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Big plantar warts: Plantar warts – Diagnosis and treatment

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Plantar warts – Diagnosis and treatment

Diagnosis

In most cases, your doctor can diagnose a plantar wart with one or more of these techniques:

  • Examining the lesion
  • Paring the lesion with a scalpel and checking for signs of dark, pinpoint dots — tiny clotted blood vessels
  • Removing a small section of the lesion (shave biopsy) and sending it to a laboratory for analysis

Treatment

Most plantar warts are harmless and go away without treatment, though it may take a year or two. If your warts are painful or spreading, you may want to try treating them with over-the-counter (nonprescription) medications or home remedies. You may need many repeated treatments before the warts go away, and they may return later.

If your self-care approaches haven’t helped, talk with your doctor about these treatments:

  • Stronger peeling medicine (salicylic acid). Prescription-strength wart medications with salicylic acid work by removing layers of a wart a little bit at a time. They may also stimulate your immune system’s ability to fight the wart.

    Your doctor will likely suggest you apply the medicine regularly at home, followed by occasional office visits.

  • Freezing medicine (cryotherapy). Cryotherapy done at a doctor’s office involves applying liquid nitrogen to the wart, either with a spray or a cotton swab. This method can be painful, so your doctor may numb the area first.

    The chemical causes a blister to form around your wart, and the dead tissue sloughs off within a week or so. Cryotherapy may also stimulate your immune system to fight viral warts. You may need to return to the doctor’s office for repeat treatments every two to four weeks until the wart disappears.

    Some studies suggest that cryotherapy combined with salicylic acid treatment is more effective than just cryotherapy, but further study is needed.

Surgical or other procedures

If salicylic acid and freezing medicine don’t work, your doctor may recommend one or more of the following treatments:

  • Other acids. Your doctor shaves the surface of the wart and applies trichloroacetic acid with a wooden toothpick. You’ll need to return to the doctor’s office for repeat treatments every week or so. Side effects include burning and stinging. Between visits, you may be asked to apply salicylic acid to the wart.
  • Immune therapy. This method uses medications or solutions to stimulate your immune system to fight viral warts. Your doctor may inject your warts with a foreign substance (antigen) or apply a solution or cream to the warts.
  • Minor surgery. Your doctor cuts away the wart or destroys it by using an electric needle (electrodesiccation and curettage). This procedure can be painful, so your doctor will numb your skin first. Because surgery has a risk of scarring, this method usually isn’t used to treat plantar warts unless other treatments have failed.
  • Laser treatment. Pulsed-dye laser treatment burns closed (cauterizes) tiny blood vessels. The infected tissue eventually dies, and the wart falls off. This method requires repeat treatments every three to four weeks. The evidence for the effectiveness of this method is limited, and it can cause pain and potentially scarring.
  • Vaccine. HPV vaccine has been used with success to treat warts even though this vaccine is not specifically targeted toward the wart virus that causes the majority of plantar warts.

Lifestyle and home remedies

Many people have removed warts with these self-care tips:

  • Peeling medicine (salicylic acid). Nonprescription wart removal products are available as a patch or liquid. Usually, you’re instructed to wash the site, soak it in warm water, and gently remove the top layer of softened skin with a pumice stone or emery board. Then after the skin has dried, you apply the solution or patch. Patches are usually changed every 24 to 48 hours. Liquid applications are generally used daily. You may need repeated applications on a regular basis over several weeks to months to see results.
  • Freezing medicine (cryotherapy). Nonprescription medicines that freeze the wart include Compound W Freeze Off and Dr. Scholl’s Freeze Away. The Food and Drug Administration cautions that some wart removers are flammable and shouldn’t be used around fire, flame, heat sources (such as curling irons) and lit cigarettes.
  • Duct tape. Using duct tape to remove warts is a harmless but unproven approach. To try it, cover the wart with silver duct tape, changing it every few days. Between applications, soak the wart and gently remove dead tissue with a pumice stone or emery board. Then leave the wart open to the air to dry for a few hours before covering it with tape again.

Preparing for your appointment

You’ll likely start by seeing your primary care doctor. He or she may refer you to a specialist in disorders of the skin (dermatologist) or feet (podiatrist). The following tips can help you prepare for your appointment.

