Plantar Warts

A plantar wart is a wart occurring on the bottom of the foot or toes. Their color is typically similar to that of the skin, however sometimes small black dots often occur on the surface. They can be very painful to walk on. They are often caused by human papilloma virus (HPV).

The virus attacks through small cracks in the skin and often warts are not present until many months after the initial insult. Because of the pressure on the sole of the foot, the wart is pushed inward and a hard layer of skin can form on top of it. They are very common and more often children are affected rather than adults.

Plantar Warts Symptoms and Anatomy

Plantar warts are often similar to calluses or corns, but can be differentiated by close observation of skin striations. Feet are covered in skin striae, which are akin to fingerprints of the feet. Skin striae go around plantar warts; if the lesion is not a plantar wart, 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 calluses (which tend to be painful on direct pressure instead).

Plantar Warts Treatment Options

Treatment is only needed if it is causing symptoms. This may include medications, cryotherapy or surgical removal. Before treatment, it is important to remove the skin on top of the lesion. In about a third to two thirds of cases they go away without specific treatment, however this may take a couple of years.

Medications used to treat these warts include salicylic acid, formic acid and immunotherapy. Alternately cryotherapy can be used to freeze off the wart from the skin. Finally, surgery is sometimes needed to remove the warts. The most common surgeries are electrodessication and surgical excision, laser surgery and cauterization.

Electrodessication makes use of an electrical current to dry out the wart and its surrounding skin so it can be removed. This can result in local scarring of the area.

Plantar Warts Prevention

HPV is spread by direct and indirect contact from an infected host. Avoiding direct contact with infected surfaces such as communal changing rooms and shower floors and benches, avoiding sharing of shoes and socks and avoiding contact with warts on other parts of the body and on the bodies of others may help reduce the spread of infection.

All warts are contagious, precautions should be taken to avoid spreading them.

Plantar Warts Surgery

Laser surgery is typically a last resort treatment, that is used for the most difficult warts. Cauterization is effective as a prolonged treatment but can cause keloiding and scarring.