PLANTAR WARTS – veruccae plantaris

PLANTAR WARTS are a buildup of thick irregular skin on the bottom of the foot.  This buildup of thick skin is different than calluses and corns because it is caused by an infection from a virus rather than rubbing or friction.  Calluses are commonly misdiagnosed as warts due to the fact that they may look similar in appearance.  Calluses on the bottom of the foot usually occur under weight bearing bones such as the metatarsal bones in the ball of the foot.  Warts can occur on any part of the skin on the foot making this helpful in differentiating them from calluses.  Calluses generally hurt when direct pressure is placed on them, whereas warts generally hurt with side to side pressure or squeezing.

It is important to distinguish between the two since the treatments are different.  Calluses generally respond to rebalancing of the way the foot bears weight, such as with a footbed or an orthotic.  As was mentioned in the section on calluses, sometimes a cutout area will be used in the orthotic to remove the excessive pressure that caused the callus to form.

Since warts are a viral infection, no attempt to rebalance the foot will have success.  The virus must be killed.  This can be accomplished with many different methods.  We will not present all of the possible treatments, but rather the more common ones.

Topical acid preparations such as salicylic acid are often used to kill the virus by destroying the layers of skin that the virus lives in and destroying the virus as well.  Topical preparations usually work better if used under occlusion.  This means covering the acid with tape or bandaging to hold the acid in place and not let it be rubbed away by socks and shoes.

Some warts are killed by using laser or electrocautery to burn the wart and surrounding tissue.

Cryotherapy or liquid nitrogen therapy attempts to kill the virus by freezing it to death.

Some warts will also respond to surgical techniques such as excision ( cutting the wart and surrounding skin out ), or curettage, which is scooping the wart tissue out of the deep layers of skin.

Various types of anti cancer medications have also been used either topically or by injection.

The immune system of a person with a wart may also be altered to favor the ability of the body to get rid of the wart.  This can occur by oral medications such as tagamet (cimetidine) or by implanting wart tissue surgically into a separate site of the body which stimulates the body to get rid of the original wart.

Duct tape has also recently been shown to have some success in the treatment of plantar warts.

If there is confusion as to whether a growth represents a wart or a callus, a podiatrist should be seen, as misdiagnosis and inappropriate treatment rendered by an unqualified individual can lead to unnecessary scarring, spread of virus to other sites or prolonged pain and disability.

Since warts occur due to the virus being able to get into the skin, it is helpful to keep the skin of the foot dry.  This is accomplished using acrylic socks, putting powder into the shoes and drying shoes in between wearing.