Summer and Swimming and... Plantar Warts!?

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With Summer just around the corner, you and your children are at risk for picking up the painful and unsightly plantar wart, which is caused by a strain of the human papillomavirus (HPV).  The human papilloma virus enters the skin through small cuts or abrasions and may take several weeks to become visible.

The plantar wart appears on the bottom of the foot. They are similar to corns and calluses as a layer of hard skin forms over top of the lesion. Plantar warts are differentiated from corns/calluses by appearance. Plantar warts typically have small black hemorrhages under the skin giving the appearance of black dots; skin lines also diverge around warts and not through the lesion.

Plantar warts are contagious; however, the HPV strains that cause plantar warts are not easily transmitted by direct contact from one person to another. The virus thrives in warm and moist environments—such as shower floors, locker rooms and public swimming areas. When children are in swimming pools they often get small abrasions on the bottoms of their feet from the rough surface of the pool bottom. The virus enters these small abrasions, infects the basal cells resulting in plantar wart a few weeks later.

Our podiatrists, here at Community Foot Specialists, see a huge increase of patients with plantar warts in the warm Summer months. Here are a few precautions you can take this Summer to reduce your risks of plantar warts:

• Don't go barefoot in public areas. Wear sandals or flip-flops in public pools and locker rooms.
• Don’t share towels, washcloths. Even with members of your own family.
• Avoid direct contact with warts. This includes your own warts.
• Keep your feet clean and dry. Change your shoes and socks daily.
• 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 think you or your child may have a plantar wart, come in and see one of our podiatrists at Community Foot Specialists; we’re located in the Dayton/Springfield area and we can treat you with one of the following options

• Salicylic acid
• Cantharadin (blistering agent from beetle extract)
• Compounded medication that triggers an immune response against the virus
• Cryosurgery (with liquid nitrogen) freezes the internal cell structure of the wart
• Laser therapy (pulsed dye laser or CO2 laser
• Surgical excision of the verruca

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

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Common Foot Conditions and Treatments

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IngrownToenail- When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the side of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

Treatment- If an infection is present, an oral antibiotic may be prescribed. A simple procedure, often performed in the office, is commonly needed to ease the pain and remove the offending nail. Surgery may involve numbing the toe and removing a corner of the nail, a larger portion of the nail, or the entire nail. A chemical or the entire root is taken out to make sure the ingrown is permanently removed.

HeelPain- is most often caused by plantar fasciitis. Heel pain may also be due to other causes such as a stress fracture, tendonitis, arthritis, nerve irritation, or rarely a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A podiatric foot and ankle surgeon is best trained to distinguish between all the possibilities and determine the underlying source of your heel pain.

Treatment- Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery. Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia. Ice. Putting an ice pack on your heel for 10 minutes several times a day helps reduce inflammation. Limit activities. Cut down on extended physical activities to give your heel a rest. Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Your shoes should provide a comfortable environment for the foot. Lose weight. Extra pounds put extra stress on your plantar fascia. Padding and strapping. Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia. Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain. Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal. Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain.

Plantar Warts- A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically they appear on the bottom (plantar side) of the foot. A solitary wart is a single wart. It often increases in size and may eventually multiply, forming additional “satellite” warts. Mosaic warts are a cluster of several small warts growing closely together in one area. Mosaic warts are more difficult to treat than solitary warts.

Treatment-  The foot and ankle surgeon may use topical or oral treatments, laser therapy, cryotherapy (freezing), or surgery to remove the wart. Regardless of the treatment approaches undertaken, it is important that the patient follow the surgeon’s instructions, including all home care and medication that has been prescribed, as well as follow-up visits with the surgeon. Warts may return, requiring further treatment.

If you or someone you know is experiencing any of these foot problems, contact your Dayton/Springfield podiatrist at Community Foot Specialists. 937-426-9500

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