What are the primary symptoms of plantar warts. How are plantar warts diagnosed. What are the most effective treatments for plantar warts. Can plantar warts be prevented. How long do plantar warts typically last. Are plantar warts contagious. What is the difference between plantar warts and calluses.

Understanding Plantar Warts: Causes and Prevalence

Plantar warts, also known as plantar verrucae, are cutaneous infections caused by the human papillomavirus (HPV). These warts primarily affect the feet and can be a source of discomfort and embarrassment for those afflicted. The most common HPV types responsible for plantar warts are HPV-1, 4, 27, and 57.

While precise epidemiological data is limited, plantar warts are most frequently observed in children and adolescents. Although not typically associated with severe clinical consequences, they can cause significant stress and pain, especially when located on weight-bearing areas of the foot or when rubbing against footwear.

Prevalence and Risk Factors

• Higher incidence in children and adolescents
• Increased risk in immunosuppressed individuals
• Greater likelihood of infection in communal areas such as swimming pools and shared bathrooms

Are plantar warts a serious health concern. While generally benign, in rare cases and particularly among immunosuppressed individuals, long-standing plantar warts have been reported to undergo malignant transformation into squamous cell carcinoma or plantar verrucous carcinoma.

Identifying Plantar Warts: Diagnostic Techniques

Accurate diagnosis of plantar warts is crucial for effective treatment. These lesions can often be mistaken for corns or calluses, making proper identification essential.

Clinical Appearance and Diagnostic Tools

How can healthcare professionals accurately diagnose plantar warts. The use of a hand-held dermatoscope can greatly assist in diagnosis for trained practitioners. Plantar warts exhibit specific characteristics that distinguish them from other foot lesions:

• Hyperkeratosis or thickening of the skin
• Small dots or lines visible inside the lesion (representing broken capillaries)
• Red to brown coloration of the dots or lines
• Presence of red/purple dots or clods (blood vessels) surrounded by white circles or lobules (keratin) when viewed through a dermatoscope

In contrast, corns display a translucent core (appearing as concentric fine white rings under dermatoscopy), while calluses show a generalized opacity across the lesion (appearing structureless under dermatoscopy).

Differential Diagnosis

What is the most important differential diagnosis for plantar warts. Although rare, melanoma is the most critical condition to rule out when evaluating a suspected plantar wart. Other tumors may also occasionally occur in this location, emphasizing the importance of thorough examination and, when necessary, biopsy for definitive diagnosis.

Transmission and Prevention of Plantar Warts

Understanding the transmission of HPV is crucial for preventing the spread of plantar warts. The virus is highly contagious and can be transmitted through various means.

Modes of Transmission

• Direct skin-to-skin contact
• Contact with surfaces touched by infected individuals
• Auto-inoculation to other parts of the body

How long can HPV persist before causing visible warts. HPV can be present for weeks or even years before a wart appears, and the virus persists for life, even after the wart has resolved. This persistence may lead to recurrence at the same site, particularly if a person becomes immunosuppressed.

Prevention Strategies

What measures can be taken to prevent the transmission of plantar warts. Effective prevention focuses on both individual and community-based approaches:

1. Wear footwear in public spaces, especially around swimming pools and in shared bathroom areas
2. Cover existing warts with waterproof tape before using communal areas
3. Avoid going barefoot in public spaces
4. Educate family members and school communities about prevention measures
5. Regularly clean and disinfect shared surfaces in homes and schools

For individuals already infected with plantar warts, taking precautions to reduce transmission to others is crucial. This includes wearing footwear in home and school environments and covering warts with tape before using communal areas.

Treatment Options for Plantar Warts

The management of plantar warts can be challenging, as some warts are resistant to multiple treatments. However, several options are available, ranging from conservative approaches to more aggressive interventions.

Conservative Management

Is watchful waiting a viable option for plantar warts. Given that up to 80% of plantar warts may resolve spontaneously, conservative management is often a reasonable first-line approach, particularly for asymptomatic warts or those in non-weight-bearing areas.

Topical Treatments

Which topical treatments show the most promise for plantar warts. Wart paints and gels containing salicylic acid have demonstrated good efficacy in clinical studies. These over-the-counter treatments work by gradually removing the infected tissue and stimulating the immune response.

• Salicylic acid preparations (various concentrations available)
• Imiquimod cream (prescription required)
• 5-Fluorouracil cream (prescription required)

Cryotherapy

How effective is cryotherapy for plantar warts. While cryotherapy using liquid nitrogen is a conventional treatment for warts, evidence supporting its effectiveness for plantar warts is limited. The procedure involves freezing the wart tissue, which then blisters and falls off.

