By Eileen Rivero, DPM, ABPM
Plantar warts, medically termed as verrucae plantaris, are a common condition that affects the soles of the feet. They are caused by the human papillomavirus (HPV), particularly types 1, 2, 4, and 63. These warts can be painful and often present a significant discomfort due to their location on the weight-bearing areas of the foot. As such, understanding their occurrence, etiology, and treatment is essential from a podiatry perspective.
Plantar warts are prevalent worldwide, affecting individuals of all ages, though they are most common in children and young adults. This is likely due to the higher rates of barefoot walking and communal activities such as swimming and gym use among these age groups, which increase the risk of exposure to the virus. The incidence of plantar warts is also higher in individuals with compromised immune systems, such as those with HIV/AIDS or those undergoing immunosuppressive therapy. Furthermore, conditions like atopic dermatitis, which compromise skin integrity, can facilitate HPV infection.
The etiology of plantar warts revolves around the HPV, which infects the skin through direct contact. The virus typically enters the body through tiny cuts or abrasions on the skin’s surface. The environment plays a crucial role in the transmission of HPV. Warm, moist areas, such as communal showers, locker rooms, and swimming pools, are common breeding grounds for the virus.
Treatment of plantar warts can be challenging and varies based on the severity, duration, and response to previous treatments. A podiatrist considers multiple factors before recommending a treatment plan. The primary goals are to remove the wart, alleviate pain, and prevent recurrence.
Topical Treatments: Over-the-counter (OTC) treatments containing salicylic acid are often the first line of defense. Salicylic acid works by exfoliating the layers of the wart. Patients are advised to apply it regularly after soaking the foot in warm water and gently filing the wart with a pumice stone or emery board. This treatment can take several weeks to months and requires persistence.
Cryotherapy: This involves freezing the wart with liquid nitrogen. The extreme cold causes the wart tissue to die and eventually fall off. Cryotherapy sessions are typically performed every one to three weeks. While effective, this method can be painful and may require multiple sessions.
Laser Treatment: Pulsed-dye laser treatment targets the blood vessels within the wart, cutting off its blood supply and causing it to die. This method is often used for stubborn warts that do not respond to other treatments.
Surgical Removal: In cases where other treatments fail, surgical options may be considered. Curettage involves scraping the wart off under local anesthesia, but this carries a risk of scarring and recurrence. Electrosurgery, which uses electrical currents to burn the wart, is another option.
Preventing plantar warts is an essential aspect of management. Patients should be advised to wear protective footwear in communal areas, avoid direct contact with warts (their own or others’), and maintain good foot hygiene. Keeping the feet dry and treating any cuts or abrasions promptly can also reduce the risk of HPV infection.
Plantar warts are a common and often painful condition that podiatrists frequently encounter. Effective management requires a comprehensive approach tailored to the individual patient, considering the wart’s characteristics and the patient’s overall health. Through a combination of preventative measures, patient education, and a range of treatment options, your podiatrist can effectively manage and alleviate the burden of plantar warts.
Eileen Rivero, DPM, ABPM, is a Podiatrist at Family Foot & Leg Centers in Port Charlotte, FL. She is a Fellow of the American College of Foot & Ankle Surgeons. Call 239-430-3668 or visit www.NaplesPodiatrist.com to make an appointment. Visit FootHealthFacts.org to learn more about foot and ankle conditions.
3161 Harbor Blvd, Suite B
Port Charlotte, FL 33952
(239) 430 – 3668 (FOOT)
www.NaplesPodiatrist.com
Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.