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Warts

Most plan­tar warts aren’t a seri­ous health con­cern, but they may be both­er­some or painful, and they can be resis­tant to treat­ment. You may need to see your Podi­a­trist to treat and remove plan­tar warts.

Signs and Symptoms

Plan­tar warts are often mis­tak­en for corns or cal­lus­es. To make the dis­tinc­tion, look for:

  • Small, fleshy, grainy bumps on the soles of your feet
  • Hard, flat growths with a rough sur­face and well-defined boundaries
  • Gray or brown lumps with one or more black pin­points, which are actu­al­ly small, clot­ted blood ves­sels, not wart seeds”
  • Bumps that inter­rupt the nor­mal lines and ridges in the skin of your feet

Caus­es

You acquire warts through direct con­tact with the human papil­lo­mavirus (HPV). There are more than 100 types of HPV. Some types of HPV tend to cause warts on your hands, fin­gers or near your fin­ger­nails. Oth­ers tend to cause warts on your feet.

The virus that caus­es plan­tar warts isn’t high­ly con­ta­gious, but it thrives in warm, moist envi­ron­ments, such as show­er floors, lock­er rooms and pub­lic swim­ming areas. So you may con­tract the virus by walk­ing bare­foot in pub­lic places.

Like oth­er infec­tious dis­eases, HPV may also pass from per­son to per­son. If you have a plan­tar wart, you can even spread the virus to oth­er places on your own foot by touch­ing or scratch­ing. The virus can also spread by con­tact with skin shed from a wart.

Each per­son­’s immune sys­tem responds to warts dif­fer­ent­ly, so not every­one who comes in con­tact with HPV devel­ops warts.

Risk fac­tors

Plan­tar warts are more like­ly to appear on the feet of peo­ple with:

  • Mul­ti­ple expo­sures to the virus
  • Dam­aged or cut skin
  • Sweaty skin

For rea­sons doc­tors don’t under­stand, some peo­ple are more sus­cep­ti­ble to the wart-caus­ing virus, just as some peo­ple are more like­ly to catch a cold. Chil­dren and teenagers tend to be espe­cial­ly vul­ner­a­ble to plan­tar warts.

When to seek med­ical advice

See your doc­tor if warts per­sist, mul­ti­ply or recur, despite home treat­ment, or if warts inter­fere with your activ­i­ties. Also see your doc­tor if your warts are painful or change in appear­ance or col­or. If you have dia­betes or a cir­cu­la­to­ry dis­or­der, don’t try to treat any plan­tar warts at home. Seek treat­ment from your doctor.

In some cas­es, you may need to con­sult your doc­tor to ensure a cor­rect diag­no­sis. It’s pos­si­ble for more seri­ous lesions to appear on your feet, includ­ing can­cer­ous tumors called car­ci­no­mas and melanomas.

Diag­no­sis

In most cas­es, your doc­tor can diag­nose plan­tar warts just by inspect­ing your feet. If there’s any doubt, your doc­tor may need to pare down the lump with a scalpel. Why? Corns and cal­lus­es don’t have a blood sup­ply and won’t bleed, while plan­tar warts will show signs of pin­point bleed­ing from their dark dots, which are real­ly blood vessels.

If there’s still doubt about the diag­no­sis, your doc­tor may take a sam­ple of your foot tis­sue and send it to a lab­o­ra­to­ry for analysis.

Com­pli­ca­tions

Plan­tar warts can be per­sis­tent. They can shed the virus into the skin of your foot before they’re treat­ed, prompt­ing new warts to grow as fast as the old ones dis­ap­pear. The best defense is to treat new warts as quick­ly as pos­si­ble so that they have lit­tle time to spread.

If untreat­ed, warts can swell to an inch or more in cir­cum­fer­ence and they can spread, devel­op­ing into clus­ters of warts called mosa­ic warts. They may also become extreme­ly painful. If you have lots of plan­tar warts, the pain may make it dif­fi­cult for you to walk or run.

Treat­ment

Plan­tar warts usu­al­ly need some type of treat­ment. Warts on the feet can be par­tic­u­lar­ly per­sis­tent and dif­fi­cult to treat. Unless you have an impaired immune sys­tem or dia­betes or are preg­nant, there’s no rea­son you can’t try to treat warts with over-the-counter reme­dies. But you may wish to con­sult your doc­tor for addi­tion­al help.