Other Treatment Modalities

What alternative treatments are available for resistant plantar warts?

• Laser therapy
• Electrocautery
• Surgical excision
• Immunotherapy (e.g., intralesional injections of Candida antigen)
• Photodynamic therapy

These treatments are typically reserved for cases that have not responded to more conservative approaches or for large, painful warts that significantly impact quality of life.

Complications and Special Considerations

While plantar warts are generally benign, certain complications and special considerations warrant attention.

Potential Complications

• Pain and discomfort, especially in weight-bearing areas
• Spread of infection to other body parts or individuals
• Rare cases of malignant transformation in long-standing warts
• Psychological distress due to appearance or persistent nature of warts

Special Populations

How should plantar warts be managed in immunocompromised individuals? Immunosuppressed patients, such as organ transplant recipients, are at higher risk for developing plantar warts and may experience more persistent or treatment-resistant infections. These cases often require more aggressive management and close monitoring.

Long-term Management and Follow-up

Effective long-term management of plantar warts involves a combination of treatment, prevention, and regular follow-up.

Monitoring and Recurrence Prevention

What steps can be taken to prevent recurrence of plantar warts?

1. Regular self-examination of feet
2. Prompt treatment of any new lesions
3. Maintaining good foot hygiene
4. Avoiding walking barefoot in public areas
5. Strengthening the immune system through a healthy lifestyle

When to Seek Further Medical Attention

Patients should be advised to seek medical attention if:

• Warts persist despite treatment
• There is a sudden change in the appearance of the wart
• Pain or bleeding occurs
• There are signs of infection (redness, swelling, warmth)
• New warts develop in different areas

Emerging Research and Future Directions

The field of plantar wart management is continuously evolving, with ongoing research into new treatment modalities and prevention strategies.

Novel Treatment Approaches

What innovative treatments are being explored for plantar warts? Recent research has focused on several promising avenues:

• Immunomodulatory therapies
• Gene-based treatments targeting HPV
• Combination therapies for enhanced efficacy
• Nanotechnology-based drug delivery systems

Vaccine Development

Is a vaccine for plantar warts on the horizon? While current HPV vaccines primarily target high-risk types associated with cervical cancer, research is ongoing to develop vaccines that could prevent infection with the HPV types responsible for plantar warts.

As our understanding of HPV and its interactions with the human immune system continues to grow, new and more effective treatments for plantar warts are likely to emerge. Ongoing clinical trials and basic science research hold promise for improved management strategies in the future.

In conclusion, plantar warts remain a common and often challenging condition to manage. While spontaneous resolution is possible, various treatment options are available for those seeking active intervention. Prevention strategies, including proper foot hygiene and avoiding barefoot walking in public areas, play a crucial role in reducing transmission. As research progresses, we can anticipate more targeted and effective treatments, potentially including preventive vaccines, to address this persistent problem.

Plantar warts: a persistently perplexing problem

Plantar warts, also known as plantar verrucae, are manifestations of infection with human papillomavirus. They can be painful due to their position on weight-bearing skin and in some patients may cause embarrassment due to their cosmetic appearance. Plantar warts often spontaneously resolve so conservative management is an option, particularly as some warts are resistant to multiple treatments. Although cryotherapy using liquid nitrogen is a conventional treatment for warts, there is limited evidence that this is an effective management method. Topical treatments for warts have variable success rates, however, wart paints and gels containing salicylic acid show good evidence of efficacy. Melanoma is a rare but important differential diagnosis.

In this article

• Diagnosis is based on clinical appearance
• Treatment of plantar warts
• References

In this article

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Plantar warts are caused by cutaneous infection with the human papillomavirus (HPV). There are numerous types of HPV
which manifest in different ways. Plantar warts are generally caused by HPV-1, 4, 27 and 57 (see: “HPV vaccine”).¹
There is limited high-quality epidemiological data on the prevalence of plantar warts. However, they generally
occur with the greatest frequency in children and adolescents.¹ Although plantar warts are not usually associated with
serious clinical consequences, they can cause stress or embarrassment, which should not be underestimated. Plantar warts
are also often painful when present on weight-bearing areas of the foot or when they rub against footwear. Plantar warts
are almost always benign, however, in rare cases (and particularly in people who are immunosupressed), warts of prolonged
duration have been reported to undergo malignant transformation to squamous cell carcinoma or plantar verrucous carcinoma.^{2,
3, 4}

