A plantar wart is a small lesion that appears on the sole of the foot and typically resembles a cauliflower, with tiny black petechiae (abnormal, thrombosed capillaries resembling specks) in the center. Pinpoint bleeding may occur when these are scratched, and they may be painful when standing or walking. Plantar warts are often similar to helomata or corns, but can be differentiated by close observation of skin striations. Feet are covered in skin striae, which are akin to fingerprints on the feet. Skin striae go around plantar warts; if the lesion is not a plantar wart, the cells' DNA is not altered and the striations continue across the top layer of the skin. Plantar warts tend to be painful on application of pressure from either side of the lesion rather than direct pressure, unlike helomata, which tend to be painful on direct pressure instead.
A plantar wart (also verruca plantaris or verruca) is a wart caused by the human papillomavirus (HPV) occurring on the sole or toes of the foot. (HPV infections in other locations are not plantar; see human papilloma virus.) Plantar warts are generally harmless and self-limiting, but should be treated to lessen symptoms (which may become painful), decrease duration and reduce transmission. It is estimated that 7-10% of the US population is infected. Infection typically occurs on moist walking surfaces such as showers, swimming pools or shoes. The virus can survive many months without a host, making it highly contagious.
Treatment of Plantar Warts
As the viral infection gains momentum in your body, the plantar warts grow rapidly on the bottom of your feet. Usually, what you see outside the skin would indicate that the wart under the skin would be at least three times that size. Since this is situated right on the sole of the feet, the plantar warts are extremely painful. As such, most people prefer to by-pass the doctor and use over-the-counter medicines based on the advertisement that see each day on TV and other media.
Though the majority of the over-the-counter medicines are quite effective, a lot of care should be taken to ensure that the healthy tissue that surrounds the wart is not destroyed as well. This is very important, lest you'll invite another problem before getting rid of your current one. The safest thing for you to do is ensure that whatever treatment you undergo, it is done under the strict supervision of a doctor.
Nonsurgical options include the use of prescription anti-wart medication (officially for use against genital warts, but effective in treating plantar warts as well) or immunotherapy, wherein doctors inject antigens directly into the wart in an attempt to trigger the natural response of your immune system against the wart itself.
Keratolytic Chemical or Salicylic Acid Method
The treatment of warts by keratolysis involves the peeling away of dead surface skin cells with trichloroacetic acid or salicylic acid. It's more effective than it sounds. Using salicylic acid—a plantar wart treatment that you can purchase over-the-counter from your local drug store—you can remove a plantar wart in generally about four weeks. The process calls for daily application of acid to the wart, as well as rubbing off the dead skin from the wart. Acid can be applied either as a solution or as a patch, and sometimes you must apply it twice a day.
You can then use a nail file or pumice stone to remove the dead skin from the plantar wart each day. It's kind of pleasing that such an old medicinal substance should still be recognized as an excellent treatment; salicylic acid was known by the ancient world to exist within willow bark. Just remember to try not to let any of it get onto clear skin, where it will cause irritation, and the treatment should be safe and effective overall.
Immunotherapy Method
Intralesional injection of antigens (mumps, candida or trichophytin antigens USP) is a new wart treatment that may trigger a host immune response to the wart virus, resulting in wart resolution. Distant, non-injected warts may also disappear.
Chemotherapy Method
Topical application of dilute glutaraldehyde (a virucidal chemical, used for cold sterilization of surgical instruments) is an older effective wart treatment. More modern chemotherapy agents, like 5-fluoro-uracil, are also effective topically or injected intralesionally. Retinoids, systemically (e.g., isotretinoin) or topically (tretinoin cream) may be effective. As warts are contagious, precautions should be taken to avoid spreading.
Surgical Methods
•Cryosurgery sounds like what they did to Ted Williams, and does involve freezing. In this case, doctors use liquid nitrogen to "freeze" your wart. It's a common treatment that works by producing a blister under the wart. It is painful but usually non-scarring. They apply the liquid nitrogen directly onto the plantar wart using a spray-tip or cotton-tip applicator.
If you've never experienced cryotherapy before, you might be struck by the sci-fi image of unearthly vapors rising from the nitrogen tank. For children, this method can be too painful and scary, and at any rate, it guarantees neither more nor less success than duct tape or acid treatments. If successful, however, you'll get rid of that plantar wart faster.
•Electrodesiccation and surgical excision produce scarring. If the wart recurs, the patient has a permanent scar along with the wart.
•Lasers may be effective, especially the 585nm pulsed dye laser that the most effective treatment of all, and does not leave scars, but is generally a last resort treatment as it is expensive and painful, and multiple laser treatments are required (generally 4-6 treatments repeated once a month until the wart disappears).
Other Methods
•X-ray is an old method that is seldom recommended due to the long term adverse side effects of irradiation.
•Duct tape treatment of plantar warts has more in common with acid treatment than with cryotherapy. Apply the tape to your wart and leave it there for six days, after which you can wash the affected area and, once dry, rub off the dead wart skin with either that nail file or pumice stone once again. The duct tape method generally takes around six weeks, but may take up to eight before you remove the plantar wart.
•Watchful waiting may be appropriate since many warts will eventually resolve due to the patient's own immune system. In many cases, the body will attack and kill the wart and verrucæ will turn black and effectively fall off, although it can be two years or longer before this takes place.
Additional disadvantages with this method are the significantly increased likelihood of passing on the virus and the possibility that in some individuals, the virus may spread more extensively over the skin surface, further increasing discomfort and making treatment more difficult and requiring it to be more extensive.
•For large mosaic warts, it can be effective to use several methods at once. First, freeze the warts and then apply acid. After this, cloth medical tape can be placed over the area. Repeating acid and tape application daily will lead to the warts being pulled out in large masses. This will leave a slightly raw layer of skin, but works much faster than other means (typically within a month). Reoccurrence is purportedly low with this intermediate, combination process.
Preventing Plantar Warts
Wear shower sandals in public areas to reduce your potential contact with HPV. Dry your feet thoroughly after showering and swimming. If you have a plantar wart, consider treatment a matter of urgency. The sooner you treat the plantar wart, the better! Delayed treatment can increase the opportunity for the plantar wart to spread its virus to other local areas of your foot. It's far less difficult to get rid of one plantar wart than an entire "mosaic" (one of the more objectionable cases of life imitating art).In the interest of reducing the likelihood of the wart multiplying, don't touch or itch the plantar wart.
If you have a plantar wart, take the first step toward treatment today!Don't hesitate to schedule an appointment with your doctor to ensure that your problem is plantar warts. In the meantime, it won't hurt to apply duct tape or salicylic acid. Be aggressive. Don't let those warts walk all over you, even as you're walking over them.