Treatment of Plantar Warts (Verruca Pedis)
What are plantar warts?
Plantar warts (Verruca pedis), are contagious skin lesions that are caused by the Human Papilloma Virus (HPV). The lesions themselves are often only limited to the upper layers of the skin but with persistent infection can infiltrate deeper layers of the skin resulting in an increased level of discomfort. While warts can occur on many regions of the body, the ones that occur on the soles of the feet can become painful because of the actions of standing and walking.
What do plantar warts look like?
Plantar warts come in different varieties and can appear either individually or in clusters. The general appearance of warts resembles that of a cauliflower plant protruding from the skin. They can appear skin coloured making them harder to identify or covered by an overlying layer of thickened skin (callous) which adds to the discomfort when weight bearing. Some warts can have small brown or black dots which indicates small blood supply to the overlying viral tissue.
What is the difference between corns and warts?
Warts can often be confused with corns because of they both occur on the underside of the feet and exhibit similar discomfort characteristics. There are a number of distinct differences though that can rule out a wart from a corn.
- Corns hurt when direct pressure is applied to the lesion while warts may not elicit this response. Pain is reproduced however when sidewards pressure is applied to wart tissues (squeeze/pinch test).
- Warts bleed when cut while corns generally do not. This is owing to the small blood supply that accompanies wart tissues.
- Debriding corns usually relieves symptoms of discomfort while cutting warts may not provide complete relief from discomfort.
How do plantar warts occur?
While the viral characteristic of warts means they can be picked up from virtually anywhere, the most common places that harbour the offending virus are damp and unsanitary places such as gym floors, swimming pools, or room floors. The virus can enter the skin through small cracks in the skin which are exposed to the virus. A person’s immune system also plays a very big role in preventing the onset of verruca infections. It is not uncommon to find that after moments of stress or illness patients have developed warts due to their immune system being suppressed. Children are more susceptible to developing warts due to their activity levels and tendency to be barefoot in environments that harbour the virus.
What treatments are available?
Warts can resolve on their own within months or years. However, whilst they are present there is a risk of them multiplying or being contagious. Plantar warts usually get deeper as they get larger, and this can become very painful to walk on. The large and longer a wart has been present on the foot, the more difficult it becomes to treat it. So it is best to see a podiatrist for professional advise and treatment as soon as you notice a wart. Podiatrists are foot and lower limbs specialists with extensive training in the effective treatment of plantar warts. A number of treatments are available which includes:
- Debridal of wart tissue to reduce its physical size.
- Application of chemicals such as Silver Nitrate or Salicylic Acid to burn existing wart tissue.
- Freezing of wart tissue using liquid nitrogen
- Burning off wart tissue using a method called electrocautery
- Surgical removal of wart tissue under local anaesthetic.
- Needling of wart tissue under local anaesthetic.
- Offloading affected area to reduce discomfort during weight bearing and everyday activities.
A number of over the counter remedies are available from the chemist which may assist in eliminating the wart tissue before it becomes excessively uncomfortable. If however, over the counter remedies are deemed unsuccessful at controlling the wart, specialist assessment and advice should be sought out.
What can be done to reduce the risk of contracting or spreading warts?
Whilst there is an element of chance in contracting warts, there are a number of methods to reduce your risk of becoming exposed to or spreading the virus. Some steps include:
- Minimising the time spent barefoot on damp floors, including gyms, communal showers and floors.
- Avoid wearing the footwear of people who have previously had or currently have plantar warts.
- Cover existing warts with waterproof plaster so that it does not contact floor surfaces.
- Wearing specialist socks during swimming activities.
- Avoid touching your or the warts of other people with your hands
- Avoid sharing towels, razors or socks with other people.
- Keep your feet as dry as possible as warts prefer moist environments.
- Avoid wearing shoes or walking on surfaces that irritate the soles of your feet as injured skin is more prone to infection.
If you or anyone you know has questions or concerns regarding their feet or potentially plantar warts, contact us at The Podiatry Centre and let our podiatrists help your feet be as healthy as they can be.
Dr Anel Kapur (Podiatrist)