Diagnosis is based on clinical appearance

Plantar warts can be confused with corns or calluses. The use of a hand-held dermatoscope can assist in diagnosis for
practitioners trained in its use. Warts are characterised by hyperkeratosis or thickening of the skin, and are often found
on pressure points. Small dots or lines are usually visible inside the lesion, which represent broken capillaries and
can range from red to brown in colour.⁵ They are more clearly shown by dermatoscopy, where red/purple dots or clods (blood
vessels) are surrounded by white circles or lobules (keratin). The blood vessels may become more obvious if the outer
layers of hyperkeratotic tissue are trimmed off. In contrast, corns exhibit a translucent core (concentric fine white
rings on dermatoscopy), while calluses show a generalised opacity across the lesion (structureless on dermatoscopy).⁵
Multiple adjacent verrucae may form mosaic warts.

Although rare, the most important differential diagnosis in a patient with a suspected plantar wart is melanoma. Other
tumours may also rarely occur in this site (see: “Melanoma of the foot”).

Prevention of transmission

HPV is transmitted by skin contact or contact with surfaces touched by other people with the virus. HPV can be present
for weeks or years before the appearance of a wart, and persists for life, even after the wart has resolved. This may
lead to recurrence at the same site, e.g. if a person who is carrying the virus becomes immunosuppressed; plantar warts
are very prevalent in organ transplant recipients.

People with plantar warts can auto-inoculate HPV and spread infection to other parts of the body. For example, picking
at warts with fingernails may result in transference of infection to the hands. Abrasive implements used to remove thickened
wart skin, and clinical implements such as dermatoscopes, have been shown to retain detectable HPV DNA.^{6, 7} Whether this
contamination represents transmissible virus is uncertain, but as a precautionary measure any implements used on the wart
should be sterilised or discarded after use.

Children frequently acquire warts from infected family members or in a classroom environment, therefore, prevention
efforts need to focus on the both the home and school.^{8, 9} Going barefoot in public spaces, around swimming pools or in
shared bathroom areas increases a person’s risk of HPV infection. People already infected with plantar warts should be
advised to take precautions to reduce transmission to others, such as wearing footwear in the home and school environments
and covering warts with tape before using communal areas.

Treatment of plantar warts

Up to 80% of people will experience resolution of plantar warts without intervention within two years.¹⁰ Many patients
will, however, wish to attempt treatment. All topical treatments for warts have variable success rates, therefore several
different management methods may need to be trialled before the wart is resolved. Wart paints and gels containing salicylic
acid show good evidence of efficacy, and can be recommended as a starting point for patients who wish to trial a treatment.

Watch and wait

It is estimated that cure rates of plantar warts with a watch and wait approach are likely to be in the range of 25%
over a period of a few months.¹¹ Eventually, most warts will resolve without treatment, but this may take several years.

If the wart is causing discomfort, the wart surface can be abraded with an emery board (disposable nail file), pumice
stone or a similarly abrasive surface. Patients should be advised that items used on the wart should be discarded after
use or sterilised (e.g. placed in boiling water for five minutes or soaked in bleach) to reduce the risk of viral transmission.
The lesion can also be debulked to improve absorption of creams or ointments into the underlying infected tissue, if pharmacological
treatment is trialled.

Topical creams and ointments

Most topical treatments for plantar warts are recommended as a daily application until the wart has resolved. There
are no specific guidelines for when treatment efficacy should be reviewed or when to switch to an alternative treatment.

Salicylic acid

Topical treatment with salicylic acid is often regarded as a first-line approach to treating plantar warts. Salicylic
acid is a keratolytic agent and works by debriding the skin. Salicylic acid 27% gel (general sale) should be carefully
applied to the wart, once daily. The surrounding skin should be protected, e.g. with soft paraffin or a specially designed
plaster. The wart should be gently abraded with an emery board or pumice stone once a week. Treatment may need to be continued
for up to three months.¹² A Cochrane systematic review of the treatment of warts included two studies assessing the efficacy
of salicylic acid for plantar warts, and found a 29% increase in cure rate with salicylic acid over placebo after 12 to
13 weeks.¹³

Topical salicylic acid may cause irritation if applied to fissures or abrasions. Caution is recommended in patients
with reduced skin sensation (e.g. patients with diabetes) as over-application may cause skin ulceration.¹²

