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Warts on feet treatment: Plantar Warts and Palmar Warts: Treatments and Causes

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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.

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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.
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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.

How to get rid of warts

Ugly and annoying, warts never seem to go away fast enough. Treating them may help speed their departure.

Warts are generally harmless and often disappear on their own over time, but they’re unsightly, and some, like those found on the soles of the feet, can make walking and exercise painful. Wart removal can be a challenge, but fortunately, the most effective treatments are the least invasive.

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.

What are warts anyway?

Warts occur when skin cells grow faster than normal because they are infected with the human papillomavirus (HPV). Among the 150 strains of HPV, about 10 cause cutaneous (skin) warts, including common, plantar, and flat warts (see “Common types of skin warts,” below). Certain other strains cause anal warts and genital warts. Some sexually transmitted types of HPV are implicated in cervical and other genital cancers, but the strains that cause skin warts have rarely been linked to cancer.

All of us come into contact with HPV repeatedly — when we shake hands or touch a doorknob, for example — but only some of us develop warts, and that’s hard to explain. Children and people with immune system abnormalities are particularly vulnerable. For reasons that aren’t entirely clear, so are people in certain occupations, such as meat, fish, and poultry handlers. But the most likely explanation is that some people are simply more prone to warts than others.

Skin warts aren’t highly contagious. They can spread from person to person by direct contact, mainly through breaks in the skin. Theoretically, you can also pick up warts from surfaces such as locker room floors or showers, but there’s no way to know how often this occurs. Warts on one part of the body can be spread to other areas, so it’s important to wash your hands and anything that touches your warts, such as nail files or pumice stones.

A wart virus infection is different from a bacterial infection such as strep throat, which can be caught, treated, and eradicated because it progresses in a distinct, reliable pattern. The ways of warts are much less predictable. According to dermatologist Dr. Suzanne Olbricht, “The wart virus resides in the upper layer of the skin, and who knows where or when you picked it up? The virus could have been there for years. Then it makes a wart for reasons we don’t understand. And when the wart goes away, you can still find the virus in the epidermis.”

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.

Treating warts

Studies indicate that about half of warts go away on their own within a year, and two-thirds within two years, so “watchful waiting” is definitely an option for new warts. But some experts recommend immediate treatment to reduce the amount of virus shed into nearby tissue and possibly lower the risk of recurrence. If you prefer not to wait it out, you have several treatment options:

  1. Salicylic acid. This is the main ingredient in aspirin, and it should usually be your first choice. According to one study, salicylic acid is the only topical treatment (treatment applied directly to the skin) that clearly outperforms a placebo. (The study, in the August 2011 issue of the British Journal of Dermatology, combined and reanalyzed data from a number of previous studies.) Salicylic acid costs little, has minimal side effects, and comes in various over-the-counter preparations, including liquids, gels, and patches. Concentrations range from 17% to 40% (stronger concentrations should be used only for warts on thicker skin). To treat a wart, soak it for 10 to 15 minutes (you can do this in the shower or bath), file away the dead warty skin with an emery board or pumice stone, and apply the salicylic acid. Do this once or twice a day for 12 weeks. Warts in thick skin, like the bottom of the foot, may respond best to a patch that stays in place for several days. Continuing treatment for a week or two after the wart goes away may help prevent recurrence.
  2. Freezing. In this treatment, also called cryotherapy, a clinician swabs or sprays liquid nitrogen onto the wart and a small surrounding area. The extreme cold (which may be as low as –321 F) burns the skin, causing pain, redness, and usually a blister. Getting rid of the wart this way usually takes three or four treatments, one every two to three weeks; any more than that probably won’t help. After the skin has healed, apply salicylic acid to encourage more skin to peel off. Some individual trials have found salicylic acid and cryotherapy to be equally effective, with cure rates of 50% to 70%, but there is some evidence that cryotherapy is particularly effective for hand warts.
  3. Duct tape. Although findings have been mixed, anecdotal evidence suggests that this low-risk, low-tech approach may be worth a try. In one study comparing duct tape with cryotherapy, subjects wore duct tape patches over their warts for six days. Then they removed the patches, soaked and filed the warts, left them uncovered overnight, and reapplied the tape in the morning, leaving them in place for another six days. They followed this regimen for two months or until the wart disappeared. In this study, duct tape was about 45% more effective than cryotherapy. Two other studies found no benefit, but those studies used clear duct tape rather than the standard silver type, which is stickier and has a different kind of adhesive. Given this limited evidence, if you plan to try duct tape, it makes sense to use the silver kind. Why duct tape works isn’t clear — it may deprive the wart of oxygen, or perhaps dead skin and viral particles are removed along with the tape. Some people apply salicylic acid before covering the wart with duct tape.
  4. Other agents. Warts that don’t respond to standard therapies may be treated with prescription drugs. The topical immunotherapy drug imiquimod (Aldara), a standard therapy for genital warts, can also be used to treat skin warts. Imiquimod is thought to work by causing an allergic response and irritation at the site of the wart. In an approach called intralesional immunotherapy, the wart is injected with a skin-test antigen (such as for mumps or Candida) in people who have demonstrated an immune response to the antigen. Other agents that may be used to treat recalcitrant warts are the chemotherapy drugs fluorouracil (5-FU), applied as a cream, and bleomycin, which is injected into the wart. All these treatments have side effects, and the evidence for their effectiveness is limited.
  5. Zapping and cutting. The technical name for this treatment is electrodesiccation (or cautery) and curettage. Using local anesthesia, the clinician dries the wart with an electric needle and scrapes it away with a scoop-like instrument called a curette. This usually causes scarring (so does removing the wart with a scalpel, another option). It’s usually reserved for warts that don’t respond to other treatments and should generally be avoided on the soles of the feet.

When to see your clinician

Some skin cancers resemble warts at first. If you have a wart that doesn’t change much in size, color, or shape, you probably don’t need to see a clinician. But if you’re in your 50s and develop new warts, consult a dermatologist. Be suspicious of any wart that bleeds or grows quickly.

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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.

Find a doctor