Plantar Warts: Causes, Symptoms, Risks, Diagnosis, Treatment and Prevention

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feet with Plantar Wart

1Overview

A wart is a growth on the skin that occurs when the skin is infected by a virus. Although warts can develop anywhere on the foot, they usually grow on the bottom of the feet. These types of warts occur most often in the elderly, adolescents, and children. There are two types of plantar warts, solitary and mosaic.

A solitary wart is just one wart. It usually increases in size. It may also eventually multiply, causing the appearance of multiple warts, or “satellite” warts.

Mosaic warts are clusters of warts that grow together in one area. These types of warts are more difficult to treat compared to the aforementioned type of warts.

Most warts are not harmful, even though they may cause pain. These warts are often mistaken for calluses or corns, which are layers of the exodermis that build up to protect areas that experience a lot of friction. The difference, however, is that warts are caused by a viral infection.

It is possible for other types of lesions to appear on the foot. These may include melanomas and carcinomas. Although these conditions are rare, they are sometimes mistaken for warts. Thus, it is wise to consult a podiatrist when any suspicious growth is observed, or any skin eruption occurs.

Plantar warts tend to be flat and hard. Their surfaces may be rough, and their boundaries well-defined. These warts are generally fleshier if they are found on the upper side of the foot. Plantar warts, on the one hand, are often found to grow inwards. These warts are often black of gray; their centers appear as pinpoints of black. They are very resistant to treatment and occur recur in patients. 

2Causes

Plantar warts are caused by the human papilloma virus (HPV). It is the same virus that causes warts on other parts of the body. This virus is often acquired when people walk barefoot in public places, or on dirty surfaces. The HPV lives in moist, warm environments. This is the reason why they are common in community bathing facilities.

If left untreated, they can grow to more than an inch in circumference. Solitary warts can become mosaic warts in these instances. They are spread by scratching, touching, or even contacting skin that is already infected. In addition, warts have a tendency to bleed. Contact with infected blood can also cause infections.

Sometimes, these warts can disappear spontaneously after a short interval. However, they can reappear in the same locations.

When these warts appear on the plantar side of the foot, such as the heels, balls of feet, for instance, they can cause sharp, burning sensations. Pain occurs when the person bears their weight on their foot and on the wart, which creates intense pain.

3Symptoms

The signs and symptoms of plantar warts are not as easily identified as other types of warts on other parts of the body.

One of the signs is thickened skin. Often, plantar warts look like calluses because of their appearance as thickened skin on the soles of the feet. The tissue is tough and thick.

Plantar warts are also painful, especially if they occur on the balls and heels of the foot that bear the person’s weight and thus experience pressure. The pressure on these warts cause pain and sometimes cause bleeding. There is usually a pain when the person is walking or standing. In addition, warts have a tendency to be painful when their sides are squeezed.

Tiny black dots are another sign. These are often found on the wart’s surface and are actually blood that has dried, These blood clots have infected the capillaries on the plantar side of the foot.

Plantar warts also usually grow into the skin. They start off as small and barely noticeable, but they grow over time. 

4Risk Factors

Having an impaired immune system is a risk factor for warts. This means that the body cannot fight off viral infections, such as HPV. The skin is the primary site of plantar warts and is susceptible to being infected.

Age is also a risk factor for plantar warts. These warts often occur in children, adolescents, and the elderly. However, some people find that their warts get fewer with age or completely go away.

Walking barefoot on wet surfaces, such as in gym locker rooms or public showers near swimming pools, is also a risk factor. HPV viruses tend to grow in warm, moist environments. These viruses typically thrive in these places and can easily infect the broken skin. Having wounds on the plantar side of the foot is also a risk factor, especially when it coincides with walking in public places where the ground is wet.

Sharing razors, towels, and personal items with a person who is infected with warts is also a risk factor. When towels are used on the feet, the HPV virus tends to cling to the towel and multiply there, since the towel is warm and moist.

Always wearing closed or tight shoes can cause feet to sweat, which causes plantar warts as well. The inside of the shoe is a wet environment and sweat makes it even wetter.

5Complications

Plantar warts have a number of complications associated with their location. One of these is severe pain, as discussed. Redness, swelling, and large wounds may also develop. When large wounds are found on the soles of the foot, they are open and may lead to more infections, especially by viruses, bacteria, and fungi that are more virulent than HPV. Swelling may make it hard for the person to walk.

Impairment in walking may sometimes cause immobility for the person with warts. This may cause the person to be agitated or anxious. It may also cause restlessness in the person who has them. Bleeding is another problem. HPV can infect blood vessels and capillaries, which may spread to other areas of the body, causing systemic infections.

6Diagnosis

To diagnose warts, the podiatrist will look at the ankles and plantar side of the foot to look for signs and symptoms that may indicate the presence of warts.

Although these warts may eventually disappear on their own, most patients want quick and immediate relief because of the pain that they cause. The goal of treatment is to remove the wart completely.

If the wart can’t be accurately diagnosed by simple visual inspection, the podiatrist of the surgeon may use other methods.

The lesion may be parsed using a scalpel to check for tiny black dots that indicate clotted blood vessels.

Another option is to shave biopsy, where the surgeon will remove a small portion of the wart’s surface. This will be sent to the laboratory for testing. In some cases, a pathologist may view the shaved surface under a microscope to determine the presence of HPV and to look for other pathological signs that indicate warts.

7Treatment

There are many ways of treating these warts. All of the treatments involve destroying warts completely. So far, there is no perfect treatment. It is preferable to treat plantar warts by using chemicals, especially if they are found on the weight-bearing side of the foot. Chemical treatment is painless and it will allow the person to resume all activities. It is very effective if used under the proper instructions. It may take several weeks or months before warts completely go away.

There are many home treatments that people can use to speed up the effects of chemical treatments, such as covering warts with waterproof adhesive tape. The tape keeps the wart and the surrounding skin moist. This softens the surface of the wart, allowing for the chemicals to seep in deeply.

When warts eventually turn a grayish color, these means that the chemical has already begun destroying them. The gray wart tissue should be scraped off using a nail file every other day. The scraping should be done after a bath or shower because this is the time when the wart is softest. It is important that every single bit of wart tissue is removed to prevent them for recurring. The chemicals used to treat the wart has to penetrate towards the living tissue underneath so that it will be most effective.

Foot pads can be worn by the person if warts cause pain while walking. These pads cushion the feet allowing the person to walk effectively while the warts are there.

8Prevention

The prevention of plantar warts is straightforward. It is best to refrain from walking on moist surfaces, especially in public areas, such as those near swimming pools. Always use flip-flops while walking to prevent the HPV from infecting the skin. Wounds on the plantar side of the foot should be covered and dressed to prevent the virus from infiltrating the underlying living tissue. Aside from these, it is advisable to sometimes wear open shoes to allow the feet to dry. Allowing closed shoes to dry at home can prevent the virus from growing inside the shoe.