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Overview
Plantar warts occur on the sole (plantar surface) of the foot. They can be very painful because the entire weight of the body presses against them continuously when standing or walking. Plantar warts are usually rough, bumpy, and spongy, although some may be thick and scaly. Most are gray or brown and have a center with one or more dark pinpoints. These are tiny capillaries that supply blood to the wart. Scraping the wart may cause it to bleed. Untreated, plantar warts may grow up to an inch in circumference and may spread into clusters.
Causes
Warts are benign tumors that can occur anywhere on the skin. The human pappiloma virus (HPV), a common organism, causes warts. The virus is often encountered on contaminated surfaces, typically the tile floors of public locker rooms, showers, and swimming pools and invades the body through tiny cuts or breaks in the skin. Normally, antibodies in the blood kill the virus. Some people are more susceptible to the human pappiloma virus than others, however, and HPV takes refuge in the skin.
A plantar wart is similar in structure to an iceberg. The part on the surface is a small fraction of the entire anomaly. Often, the portion of the wart under the skin is at least twice as big as the part you can see.
Many of these viruses die within a year or two and the warts they produce simply disappear. Many podiatrists recommend having them removed because they are irritating and often painful.
Treatment
There are several different techniques for removing plantar warts:
Acid One of the most common methods is to burn them off with a mild acid applied topically to the wart. This disintegrates the viral cells and allows healthy skin cells to replace them. Multiple applications over the course of several weeks may be required, but the technique is very successful.
Cryotherapy Freezing warts with a very cold solution (e.g., sodium nitride) can kill the virus, causing the wart to turn black and fall off within a few days. Cryotherapy is sometimes ineffective on plantar warts because the cold may not penetrate far enough to kill the virus completely.
Laser Treatment Doctors can use lasers to kill the virus. The procedure can be performed in the physician's office and is effective, clean, and accurate. It also is expensive and some physicians do not use laser treatment for warts because the benefits do not warrant the cost.
Debridement In this technique, the physician uses a scalpel to remove the warts under anesthetic. This is often the procedure of choice for numerous small warts in a limited area. It also can be used with acid to ensure the virus is killed and prevent the warts from regrowing.
Complications
Warts can regrow, indicating that the virus is still growing in the body. The virus that causes plantar warts is relatively benign and causes few problems, but it can spread to other parts of the body. Blood from a wart contains the virus and can cause a new wart to grow in an area that it touches. Therefore, it is important to treat warts and eliminate them as quickly as possible.
