Plantar Warts Overview

Plantar (verrucae) warts affect the soles of the feet, especially the weight bearing regions. The pressure in these areas may also cause plantar warts to grow inwards underneath a thick, hard layer of skin known as a callus. These kind of warts are quite common, and many people will experience them at least once in their lives.

Not unlike other types of warts, plantar warts are caused by human papilloma virus (HPV), particularly strains 1, 2, 4, 60 and 63. The virus is known to attack the skin on the soles of the feet and enter the body through tiny breaks, cuts or other weak spots. Plantar warts are not a serious health concern and usually respond well to treatment.

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Causes of Plantar Warts

Plantar warts develop as a result of an HPV infection on the outer layer of skin that covers the soles of the feet. There are about 100 different strains of HPV, but only a few of them are known to cause plantar warts. 

Different immune systems respond differently to the HPV virus, and not everyone who gets infected will develop warts. Even people in the same family may react to the virus in different ways. 

The types of HPV that cause plantar warts are not very contagious, so even direct contact may not guarantee spreading. However, the virus thrives in moist and warm environments, so it may be contracted while walking barefoot around a locker room or swimming pool. More warts may appear if the virus spreads from the first point of infection.

Diagnosis of Plantar Warts

Plantar warts can be diagnosed via:

  • Shave biopsy which involves the removal of a small section of the lesion to be tested in a laboratory.
  • The lesions could be pared with a scalpel to be checked for dark or tiny clotted blood vessels.

Prevention of Plantar Warts

To reduce the risk of contracting plantar warts:

  • Avoid walking barefoot around locker rooms and swimming pools.
  • Avoid direct contact with warts, including your own. Wash your hands carefully after touching a wart.
  • Ensure your feet are dry and clean. Change your socks daily.
  • Do not scratch or pick at warts.
  • Do not use the same pumice stone, emery board or nail clipper on your warts that you use on your healthy nails and skin.

Living with Plantar Warts

Plantar warts are quite common and are also treatable. While they may be treated at home, there are severe cases of plantar warts that will require treatment at a doctor’s office.

Symptoms of Plantar Warts

When plantar warts are forming, they can be difficult to detect due to their small size and minimal pain and discomfort. As they grow, however, they may appear brownish or yellowish in color. They often become dry, rough, and hard in texture. A few black dots may also appear deep inside the surface of the wart. This is nothing more than dried blood vessels.

Walking and standing can become painful as pressure is applied to the affected area. Initially, they appear as small bumps, becoming flat-surfaced from continued walking and standing. They can grow more than an inch in size if left untreated, increasing in pain and discomfort. In extreme cases, pain from the foot can travel upwards to leg and back and be misdiagnosed for something else when all along it was simply one of the symptoms of the untreated wart.

  • Tenderness when walking due to the pressure on the area.
  • Extreme pain.
  • The appearance of a circular flat spot on the skin with a depressed center.
  • The spot may have a crust, it might appear yellow and it may even have a black dot at the center.
  • Finger-like callused roots that grow and reach down underneath the skin.

Questions to Ask Your Doctor

  • What are the most significant symptoms of plantar warts?
  • Is it safe to treat my plantar warts at home?
  • If I decide to treat the plantar warts at home, under what conditions will I need to contact you?
  • How long will the treatment take?
  • What tests do I need to take to confirm the lesion is a plantar wart?

Risk by Age Group

0-2
3-5
6-13
14-18
19-40
41-60
61+

Low Risk

High Risk

 

How Common are Plantar Warts?

Plantar Warts are very common with more than 3 million cases per year in the United States.

  • Usually self-treatable
  • Usually self-diagnosable
  • Lab tests or imaging rarely required
  • Medium-term: resolves within months
  • Spreads Easily

Plantar Warts Treatment

While plantar warts are often harmless and may go away without treatment, it may take 1-2 years before the infection finally goes away on its own. If your plantar warts are spreading or become painful, you may need to treat them repeatedly before the warts fully disappear.

If your self-care approach doesn’t help, your doctor may recommend:

  • Stronger peeling medicines that contain salicylic acid (such as Wartrin) which removes the warts layer by layer. These medications may also stimulate the ability of the immune system to help defend the body against warts.
  • Freezing (cryotherapy) involves the application of liquid nitrogen to the wart, usually at a doctor’s office. The liquid nitrogen is either applied with a cotton swab or a spray and it can be painful, which is why the doctor may first numb the area.
  • When freezing and salicylic acid do not work, your doctor may recommend minor surgery, the use of other acids, immune therapy, laser treatment or vaccination.
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