Plantar warts (warts, verruca, Afrikaans – soolvrat)

Going barefoot is one of the luxuries of a South African summer but it also carries an increase risk of contracting a virus that can produce unsightly looking and painful warts on the bottom of your feet, called plantar warts.

Plantar warts, meaning warts under the foot, are small growths (benign skin tumours / lesions) in the skin that develop when the skin comes in contact with the human papilloma virus (HPV). The virus can be transmitted in any public place where people go barefoot, most often swimming pools, school change rooms and gym showers.

Plantar warts are more common in the early teenage years but can also affect adults.

Plantar warts can appear as a single lesion that often increases in size and may eventually multiply, forming additional “satellite” lesions. They can also appear as mosaic warts — a cluster of several small warts growing closely together in one area. They may grow to a substantial size which is unsightly and usually painfull because of walking on them.

Single plantar wart

Single plantar wart

Symptoms

Most warts are harmless, even though they may be painfull. They are often mistaken for corns or calluses, which are layers of dead skin that build up to protect an area which is being continuously irritated or traumatized.
The wart, however, is a viral infection. Very carefull thought must be given to the diagnosis as they are often misdiagnosed and then treated incorrectly. Other hyperkeratotic (corn) lesions may look very much like a wart under the foot.

Seed corn

Seed corn

When plantar warts develop on the weight-bearing areas of the foot (the ball of the foot, or the heel) they can be the source of sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.

Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Under then foot they are being pushed backwards into the skin by the pressure of walking. Plantar warts are often gray or brown (but the colour may vary), with a centre that appears as one or more pinpoints of black. This is what we call a cauliflower appearance.

Plantar warts

Plantar warts

 

It is important to note that warts can be very resistant to treatment and have a tendency to reoccur. They may be more common in adolescents and immune compromised patients.

 

Other symptoms

• Thickened skin that resembles a callus.Tough, thick skin can build up in the surrounding area and over the
lesion.
• Pain during walking, standing, and when the sides of the wart are squeezed.
• Tiny black dots (pinpoint bleeding) that often appear on the surface of the wart.

Mosiac plantar warts

Mosiac plantar warts

 

Home care

Self-treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also destroying surrounding healthy tissue.

Self-treatment with such medications especially should be avoided by people with diabetes and those with circulatory disorders. Never use these medications in the presence of an active bacterial or fungal infections.

 

Diagnosis and treatment

It is possible that your podiatrist will prescribe and supervise your use of a wart-removal preparation. This may take some time to show the result.
More likely, however, removal of warts by a simple surgical procedure, performed under local anaesthetic, may be indicated.

There are many different treatment options for patients diagnosed with plantar warts, including:
• Prescription medication for topical use
• Removal with chemicals or acids (also referred to as chemotherapy)
• Freezing of the warts (also known as cryosurgery)
• Surgical removal (electrocautery or burning of the lesion)
• Laser treatment – Typically, only one treatment is needed with this option. Following laser treatment, daily
soaking of the foot until the area is healed is recommended. The laser reduces post-treatment scarring and
is a safe form for eliminating wart lesions.

Multiple plantar warts

Multiple plantar warts

 

My opinion is that electrocautery (destroying of the lesion by burning it) is the best way of treating these warts on the feet.

 

Prevention

• Avoid walking barefoot, especially in public places
• Change shoes and socks daily
• Keep feet clean and dry
• Check children’s feet (and other parts of the body) regularly for any warts or other lesions
• Avoid direct contact with warts from other persons or from other parts of the body
• Do not ignore growths on your skin
• Visit your podiatrist as part of your annual health check-up

Plantar wart

Plantar wart

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