Plantar Wart Example

Plantar Warts

A plantar wart (also known as "Verruca Plantaris") is a wart caused by the human papillomavirus (HPV) occurring on the sole or toes of the foot. (HPV infections in other locations are not plantar; see human papillomavirus.) Plantar warts are usually self-limiting, but should be treated to lessen symptoms (which may include pain), decrease duration, and reduce transmission.

Infection typically occurs from moist walking surfaces such as showers or swimming pools. The virus can survive many months without a host, making it highly contagious.

Plantar warts are benign epithelial tumors caused by infection by human papilloma virus types. These types are classified as clinical (visible symptoms). The virus attacks the skin through direct contact, entering through possibly tiny cuts and abrasions in the stratum corneum (outermost layer of skin). After infection, warts may not become visible for several weeks or months. Because of pressure on the sole of the foot or finger, the wart is pushed inward and a layer of hard skin may form over the wart. A plantar wart can be painful if left untreated.

Warts may spread through autoinoculation, by infecting nearby skin or by infecting walking surfaces. They may fuse or develop into clusters called mosaic warts.

Plantar Wart Prevention and Treatment

Because plantar warts are spread by contact with moist walking surfaces, they can be prevented by not walking barefoot in public areas such as showers or communal changing rooms, not sharing shoes and socks, and avoiding direct contact with warts on other parts of the body or on other people. Humans build immunity with age, so infection is less common among adults than children.

Once a person is infected, there is no evidence that any treatment eliminates HPV infection or decreases infectivity, and warts may recur after treatment because of activation of latent virus present in healthy skin adjacent to the lesion. There is currently no vaccine for these types of the virus. However, treatments are sometimes effective at addressing symptoms and causing remission (inactivity) of the virus.

The treatment that will be effective in a particular case is highly variable. The most comprehensive medical review found that no treatment method was more than 73% effective and using a placebo had a 27% average success rate.

Some treatments that have been found to be effective include:

  • First-line therapy Over the counter salicylic acid.
  • Second-line therapy Cryosurgery, intralesional immunotherapy, or pulsed dye laser therapy
  • Third-line therapy Bleomycin, surgical excision

Podiatrists and dermatologists are considered specialists in the treatment of plantar warts, though most warts are treated by primary care physicians.

As warts are contagious, precautions should be taken to avoid spreading.