Overview

Plantar warts are small, rough growths that usually appear on the heels or other weight-bearing areas of your feet. They are caused by the human papillomavirus (HPV), which infects the outer layer of skin on the soles of your feet.

These warts are very common, especially in children and teenagers, but anyone can get them. Athletes who use communal showers or locker rooms, and people with weakened immune systems, might also find themselves more prone to plantar warts. Yes, plantar warts are contagious. The virus can spread through direct contact with a wart or by touching surfaces contaminated with the virus, like shower floors or towels. While usually not a serious health concern, plantar warts can be uncomfortable, sometimes painful, and can certainly impact your daily activities and make walking or standing for long periods difficult.

Symptoms

You might be wondering what to look for. Here are some common signs:

• A small, fleshy, rough, grainy growth - on the bottom of your foot, usually on the heels or balls of your feet.
• Hard, thickened skin (callus) - over a well-defined "spot" on the skin, where the wart has grown inward.
• Black pinpoints - which are often called "wart seeds" but are actually small, clotted blood vessels.
• Pain or tenderness - when walking or standing, like having a pebble in your shoe.
• A lesion that interrupts the normal lines and ridges - in the skin of your foot.
• Sometimes, warts can grow in clusters - known as mosaic warts.
• The area might feel slightly raised or flat - depending on the pressure applied to it.

Diagnosis

Figuring out if you have a plantar wart is usually straightforward. A doctor can often diagnose a plantar wart simply by looking at it.

They might also pare down the surface of the growth with a scalpel to check for the tell-tale signs of tiny, clotted blood vessels (those black dots). In rare cases, if the diagnosis isn't clear, a small sample (biopsy) might be taken and sent to a lab for examination.

Management & Treatment

Dealing with plantar warts can be a frustrating journey, but the good news is that many treatment options are available. While some warts disappear on their own over time, especially in children, this can take months or even years. If the wart is painful, growing, or spreading, treatment can help you get relief sooner.

It's always a good idea to talk with a healthcare provider before starting any treatment, especially if you have diabetes, poor circulation, or a weakened immune system.

Over-the-Counter (OTC) and Home Care

For many people, at-home treatment is a great first step. These options are available at most pharmacies:

• Salicylic Acid: This is one of the most common and effective OTC treatments. It comes in various forms, like gels, liquids, or patches. The acid works by gently peeling away the layers of the wart over several weeks. Consistency is key with this method.
• Freezing Kits (Cryotherapy): You can also find kits that use a freezing spray (like liquid nitrogen) to destroy the wart tissue. This is similar to what a doctor might do, but the OTC versions are not as strong.

Prescription & Professional Treatments

If over-the-counter options haven't worked or if your warts are severe, a doctor can offer more powerful treatments. It's important to remember that even these methods may require multiple sessions.

• Prescription-Strength Salicylic Acid: Your doctor can prescribe a stronger concentration of salicylic acid than what's available over the counter.
• Cryotherapy: A doctor will apply liquid nitrogen directly to the wart. This freezes the wart tissue, causing a blister to form underneath. The blister and wart typically fall off within a week or so.
• Immunotherapy: This treatment stimulates your own immune system to fight off the virus causing the wart. Your doctor may inject a substance (like a Candida antigen) into the wart to trigger this immune response.
• Minor Surgery: In persistent cases, a doctor might recommend electrosurgery and curettage. This involves scraping off the wart and then using an electric needle to destroy the base.
• Laser Treatment: A pulsed-dye laser can be used to burn and destroy the tiny blood vessels that feed the wart, causing it to die and fall off.

What to Expect

Patience is essential when treating plantar warts. They can be stubborn, and it may take several weeks or months of consistent treatment to see them disappear completely.

If you've tried OTC treatments for a few months without success, or if a wart becomes more painful, bleeds, or changes in appearance, it's time to see a doctor. They can confirm the diagnosis and help you find the most effective treatment plan for your specific situation.