Silver nitrate

Silver nitrate (general sale) is available in the form of a stick which is moistened (ideally with distilled water rather
than tap water) and applied directly to the wart for one to two minutes.¹⁴ Treatment should be applied once daily for
a maximum of six applications.¹⁴ The surrounding skin should be protected. The efficacy of silver nitrate treatment has
only been assessed in one randomised controlled trial where patients using silver nitrate showed complete cure rates approximately
30% higher than patients using placebo applications.¹³ Adverse effects include stains on surrounding skin, or clothing
coming into contact with the application area, as well as the possibility of chemical burns.¹²

Fluorouracil (5-FU)

Fluorouracil is a chemotherapeutic agent used in the treatment of various cancers. Topical fluorouracil is indicated
for malignant and pre-malignant skin lesions. The use of fluorouracil cream for plantar warts is an off-label indication.
After debridement with a pumice stone, patients can be instructed to apply fluorouracil 5% cream (prescription only, subsidised)
to the lesion, twice daily.¹⁵ The wart should be covered with an occlusive dressing after each application of fluorouracil
with treatment continued for up to 12 weeks.¹⁵ Complete eradication rates as high as 95% have been reported after 12 weeks
of treatment with fluorouracil 5% cream.¹⁵ Patients may experience pain, blistering and local irritation. When used close
to the nail, fluorouracil can cause nail detachment.¹³

Other treatments for plantar warts have limited evidence of effectiveness

Imiquimod and podophyllotoxin

These two medicines are not indicated for the treatment of cutaneous warts. While they should theoretically be useful
given their indication for the treatment of anogenital warts, there is little evidence at present to support their use
for plantar warts.

Imiquimod 5% cream has been assessed in two randomised controlled trials for the treatment of cutaneous warts, conducted
by the manufacturer, which suggested some benefit but this indication has not been pursued further.¹³ Inefficacy may be
due to poor penetration of imiquimod through the hyperkeratotic skin.

Podophyllotoxin, the major active ingredient of podophyllum, has not been assessed in randomised controlled trials for
the treatment of cutaneous warts.¹³ In the past, patients may have used a product marketed for plantar warts which contained
podophyllum resin 20% and salicylic acid 25% (posalfilin ointment), but this is no longer available in New Zealand. Podophyllum
can cause painful necrosis, particularly of normal skin adjacent to the wart, and is contraindicated in pregnant women
and young children. ¹²

Topical zinc cream

The application of zinc to a wart is thought to augment immune function and/or assist in skin repair. Topical zinc cream
for the treatment of cutaneous warts has been assessed in two studies, which suggest it is superior to placebo treatment
and comparable to salicylic acid in efficacy.¹³ However, one of these studies used zinc sulphate which is not available
as a topical product in New Zealand.

A zinc oxide barrier cream 15 – 40% (general sale) may be trialled to treat a plantar wart, but there is limited evidence
of effectiveness.

Occlusive treatments

Covering a wart with adhesive tape or plaster has been anecdotally reported as a cure. Three clinical trials have assessed
its efficacy versus either cryotherapy as a comparison treatment, or a corn pad or moleskin wrap as a dummy placebo treatment.¹³
Although the first of these studies showed that duct tape was superior to cryotherapy, the two studies where duct tape
was compared to a corn pad or moleskin wrap found no statistically significant differences between treatments. Available
evidence does not support the notion that applying tape to a wart results in increased cure rates.

Cryotherapy

Cryotherapy has traditionally been used for plantar warts. However, clinical trials report low rates of cure and it
results in significant pain and blistering, reducing mobility for up to several weeks. A meta-analysis of trials of cryotherapy
(with liquid nitrogen or any other substance which induces cold damage to warts, e.g. dimethyl ether and propane [DMEP])
showed that freezing of cutaneous warts located on the hands or feet was no better than placebo.¹³ Studies of combination
treatment of cryotherapy with additional topical salicylic acid application do not support the idea that this treatment
is better than salicylic acid alone.¹³ Cryotherapy for plantar warts is therefore a non-evidence based intervention, associated
with significant morbidity.

N.B. Cryotherapy is less effective for treating plantar warts due to the thickness of the stratum corneum in this area.
It may be more effective for treating warts in other body sites, e.g. anogenital warts.