What you can do

Bring a list of all medications you take regularly — including over-the-counter (nonprescription) medications and dietary supplements — and the daily dosage of each.

You may also want to list questions for your doctor, such as:

  • If I have a plantar wart, can I start with at-home care?
  • If I proceed with home treatment, under what conditions should I call you?
  • If the first treatment doesn’t work, what will we try next?
  • If the lesion isn’t a plantar wart, what tests do you need to do?
  • How long will it take to get results?
  • How can I prevent warts?

What to expect from your doctor

Your doctor may ask you questions such as:

  • When did the lesion first appear?
  • Has it changed in size or appearance?
  • Is your condition painful?
  • Have you had warts before?
  • Do you have diabetes or poor sensation in your feet?
  • Do you have any condition or take any medication that has weakened your ability to fight disease (immune response)?
  • Have you tried any home remedies? If so, how long have you used them and have they helped?
  • Do you use a swimming pool or locker room — places that can harbor wart-causing viruses?

What you can do in the meantime

If you’re sure you have a plantar wart, you may try over-the-counter remedies or alternative medicine approaches. But talk with your doctor before trying self-care treatments if you have:

  • Diabetes
  • Poor sensation in your feet
  • Weakened immunity

If pressure on the wart causes pain, try wearing well-cushioned shoes, such as athletic shoes that evenly support the sole and relieve some of the pressure. Avoid wearing uncomfortable shoes.


April 02, 2020

Show references

  1. Goldstein BG, et al. Cutaneous warts. http://www.uptodate.com/home. Accessed March 2, 2017.
  2. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. March 14, 2017.
  3. Some wart removers are flammable. U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm381429.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery. Accessed March 2, 2017.
  4. Landis MN, et al. Recalcitrant plantar warts treated with recombinant quadrivalent human papillomavirus vaccine. Journal of the American Academy of Dermatology. 2012;67:e73.
  5. Habif TP. Plantar warts. In: Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Edinburgh, U.K.; New York, N.Y.: Elsevier; 2016. https://www.clinicalkey.com. Accessed March 2, 2017.
  6. Kwok CS, et al. Topical treatments for cutaneous warts. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001781.pub3/abstract. Accessed March 2, 2017.
  7. Warts. American Academy of Dermatology. http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/u—w/warts. Accessed March 2, 2017.

Plantar Warts and Palmar Warts: Treatments and Causes

 

Plantar warts and palmar warts are common, especially in children. These warts are named for where they appear on the body. Palmar warts occur on the hands, and plantar warts on the bottom of the foot.

Virtually everyone will have a wart (or several) someplace at some time in their lives.

What Are Plantar Warts and Palmar Warts?

Plantar warts and palmar warts are noncancerous skin growths, caused by a viral infection in the top layer of the skin. The culprit is a strain of virus called human papillomavirus or HPV. Many strains of the virus exist, and those that cause common warts on the hands and feet are not the same strains of HPV that cause genital warts.

Some people mistakenly think plantar warts or palmar warts are malignant. In fact, they are not harmful. Eventually, in about two years, most warts go away without treatment. Warts can, however, cause irritation or minor pain, depending on their location. 

What Do Plantar Warts and Palmar Warts Look Like?

On average plantar warts and palmar warts are small, about the size of a pencil eraser. But some warts grow bigger. Sometimes plantar warts can grow in clusters; those are called mosaic warts.

Sometimes corns or calluses are mistaken for a palmar or plantar wart. In some warts, little black dots appear, leading people to call them “seed” warts. Actually the black dots are little blood vessels that have grown up into the wart. Warts don’t really have “seeds.”

Plantar warts usually don’t stick up above the skin as much as warts on the hand, partly because of the pressure of walking and its flattening effect.

How Do You Get a Plantar Wart or Palmar Wart?

Warts are spread from person to person. The transmission can be indirect. For instance, a child with a wart on their hand may touch a playground surface that is then touched by another child and the wart spreads. Or a person with a plantar wart uses a shower without wearing shower shoes and another person then uses it and develops a wart. The risk of getting a hand or foot wart from another person is small.

