts grow, they usually get more brownish color and appearance of the surface is like cauliflower, they have a clear border, black dots (blood vessels) on the surface of the lesion. They cause pain during running or walking.

Due to the pressure on these warts, plantar warts have flat surface and often occur in groups. Flat warts are smaller, smooth, flat and usually they have color of skin. Quite often the athletes have deep and painful warts that are deteriorate by running as they pounding deep into the skin of soles.

Flat warts can be extremely painful. Unlike the calluses, plantar warts tend to bleed from many tiny spots, which looks like a head of a pin, when a doctor shaves or cuts the surface of wart with a scalpel.

How to diagnose plantar warts?

The process is usually simple and based on appearance. However, sometimes flat wart is difficult to discern from corns and calluses. One tip to distinguish them is that plantar wart interrupts fine edges of the skin of the foot while corns do not.

Your doctor will need to cut out the area to be sure in the diagnosis. He will look for small black dots that confirm diagnosis of viral warts. Other checks are not necessary.

Is it posible to cure plantar warts?

Yes, but none of the treatments can not guarantee effectiveness in any case. The highest cure rate is among young people that have not been infected with warts for a long time.

However, most warts will withdraw themselves over time, so it is most reasonable to leave them if they do not cause problems.

When to start with treatment of plantar warts?

Treatment of flat warts is not good to start the day before an important match or competition or a long trip, because as with any other therapy there can be a reaction in the form of redness, or formation of blisters.

When you think about the treatment of plantar warts, it is necessary to consider the following:

  • Warts usually withdraw themselves and when they’re gone, do not leave scars
  • Successful treatment of viral warts does not prevent the development of new wart
  • Some warts can be extremely stubborn. The treatment does not always work and can be
    long-term
  • Treatment of plantar warts can be painful, especially treatment with liquid nitrogen because of which could form a scar on the foot which can cause discomfort during walking

Sometimes it is most reasonable to leave the plantar wart to withdraw by themself. However, if treatment is necessary, your doctor will usually start with less painful options, especially in children. Most plantar warts that require treatment can be adequately treated at home or at your doctor instead of a dermatologist.

Some of the most common ways of treating are:

Preparations with salicylic acid.

It is best to start with one of the commercial preparations containing salicylic acid, a chemical that helps remove the hard outer layer of warts. To improve the effectiveness of these preparations, before they are applied to the wart, it should be slimmed down by cutting or grinded with a sandpaper or nailfile.

Soak warts in warm water for at least 5 minutes to soften them before treatment. Treatment should be carried out on a daily basis for at least 12 weeks.

Treatment should be repeated every night, only on wart and not on the surrounding healthy skin, but if the area becomes hypersensitive, you need to stop treatment for a day or
two.

The success rate is higher in those who persist in treatment.

Removal of plantar wart with cryotherapy

Freezing the wart with liquid nitrogen using a spray can be the next option. If the wart is especially thick, it will have to be scraped off before freezing. It is ideally to repeat cryosurgery every three to four weeks.

The treatment is painful and can cause subsequent formation of blisters therefore your doctor may not recommend it for small children. It may take several freezing befor any results. Cryotherapy may be combined with preparations with salicylic acid.

Alternative treatments are

Include the occlusal therapy with duck tape or the application of tea tree oil.

If the plantar warts do not withdraw from the treatment described above, you might consider one of the following techniques:

Wart removal under local anesthesia.

The usual technique is to scrape the plantar wart with a sharp instrument like a spoon (Curette) and then cauterization of remaining area. However, all surgical procedures leave scars that may be painful on the foot. Besides that wart can reappear.

What can I do if I notice warts?

If you have a plantar wart:

  • Wear comfortable shoes that you are not cramped. Do not share your shoes and socks with anyone. In pharmacies, you can buy special insoles that reduce pressure on the plantar warts
  • Keep your feet clean and dry and change socks daily
  • Do not be barefoot in public areas. Plantar warts should be covered with waterproof plasters if you go to swim
  • Do not touch the warts. When you cut wart, carefully dispose peeled skin. Sandpaper or emery board will also bear a live virus of warts and do not use them for any other purpose as you could spread the virus
  • If you cutt or grind wart, take care not to damage the surrounding skin, as this may cause the spread of warts
  • If you have children, you should periodically check do they have viral warts.

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