Hyperthermia

Raising skin temperature is thought to promote apoptosis (programmed cell death) and subsequently bring about an influx
of inflammatory and immune cells. In the context of wart treatment, these effects could theoretically improve HPV clearance.
However, given the specialised devices required (e.g. exothermic skin patches, radiofrequency heating apparatus’ or infrared
lasers) and the potential for burns with misapplication, the use of hyperthermia to treat plantar warts has limited application
in a general practice setting.

Surgical removal of warts

For some patients, plantar warts will persist despite multiple treatment approaches. Surgical removal of the wart may
be considered as a treatment of last resort. However, in many cases, surgery may also prove unsuccessful. Therefore, the
alternative option of ceasing active treatment of the wart can be discussed with the patient.

A plantar wart can be removed under local anaesthetic by shave, curette and electrosurgery, laser ablation or full-thickness
excision. Since plantar warts often arise on load-bearing tissue, the need to keep weight off the area of excision following
the procedure may cause reduced mobility and interference with daily living or work commitments. Adverse effects are those
expected from any minor surgery, including the risk of infection and post-procedural pain and scarring.

There is little data available on the success rates of surgical approaches to plantar wart treatment.

HPV vaccination

The quadrivalent HPV vaccine funded in New Zealand, Gardasil, protects against cervical cancer and genital warts, and
targets HPV-6, 11, 16, and 18. It is therefore not active against the HPV variants that are most commonly implicated in
plantar warts (HPV-1, 4, 27 and 57). However, there are some case reports where patients with recalcitrant plantar warts
have been successfully treated after the administration of quadrivalent HPV vaccine. ^{16, 17} These cases suggest that the
vaccine induced a broader immune response. This approach has not been assessed in randomised controlled trials.

Acknowledgement

Thank you to Dr Amanda Oakley, Specialist Dermatologist, Clinical Associate Professor, Tristram Clinic,
Hamilton for expert review of this article.

References

1. Bruggink SC, de Koning MNC, Gussekloo J, et al. Cutaneous wart-associated HPV types: prevalence and relation with
   patient characteristics. J Clin Virol 2012;55:250–5.
2. Coates CM, Boehm AP, Leonheart EE, et al. Malignant transformation of plantar verrucae. Adv Skin Wound Care 2006;19:384–5.
3. Schroven I, Hulse G, Seligson D. Squamous cell carcinoma of the foot: two case reports. Clin Orthop 1996;227–30.
4. Guadara J, Sergi A, Labruna V, et al. Transformation of plantar verruca into squamous cell carcinoma. J Foot Surg
   1992;31:611–4.
5. Bae JM, Kang H, Kim HO, et al. Differential diagnosis of plantar wart from corn, callus and healed wart with the
   aid of dermoscopy. Br J Dermatol 2009;160:220–2.
6. Aubin F, Gheit T, Prétet JL, et al. Presence and persistence of human papillomavirus types 1, 2, and 4 on emery
   boards after scraping off plantar warts. J Am Acad Dermatol 2010;62:151–3.
7. Penso-Assathiany D, Gheit T, Prétet JL, et al. Presence and persistence of human papillomavirus types 1, 2, 3,
   4, 27, and 57 on dermoscope before and after examination of plantar warts and after cleaning. J Am Acad Dermatol
   2013;68:185–6.
8. Bruggink SC, Eekhof JAH, Egberts PF, et al. Warts transmitted in families and schools: a prospective cohort. Pediatrics
   2013;131:928–34.
9. Van Haalen FM, Bruggink SC, Gussekloo J, et al. Warts in primary schoolchildren: prevalence and relation with environmental
   factors. Br J Dermatol 2009;161:148–52.
10. Sterling JC, Handfield-Jones S, Hudson PM, et al. Guidelines for the management of cutaneous warts. Br J Dermatol
    2001;144:4–11.
11. Kwok CS, Holland R, Gibbs S. Efficacy of topical treatments for cutaneous warts: a meta-analysis and pooled analysis
    of randomized controlled trials. Br J Dermatol 2011;165:233–46.
12. New Zealand Formulary (NZF). NZF v29. 2014. Available from: www.nzf.org.nz (Accessed Nov, 2014).
13. Kwok CS, Gibbs S, Bennett C, et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev 2012;9:CD001781.
14. NHS choices. Silver nitrate. Available from:
    
    www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?medicine=Silver%20nitrate (Accessed Nov, 2014).
15. Salk RS, Grogan KA, Chang TJ. Topical 5% 5-fluorouracil cream in the treatment of plantar warts: a prospective,
    randomized, and controlled clinical study. J Drugs Dermatol 2006;5:418–24.
16. Landis MN, Lookingbill DP, Sluzevich JC. Recalcitrant plantar warts treated with recombinant quadrivalent human
    papillomavirus vaccine. J Am Acad Dermatol 2012;67:e73–4.
17. Daniel BS, Murrell DF. Complete resolution of chronic multiple verruca vulgaris treated with quadrivalent human
    papillomavirus vaccine. JAMA Dermatol 2013;149:370–2.