Duration & Outlook

Plantar warts can be a bit unpredictable. Sometimes, they go away on their own without any treatment, especially in children, but this can take many months or even a couple of years. For others, they can be stubborn and persist for a long time, or even spread.

They are generally considered an acute issue, meaning they aren't usually a lifelong condition like some other skin problems. However, they can recur even after they seem to have cleared. The outlook is generally good, but patience is often key. A warning sign for complications could be if a wart becomes extremely painful, changes color rapidly, bleeds without being irritated, or if you have many warts appearing, especially if you have a weakened immune system.

Prevention

While you can't always prevent plantar warts, you can certainly reduce your risk. Here are some helpful tips:

• Avoid walking barefoot in public places - especially warm, moist areas like swimming pools, locker rooms, and communal showers. Wear flip-flops or shower shoes.
• Keep your feet clean and dry - Change your socks daily.
• Avoid direct contact with warts - including your own. If you touch a wart, wash your hands thoroughly.
• Don't pick or scratch at warts - as this can spread the virus to other parts of your body or to other people.
• Use a separate emery board, pumice stone, or nail clipper - for your affected skin and nails.

Causes & Triggers

As we mentioned, plantar warts are caused by the human papillomavirus (HPV). There are many types of HPV, and only a few cause warts on the feet. The virus thrives in warm, moist environments.

Common triggers or ways you might get exposed include:

• Walking barefoot in public showers, locker rooms, or around swimming pools.
• Direct contact with someone else's wart.
• Using a towel or other personal item that has been in contact with a wart.
• Having small cuts or breaks in the skin on the bottom of your feet, which can allow the virus to enter.

Anyone can develop plantar warts, but they are most common in:

• Children and teenagers.
• People who frequently use public swimming pools or gyms.
• People with weakened immune systems.
• People who have had plantar warts before.

When to see a doctor

It's always a good idea to see a healthcare professional if you're unsure about any skin growth. You should definitely make an appointment if:

• The lesion is painful, bleeding, or changes in appearance or color.
• You've tried over-the-counter remedies without success.
• The warts are spreading or multiplying.
• You have diabetes, poor sensation in your feet, or a weakened immune system. In these cases, it's very important to have any foot lesion checked by a doctor.
• You are not sure if the lesion is a wart.
• The wart interferes with your daily activities.

A dermatologist is a specialist in skin conditions and can confirm the diagnosis and discuss your options if treatment is desired. We are here to help you get back on your feet comfortably!

Frequently Asked Questions (FAQs):

• Are plantar warts cancerous? No, plantar warts are benign (non-cancerous) growths caused by HPV. However, if you notice any unusual changes, it's always best to have it checked by a doctor.
• Can I get plantar warts from a handshake? It's highly unlikely. Plantar warts are caused by strains of HPV that prefer the skin on the feet. Warts on hands are typically caused by different HPV strains.
• If I have one plantar wart, will I get more? It's possible. The virus can spread, especially if you pick at the wart or if there are small breaks in your skin nearby. This is why it's important not to scratch or pick them.
• Do "wart seeds" mean the wart is growing deeper? Those tiny black dots, often called "wart seeds," are actually small, clotted blood vessels. They are a common feature of plantar warts and don't necessarily indicate how deep the wart is, but they do confirm it's likely a wart.
• Can stress cause plantar warts? While stress doesn't directly cause plantar warts (the HPV virus does), stress can weaken your immune system, potentially making you more susceptible to infections like HPV, or making existing warts harder to clear.

Remember, this information is to help you understand more about plantar warts. If you're concerned about something on your skin, please don't hesitate to reach out to a healthcare professional. We're here to support you.

Sources

• American Academy of Dermatology. (n.d.). Warts. Retrieved from https://www.aad.org/public/diseases/a-z/warts-treatment
• Mayo Clinic. (2022, August 23). Plantar warts. Retrieved from https://www.mayoclinic.org/diseases-conditions/plantar-warts/symptoms-causes/syc-20352691