Everything You Need to Know about Warts

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By: Dr. Belinda M. Dotter

Plantar warts are noncancerous skin growths on the soles of your feet caused by the human papillomavirus (HPV), which enters your body through tiny cuts, breaks or other vulnerable sites on the skin of your feet.  Plantar warts often develop beneath pressure points in your feet, such as the heels or balls of your feet. This pressure also may cause a plantar wart to grow inward beneath a hard, thick layer of skin (callus).  Most plantar warts aren't a serious health concern and may not require treatment. However, plantar warts can be bothersome or painful so it's important to contact your Dayton/Springfield, Ohio Podiatrist at Community Foot Specialist so we can get you back on your feet. Call today for an appointment 937-426-9500

Signs and symptoms of plantar warts include:

• Small, fleshy, grainy lesions, or growths, on the soles of your feet
• Hard, thickened skin (callus) over a well-defined "spot" on the skin, where a wart has grown inwards
• Black pinpoints, which are commonly called "wart seeds" but are actually small, clotted blood vessels
• Lesions that interrupt the normal lines and ridges in the skin of your feet
• Pain or tenderness when walking or standing

Plantar warts are caused by an infection with the human papillomavirus (HPV) in the outer layer of skin on the sole of your feet.

There are more than 100 types of HPV, but only a few types are known to cause warts on your feet. Other types of HPV are more likely to cause warts on other areas of your skin or on mucous membranes.

Transmission of the virus
Each person's immune system responds differently to HPV, so not everyone who comes in contact with the virus develops warts. Even people in the same family react to the virus differently.

The HPV strains that cause plantar warts aren't highly contagious. Therefore, it isn't easily transmitted by direct contact from one person to another. However, the virus does thrive in warm, moist environments — such as shower floors, locker rooms and public swimming areas. Consequently, you may contract the virus by walking barefoot around pools or gyms.

The virus also needs to have a point of entry into the skin:

• Cracks in dry skin
• Cuts or scrapes
• Wet, softened, fragile skin from prolonged water exposure (macerated skin)

Multiple warts
If the virus spreads from the original site of infection, multiple warts may appear. These may include:

• Several individual warts at different sites on the foot
• "Kissing warts," a pair of warts that appear where two parts of the foot touch, such as a point of contact between two toes or between a toe and the ball of foot
• Mosaics, clusters of warts that essentially form a large, single lesion

Treatment options include the following:

• Freezing (cryotherapy). Application of liquid nitrogen with a spray canister or cotton-tipped applicator to freeze and destroy your wart. The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. The application itself can be painful, and cryotherapy can result in painful or tender blisters that resolve on their own.
• Cantharidin. Application of cantharidin — a substance extracted from the blister beetle — on your plantar warts. Typically, the extract is paired with salicylic acid, applied to the plantar wart and covered with a bandage. The initial application is painless, but the subsequent blister that forms may be painful. The dead part of the wart is clipped off in about a week.
• Immunotherapy. This therapy attempts to harness your body's immune system to remove tough-to-treat warts. This can be accomplished in a couple of ways. Injection on your warts with interferon, a medication that boosts your immune system's instinct to reject warts. Or injection of your warts with a foreign substance (antigen) that stimulates your immune system. Often, mumps antigens are used, because many people are immunized against mumps. As a result, the antigen sets off an immune reaction that may fight off warts. Interferon treatment may result in flu-like symptoms for a few hours after treatment. Both treatments may cause pain.
• Imiquimod (Aldara). This prescription cream applied directly to a wart is an immunotherapy medication that encourages your body to release immune system proteins (cytokines) to attack HPV. This treatment can result in severe inflammation near the site and damage to the tissues beyond the wart. If this occurs, the treatment is dropped. The drug may also result in flu-like symptoms that may lessen with a lower dosage.
• Minor surgery. This involves cutting away the wart or destroying the wart by using an electric needle in a process called electrodesiccation and curettage. Anesthesizing your skin before this procedure is required. This treatment is avoided if possible with plantar warts because of the risk of scarring.
• Laser treatment. A type of laser treatment called pulse dye laser treatment burns closed (cauterizes) tiny blood vessels. The infected tissue eventually dies, and the wart falls off. This treatment can cause pain and scarring.

To reduce your risk of plantar warts:

• Avoid direct contact with warts. This includes your own warts.
• Keep your feet clean and dry. Change your shoes and socks daily.
• Don't go barefoot in public areas. Wear sandals or flip-flops in public pools and locker rooms.
• Don't pick at warts. Picking may spread the virus.
• Don't use the same file, pumice stone or nail clipper on your warts as you use on your healthy skin and nails.
• Wash your hands carefully after touching your warts.

If you or you know someone who may be experiencing any of these painful plantar wart symptoms, call your local Springfield/Dayton, Ohio Podiatrist at Community Foot Specialist so we can find the best treatment option for you. Call and schedule your appointment today with any of our 6 conveniently located Greater Dayton offices. 937-426-9500