Plantar Warts 101 – Everything You Need to Know

Plantar warts, which affect the bottoms of the feet, are one of the many common wart varieties. Where most warts are painless growths on the skin, plantar warts can be quite painful, and the bulk of their growth occurs beneath the skin’s surface. If you’ve ever experienced plantar warts, you know how uncomfortable this condition can be and how challenging it can be to fully rid your body of these warts. At North Valley Dermatology, a U.S. Dermatology Partners office in Peoria, Arizona, Dr. Rachel Cetta works with patients to treat plantar warts quickly and comfortably. In this blog, Dr. Cetta walks through some of the basic information about plantar warts and how to remove them.

Related: How to Identify a Wart

What are Plantar Warts?

Plantar warts are very common. These small warts grow on the heels and other parts of the feet that bear the body’s weight. They may have dark centers where the wart grows inward beneath a thick, callused layer of skin.

What Causes Plantar Warts?

Plantar warts grow as a result of human papillomavirus (HPV), which can enter the body through cuts, blisters, and other openings in the flesh on the feet. The virus accumulates in the outer layers of skin attacking skin cells and creating a rough, callused area. Because plantar warts are caused by a viral infection, they can be spread from person to person. This is a common occurrence for those who regularly use public showers, visit public pools, and those who have weakened immune systems. There are numerous different strains of HPV, and while other forms have been linked to cervical cancer and other serious health risks, there is no evidence that the HPV strains that cause plantar warts are dangerous to overall health. While anyone can develop a plantar wart, the following people are at greater risk:

• Children and teens account for the majority of plantar wart cases.
• Those who have weakened immune systems may be especially susceptible to HPV, which causes plantar warts to develop.
• If you regularly go barefoot, shower in public locker rooms, or otherwise expose your bare feet, you are at increased risk for plantar warts.
• Those who have already had plantar warts may develop more after they heal.
• If you are exposed to the virus by someone else who has plantar warts, you may develop this condition.

What Symptoms are Common?

Most warts look like small lumps that stick off of the skin. Plantar warts differ in that their growth typically occurs inward beneath a thick callus on the skin’s surface. Some common characteristics of plantar warts include:

• One or a cluster of small, flesh-colored calluses on the bottom of the foot, especially in weight-bearing areas of the foot.
• A hard callus of skin over a darker-colored area where the wart is growing inward.
• Black spots, sometimes called wart seeds, that are actually the result of clotted blood vessels beneath the skin.
• Pain when walking or standing.

How are Plantar Warts Treated?

Plantar warts, like other common warts, will often clear up on their own.  However, they can be quite painful and many patients choose to remove them with at-home remedies or work with a dermatologist to remove them more quickly. One risk of non-treatment is the wart virus may have an opportunity to spread causing more lesions.

Common At-Home Plantar Wart Remedies

According to Dr. Cetta, “Many people who struggle with chronic plantar warts swear by the duct tape removal method. While not necessarily backed by scientific research, the harmless and noninvasive treatment has significant anecdotal support.” The process is simple. After soaking your feet, use a pumice to remove the dead tissue. Then, dry the foot thoroughly and place a piece of duct tape over the wart. The process is then repeated every day or every other day until the wart is removed.

In addition to this common remedy, you can also purchase topical, over the counter peeling and freezing solutions. Both of these options require patients to place the acidic medication or source of cold directly onto the wart every day for several weeks or even months until the wart is healed.

Common In-Office Plantar Wart Treatments

At-home therapy options are often effective, but they can take a long time. If your plantar wart is causing significant discomfort, you may not want to wait weeks or months to complete home remedies. In-office treatments include:

• Cryotherapy– liquid nitrogen is applied directly to the lesion using a spray can or Q-tip causing local destruction of the wart.
• Acid – a stronger trichloroacetic acid is applied every week in the dermatology office in combination with the at-home application of salicylic acid. This typically expedites the treatment process.
• Immune therapy – may be recommended if you have chronic or persistent plantar warts. This treatment uses oral medications, injected antigens, and/or topical immune boosters to help your body fight the virus that causes plantar warts more effectively.
• Laser therapy – lasers can be used to treat the tissue that makes up the wart, which will then fall off.
• Surgical removal – typically used as a last recourse, your plantar wart may be surgically removed if other, less invasive options have been unsuccessful.