No wart treat­ment works 100 per­cent of the time. In gen­er­al, your doc­tor will rec­om­mend the least painful — and least destruc­tive — meth­ods first, espe­cial­ly for children.

Com­mon treat­ments for sim­ple plan­tar warts

Your doc­tor may sug­gest try­ing these com­mon treat­ments one at a time or in combination:

  • Over the Counter Sal­i­cylic acid Wart med­ica­tions and patch­es are avail­able at drug­stores. To treat plan­tar warts, you’ll need a sal­i­cylic acid solu­tion or patch which peels off the infect­ed skin a lit­tle bit at a time. Apply the solu­tion once or twice each day, being care­ful to avoid healthy skin, which can become irri­tat­ed from the acid. In between appli­ca­tions, pare away the dead skin and wart tis­sue using a pumice stone or emery board. You may need to repeat this process for up to three or four weeks to com­plete­ly elim­i­nate warts.
  • Duct tape In a well-pub­li­cized 2002 study, duct tape wiped out more warts than freez­ing (cryother­a­py) did. Study par­tic­i­pants who used duct tape ther­a­py” cov­ered their warts in duct tape for six days, then soaked their warts in water, and gen­tly rubbed warts with an emery board or pumice stone. They repeat­ed this process for up to two months or until their warts went away. Researchers hypoth­e­size that this uncon­ven­tion­al ther­a­py may work by irri­tat­ing warts and the sur­round­ing skin, prompt­ing the body’s immune sys­tem to attack. Today, duct tape is com­mon­ly used to treat warts, espe­cial­ly for chil­dren who may find freez­ing painful or scary. It’s often com­bined with sal­i­cylic acid.
  • Freez­ing (cryother­a­py) Freez­ing is one of the most com­mon treat­ments for plan­tar warts and is some­times effec­tive, but may require mul­ti­ple trips to your doc­tor every two to four weeks. Your doc­tor can apply liq­uid nitro­gen with a spray can­is­ter or cot­ton-tipped appli­ca­tor. The chem­i­cal caus­es a blis­ter to form around your wart, and the dead tis­sue sloughs off with­in a week or so. Freez­ing isn’t com­mon­ly used in young chil­dren because it can be painful.
  • Can­tharidin Doc­tors and heal­ers have used can­tharidin — a sub­stance extract­ed from the blis­ter bee­tle — to treat warts for cen­turies. Your doc­tor paints this bee­tle juice onto your wart and cov­ers it with clear tape. The appli­ca­tion is ini­tial­ly pain­less, but it caus­es the skin under the wart to blis­ter, lift­ing the wart off the skin. Your doc­tor can then clip away the dead part of the wart in about a week. Some­times the blis­ters are painful but this is of the most effec­tive treat­ments available.

Aggres­sive treat­ments for per­sis­tent plan­tar warts

If your warts don’t respond to com­mon treat­ments, your doc­tor may sug­gest one or more of these oth­er options. Please note each of these treat­ments has a chance of reoc­cur­rence as well.

Minor surgery This involves cut­ting away the wart or destroy­ing the wart by using an elec­tric nee­dle in a process called elec­trodes­ic­ca­tion and curet­tage. This treat­ment is effec­tive, but may leave a scar if not done care­ful­ly. Your doc­tor will anes­thetize your skin before this procedure.

Laser surgery Doc­tors can use sev­er­al types of lasers to elim­i­nate stub­born warts. Sur­gi­cal and non-sur­gi­cal types require mul­ti­ple treat­ments as well. The effec­tive­ness may vary among patients.

Oth­er med­ica­tions In severe cas­es that haven’t cleared with oth­er ther­a­pies, your doc­tor may inject each wart with a med­ica­tion called bleomycin, which kills the virus. This med­ica­tion is giv­en sys­tem­i­cal­ly in high­er dos­es to treat some kinds of can­cer. The injec­tions for wart treat­ment can be painful and can cause rash­es or itch­ing. They’re not used if you’re preg­nant or breast-feed­ing or if you have cir­cu­la­tion prob­lems, and used in very extreme circumstances.

Prevention

To reduce your risk of plan­tar warts:

  • Avoid direct con­tact with warts. This includes your own warts.
  • Keep your feet clean and dry. Change your shoes and socks daily.
  • Don’t go bare­foot in pub­lic areas. Wear shoes or san­dals in pub­lic pools and lock­er rooms.
  • Don’t pick at warts. Pick­ing may spread the virus.