Plantar Wart (Verruca Plantaris)

Dr. Leonora Fihman is a board-certified podiatrist who serves the entire Southern California area. Along with her staff, she offers both in-office and concierge visits to her patients. She offers treatment for a wide variety of foot conditions including plantar warts, athlete's foot, and plantar fasciitis. Dr. Fihman offers state of the art diagnostic tools and personalized treatment options for each of her patients.

What are Plantar Warts?

There are two types of plantar warts, solitary warts, and mosaics that form small clusters. Plantar warts (verruca plantaris) are small growths that can appear anywhere on the on the body but are most commonly found on the bottom near the ball of the foot or the heel. The growths develop on the surface of the skin but have roots that can affect the deeper layers of tissue. Some warts start very small. They almost look like small dots of skin. As they continue to develop, they will increase in size. In some cases, more warts will form as the first wart continues to grow. Warts can also develop on the hands, fingers, faces and other areas of the body.

What causes Plantar Warts?

Exposure to the human papillomavirus or HPV is the cause of most plantar warts. Because the HPV virus can live on surfaces, you may not have to have contact with someone who has it. Much like athlete's foot, the virus can be picked up by walking on a contaminated surface. The virus is also spread by coming into contact with the skin of someone who has HPV. There are over 100 types of the HPV virus and skin to skin contact may cause the virus to spread, no matter which of the 100 are present. This is also the same type of virus associated with genital warts. Warts that begin to appear on the feet may spread to other areas of the body. Scratching, picking or trying to shave them off can cause the virus to spread much faster than if the warts are left alone.

What Symptoms are Associated with Plantar Warts?

The primary symptoms of plantar warts include pain and general discomfort when you stand for long periods of time, walk, or run. Pressure on the wart may cause pain, as well as squeezing or pinching the sides. The root of the wart may begin forming before it actually appears on the skin. This may cause pain that appears to have no cause while walking, running, or standing. The area may appear red or be tender to the touch several days before the wart actually begins to take on wart-like characteristics.

A wart will not “pop” like a pimple, simply because it is not filled with fluid. Warts are actually made up of infected skin cells that grow and harden over time, resulting in a grainy, rough appearance. The skin surrounding the wart can become thick and pitted. The thicker the skin becomes, the more the wart will begin to look like a callus. Warts contain tiny blood vessels that will cause the wart to bleed if they are disturbed. Over time, many warts may appear to have small black dots. These are the small blood vessels pushing towards the top or sides of the wart.

How are Plantar Warts Diagnosed?

There are no specific tests that are designed specifically for plantar warts. They are easily identified by their appearance and texture. In most cases, you can identify them without the aid of a doctor. Unlike a mole or skin tag, warts have a unique appearance and start to cause discomfort long before they begin to show on the surface of the skin. Dr. Fihman will initially look for small dots that can be either red or black and scattered throughout the wart. These small dots are actually the tips of capillaries that contain small amounts of blood. If the wart is cut or shaved off, the capillaries will begin to bleed, Because the wart is self-contained, skin lines may begin to appear around it. Over time, the skin may pull away from the wart and start to peel or create a ridge.

If you have any questions about the growth and are unsure whether or not it is a plantar wart or another type of growth, schedule a visit with Dr. Fihman. She can examine the wart and, if necessary, remove it to have a biopsy performed. In most cases, her biggest concern will be if the lesion has or is starting to cause you pain. Warts can become extremely painful if they are pinched or if direct pressure is applied to their surface. If you are self-treating the wart and it doesn't seem to be responding, visiting Dr. Fihman is the best way to get the answers you need. She will be able to perform a thorough examination and give you an accurate diagnosis and several treatment options to choose from.

Treatment Options for Plantar Warts

Warts often come and go without any treatment at all, but for the lesions that remain, treatment may be necessary. When a wart appears, never try to remove it on your own. Even if you do get the top portion of the lesion off, the root that remains embedded in the tissue will cause it to return. Because the root of a wart goes deep into several layers of tissue, it can't just be shaved away or pinched off. If the top of the wart is removed but the root is left behind, it will come back, often spreading to other areas of the foot or body in the process. There are many treatment options that can be used to dissolve or remove the wart and kill the root. One of the most common is the use of a patch that contains salicylic acid. Although it may take several applications for the patch to work, the acid will eventually destroy the wart and kill the root, preventing its return.

Anti-viral creams work well and boost the body's immune system so it can fight off the spread of the virus. One of the treatments used by Dr. Fihman is an anti-cancer medication called Bleomycin. Bleomycin is injected directly into the wart and down into the root. She has also effectively used lasers and cryotherapy to help destroy the wart and its extended root. When clusters of warts are present, surgery may be needed to ensure the entire cluster is removed as well as the roots that are embedded deeply into the tissues of the foot. Even if the surgery is successful, Dr. Fihman may recommend applying an anti-fungal cream to prevent warts from growing back. Maintaining this practice for a few weeks after surgery will allow the immune system to eliminate the virus completely.

Preventing Plantar Warts

While it may be impossible to actually prevent a wart from appearing, you can reduce your risk of exposure and infection. Instead of walking barefoot in public areas, wear sandals or some type of footwear to keep your feet from coming into contact with the ground. It's also important to keep the surfaces in your home clean as well. Clean showers and bathrooms thoroughly. Mop kitchen and bathroom floors with a disinfectant and if you have a back patio or deck, rinse it off occasionally with a mild soap and water mixture. Keeping floors and surfaces clean is the best way to reduce your risk of HPV infection as well as that of athlete's foot.

Shower or bathe regularly, taking care to wash your feet thoroughly with soap and water. Sprinkle anti-fungal powder or use an anti-fungal spray inside your shoes on a regular basis. In addition to good hygiene, you can boost your immune system by eating a healthy diet. Use olive oil, garlic, ginger, cloves, and cinnamon to prepare your foods. Include foods that are high in vitamin C like citrus fruits, strawberries, Brussel sprouts, broccoli, and kiwis. Giving the body what it needs to stay healthy is always your first and foremost line of defense.

If you believe you have a plantar wart, don't try to treat it yourself. It's always better to be safe than sorry. Contact Dr. Fihman and allow her to perform a thorough examination. She will be able to identify and diagnose the lesion and provide you several treatment options to remedy the problem. Because plantar warts can go deep into the tissues of the foot, treating them on your own doesn't always work. With a personalized treatment plan created by Dr. Fihman, your wart will begin to clear itself in a short period of time. If surgery is needed, she will remove the entire lesion, including the root and provide you with detailed aftercare instructions.