Can I Prevent Plantar Warts?

You may not be able to totally prevent the development of plantar warts, but you can take the following steps to reduce your risk:

• Avoid touching, picking, or scratching at warts.
• Don’t touch warts on other people.
• Wash hands thoroughly after treating warts.
• Keep feet clean.
• Change socks daily and sanitize the insides of shoes regularly.
• Do not walk barefoot in public showers, at pools, or in locker rooms.
• Don’t use the pumice or other abrasive devices used in at-home plantar wart removal on other parts of the body.
• The HPV vaccine has shown some success in preventing plantar warts even though the vaccine does not specifically target the strains of HPV that are commonly associated with the development of plantar warts.

When Should I Visit U.S. Dermatology Partners for Plantar Wart Treatment?

You should visit U.S. Dermatology Partners for plantar wart treatment in the following situations:

• If you’re not sure that a lesion is a plantar wart.
• Attempts to heal the wart at home are unsuccessful.
• Pain increases or makes it difficult for you to walk or stand.
• The wart is bleeding, changing in appearance, or showing signs of infection.
• Those with diabetes, poor circulation, and immune system disorders (like HIV) should seek professional treatment for plantar warts right away.

If you need help treating your plantar warts or want to discuss any other dermatologic condition or service, it’s easy to schedule an appointment with U.S. Dermatology Partners. Simply complete our online request form. Then, one of our local dermatology practices will be in touch to help you schedule your visit.

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Is it possible to remove warts during pregnancy? Removing any type of wart is very simple and painless!

Being in an “interesting position”, the expectant mother experiences natural anxiety for the baby’s health, trying to minimize all possible risks.

What to do if pregnancy provoked the appearance of warts on the face and body, or long-formed skin neoplasms began to cause discomfort to a woman? We will try to figure out whether it is advisable to remove warts during pregnancy.

Are warts dangerous for pregnant women and children?

Warts are benign skin growths caused by the human papillomavirus. HPV carriers are 90% of the world’s population, however, the development of such visual manifestations as warts is usually associated with a decrease in immunity, endocrine disorders or tissue trophic disorders. During pregnancy, a woman’s body experiences tremendous stress, which often becomes a trigger for the activation of the papillomavirus.

However, you should not panic ahead of time. Most of the warts localized on the hands, feet and face are not capable of harming the fetus or affecting its development. Such manifestations are unpleasant only from the point of view of causing discomfort to a pregnant woman. The only exception can be considered genital warts (condylomas), which form in the vagina or on the mucous membrane of the cervix. Such manifestations can be dangerous, both in the process of bearing a baby, and during childbirth, when there is a possibility of infection of the child when it passes through the birth canal.

Should warts be removed during pregnancy?

Most often, experts recommend postpartum removal of benign growths such as warts , especially in cases where skin growths do not cause discomfort to the woman.

Things are different with the warts already mentioned above and multiple, rapidly growing defects. Genital warts may require a Pap test and a biopsy to identify atypical tumor cells that indicate the transformation of a benign neoplasm into an oncological process.

If there is an activation of the formation of warts and their massive spread, the doctor may recommend removing the neoplasms, however, such a manipulation should be performed only at a gestational age of more than 28 weeks, when the process of formation of the morphological organs and systems of the child’s body ends. You should be especially careful when taking antiviral drugs, which are often prescribed after a wart removal procedure. Pregnancy is not the time for experimentation, and it is essential to consult a specialist before using any medication.

Removal of warts during pregnancy – recommendations

If the removal of warts during pregnancy is a non-alternative option, the following rules should be followed in the process of choosing a technique:

• It is strictly forbidden to self-medicate;
• Folk methods based on fresh celandine and the preparation “Super-celandine” can have a toxic effect on the body of a pregnant woman;
• Cryodestruction should not be used;
• Do not use harsh chemicals on warts such as acetic acid;
• Wart removal should not involve the use of anesthesia.

Is it possible to remove warts during pregnancy by laser destruction?

Laser wart removal is the safest method for a woman to get rid of warts during pregnancy.