A person’s risk of getting a wart varies. Those with a weakened immune system are more susceptible. But those with healthy immune systems can also develop warts.

What Are Treatments for Plantar Warts and Palmar Warts?

Plantar warts and palmar warts will often eventually go away without treatment. If they bother you, however, you can treat common skin warts in a variety of ways.

  • Duct tape is one home remedy. Put a small strip over the wart and leave it on for six days. Then, remove the tape, soak the wart in water, and then gently debride it with a pumice stone or emory board. Repeat the process many times until the wart is gone. This may take a couple of months. Don’t expect miracles with this type of treatment since it probably does not work any better than a placebo.
  • Over-the-counter wart treatments include a medication that is applied topically (gel, ointment, lotion) and usually includes salicylic acid which works by peeling the wart. Another option is a freezing spray that kills the tissue. These remedies work about 50% of the time.
  • Doctor’s treatments are generally more effective. They include freezing the wart off with liquid nitrogen, removing the wart with laser or surgery, or applying or injecting medicines to strengthen the immune system so it can clear your body of the virus.

Treatment, however, is not fast and easy. Home treatment for hand warts, for instance, can take a few weeks up to a few months. Foot warts are challenging to treat because most of the wart lies below the skin surface.

Even if a treatment is successful, the wart can reappear.

If a wart is not bothersome, doctors say it can be left alone. Given time, the wart may disappear on its own, thanks to the immune system.

The Best Ways to Get Rid of Plantar Warts for Good

Skip the home remedies for wart removal. Proper treatment of plantar warts requires the expertise of your healthcare provider.

Posted
by The Iowa Clinic on Tuesday, August 18, 2020


Nose, fingers, toes and everywhere in between, warts can show up anywhere on your skin. They are one of the most common skin conditions. They’re also quite contagious.


Warts are more than an abnormal growth. They’re the result of an infection, specifically a virus more often associated with cervical cancer than a bump on the skin: human papillomavirus (HPV).


HPV enters your body through a cut or break in your skin. Then, it forms that ugly, rough bump. Since warts are caused by a viral infection, they are easily spread through contact. Anything that has had contact with a wart — your hand, a towel, a sock, the floor — can spread it.


And when warts show up on your feet, they can be as painful as they are unsightly.


What makes a wart on your foot worse than a wart somewhere else?


Pain.


Warts don’t usually present problems. They are on your skin until they go away on their own or by removal. Warts on the bottom of your feet, known as plantar warts, are the most likely type to give you any other trouble or symptoms.


Because of their location — the soles, heels, toes and balls of your feet — plantar warts send you a painful reminder of their presence with every single step. It feels like you’re walking with a rock in your shoe. Even if you’re barefoot.


Plantar warts are most common on the parts of the foot that receive the most pressure when you’re standing or walking. Since those are two things you can’t avoid, additional standing and walking increase the pressure on the wart and send it further inward, deep into your skin.


All that pressure also flattens the plantar wart. It ends up looking less like a wart and more like a callus. If you can’t tell the difference by looking at it, give it the squeeze test. A plantar wart is painful when squeezed; a callus is not.


It’s an important test. Many people rub calluses with abrasive objects like pumice stones, nail files and emery boards to remove the thick, rough skin. And that is not recommended for removal of plantar warts.


Painful plantar warts? Get help. 

Self-care of plantar warts can make things worse. Put your feet in the hands of experts.

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Wart anatomy

Warts grow only in the epidermis, the upper skin layer. A typical wart has a raised, rough surface. (Some, like those on the face, may be smooth and flat.) The center of a wart may be flecked with dark dots; these are capillaries that supply it with blood.

Common types of skin warts

Type

Appearance

Characteristics

Common

Raised, rough surface, sometimes with dark specks; light-colored to gray-brown.

Found mostly on the hands, but may appear anywhere. Those under or around the fingernails and toenails can be hard to treat.

Plantar

Rough, spongy surface kept flat by walking; gray or brown with dark specks.

Found only on the soles of the feet. Clustered plantar warts are called mosaic warts.

Flat

Flat or slightly raised; smooth and pink. Smaller than other warts.

Found mostly on the face, hands, and shins. They’re less common than other warts, but when they do appear, it’s often in large numbers.