Learn more about the service and its cost >>

This method does not have a systemic effect on the body, locally “burning out” the source of discomfort. The procedure is so simple that it takes no more than an hour and does not require mandatory hospitalization of the patient. The only “pitfall” may be the impossibility of using standard local anesthesia, which implies some discomfort in the process of manipulation for a pregnant woman. However, pain is usually described as moderate and tolerable, and the effectiveness of the procedure fully compensates for some inconvenience.

The need to remove warts during pregnancy is determined individually , taking into account the characteristics of the organism, the type of neoplasm and its effect on the woman’s body. The multidisciplinary clinic “NEOMED” offers the organization of laser destruction of warts with a preliminary consultation for pregnant women. Modern equipment, affordable prices and an individual approach to each patient will make you take a fresh look at medical care.

Find out the cost of the procedure “Removal of neoplasms”

Why plantar warts appear and methods of treatment – Network of medical centers “Laser +” for removal in St. Petersburg

Plantar warts, or spines

not only aesthetic defect. They cause pain when walking, a person begins to limp. Lameness leads to violations of posture, pain in the back and legs, and cramps. The patient’s quality of life is drastically reduced. Attempts to heal on their own end in failure, because people often make mistakes and take neoplasms for ordinary dry corns. The reasons for the appearance of these formations and the tactics of their treatment are different.

Causes of plantar warts

Plantar warts are the result of infection with the human papillomavirus type 1 and 2. Both types of HPV are relatively harmless: they never cause cancer. HPV-1 only affects the plantar area, while HPV-2 can manifest as warts on the fingers.

You can become infected with this virus if the skin has microcracks or it has softened from a long stay in the water. Therefore, visitors to swimming pools, baths, public beaches, as well as people whose feet sweat a lot are at risk. Predisposing diseases – atopic dermatitis, as well as all diseases in which immunity is reduced.

Invading through lesions in the skin, the virus enters the cells and begins to multiply in them. Cells cease to follow the instructions of the body’s genes and work only for the benefit of the virus. As a result, 1.5-6 months after infection, a wart appears at the site of infection.

Plantar warts do not grow outwards, as usual, but inside the skin. They compress the nerves, especially when walking, hence the pain arises, which increases with the growth of the formation.

Diagnosis

An examination by a dermatologist is sufficient to establish a diagnosis. The doctor can easily distinguish a wart from a corn or callus by sight and prescribe the correct treatment. It is not necessary to take any tests: the characteristic location and appearance of the formation will not make a mistake, and since formations of this type are always benign, there is no need to specify the type of virus or do a histological examination.

Treatment methods

Without consulting a dermatologist, there is a high risk of starting to treat a plantar wart incorrectly. To a non-specialist, these formations are misleading: they look very similar to dry corns. But if you start treating the spike like a corn, trying to soften it and remove it, you can injure the skin, spread the virus and get multiple instead of one plantar wart. This will complicate the treatment and make it more expensive. Therefore, only a dermatologist should prescribe therapy after an internal examination.

There are several treatments for warts

Cryotherapy or liquid nitrogen cauterization was considered the treatment of choice for warts, including plantar warts, 20 years ago. The method is quite effective, almost never leads to scarring. Although cauterization with liquid nitrogen itself is painless, when plantar warts are removed, pain occurs some time after the procedure, sometimes quite severe. Often, repeated procedures are required to completely destroy the formation.

Surgical removal of is a good option for treating many types of warts, especially if the doctor is not sure that the growth is benign and plans to send the material for additional analysis to the laboratory. Spikes do not require such diagnostic procedures. The area of ​​scars after surgical removal of warts on the feet can remain painful for a long time.

Electrocoagulation – electric current to burn the wart. Suitable only for shallow formations, local anesthesia is required. A few days after treatment, dressings are required.

Radioknife – excision of formations, including deep ones, with radio waves. With this method, bleeding does not occur, there is no likelihood of infection in the wound. Relapses of the disease in the same place are rare.

Laser removal is considered the most modern and effective way to treat spinal thorns.

Laser removal of plantar warts

Laser removal of plantar warts is performed in one session. The procedure is considered painless, but in some cases local anesthesia is required.

Indisputable advantages of the method:

⇒ several formations can be completely removed at a time;

⇒ there will be no recurrence of the disease at the site of the removed wart, since the spine is completely removed;

⇒ the method practically does not injure the surrounding healthy tissues;

⇒ no significant scarring, so the area to be removed remains painless;

⇒ postoperative care is simple, it comes down to protecting the scab from injury and treating with external antiseptics, which the patient can do independently.