Warts: Verruca pedis
Plantar warts, also referred to as verruca pedis or papilloma’s are considered to be benign lesions that can grow on the feet. Plantar warts most commonly occur on the sole of the foot, on or in between the toes and can even develop underneath and surrounding the toenails. It is important to consult a podiatrist if you think you have a wart to prevent the spread as they are highly contagious.
How do I know if I have a wart?
- Lesion will commonly have a cauliflower appearance or mosaic pattern.
- The lesion will typically feel quite firm and can be raised.
- There may be multiple growths which form a cluster.
- You may be able to visualise small black dots within the lesion which are small blood vessels.
- The lesion is painful to squeeze rather than if direct pressure is applied.
- There is a disruption to skin striations so the lines of the skin cannot be seen through the lesion.
- Warts may or may not cause pain or discomfort pending on the location of the lesion.
It is important to get any lesion on your foot assessed as warts are commonly misdiagnosed as they can appear similar to other conditions. Differential diagnosis for warts include hyperkeratosis (callous), heloma durums (hard corns), eccrine poroma’s and certain skin cancers.
How did I get a wart?
Warts are an extremely common skin condition caused by the human papilloma virus (HPV). There are many strains of the virus which can cause warts in different parts of the body. As these warts are caused by a viral infection they typically enter the body through tiny breaks in the skin. The most common way warts spread are through direct contact. This may come in the form of directly touching someone who has a wart whether it be through shaking hands or coming into contact with an object that someone else has touched.
Factors that increase the likelihood of developing a wart on the feet may include:
- Direct exposure to a wart.
- Having warts on the fingers or hands.
- Activities such as swimming.
- Having sweaty feet or being in an environment where feet cannot air out.
- Walking barefoot in communal areas such as swimming pools, sporting clubs, change rooms and gyms.
- Having family members with warts.
- Having any medical conditions that compromise the immune system.
How do I get rid of my wart?
Here at Be Podiatry we offer many different options to help resolve warts. Our experienced podiatrists will assess the size, location and type of wart and formulate an appropriate treatment plan.
Warts can be tricky to treat as they are caused by a viral infection. The first step when treating any wart is to remove excess tissue and expose the wart to allow treatment to have the best chance of success. This is done by sharps debridement with a scalpel by a podiatrist and is often painless although sometimes the area may feel a bit sensitive. It is best to debride the wart tissue until some pin pricking bleeding occurs at the site. After the wart is adequately exposed treatment can be administered
Treatments that your podiatrist may choose to use include:
- Silver nitrate (AGn03) sticks – Silver nitrate is a caustic agent which aims to dry out the wart once it has been adequately exposed. This is often a good option for children as it is painless when used. When silver nitrate is applied it will cover the wart and leave a black stain in the area. This is completely normal and can be washed off and/or debrided away. Silver nitrate is less effective than other treatment options.
- Salicylic acid 60% paste – This paste is a keratolytic which is applied directly to the skin and then absorbed by the body. It aims to macerate the warty tissue to make the skin break down and allow it to peel away. Multiple applications are usually necessary with this option. This is suitable for both children and adults as it is a painless treatment. This treatment needs to be kept dry for it to work best.
- Phenol 80% with 60% Salicylic – Phenol is a caustic agent and when combined with salicylic acid works well against warts. It is important to note that phenol cannot be used during pregnancy or when breast feeding as it is a very potent chemical so it is not suitable for everyone.
- Cryotherapy – This method uses liquid nitrogen to freeze the warts off. It is applied directly to the lesion and works by creating cell death and causing an inflammatory response in the body. This process can be quite painful and is not recommended for children or those with a compromised immune system. This modality is most commonly used by general practitioners.
- Faulkner’s needling – This is a technique whereby a thin needle is used to penetrate the wart a number of times. It is thought that this triggers a controlled immune response in the body and causes keratinocyte destruction. For this procedure local anaesthetic is required to numb the area prior to treatment. The use of this technique may depend on the size, location and depth of the wart.
- K-Laser – Laser technology is quite new when it comes to treating warts. The laser aims to cause cell death and heat up the cells to a level where they can’t survive. Typically warts require one or two sessions of laser therapy although results may vary depending on other factors. To read more about K-laser click here.
- Over the counter products – Products such as Duofilm Solution or Wart-Off may be advised to be used in conjunction with above treatment methods. These products contain a small amount of salicylic acid in them which makes them beneficial to use in between some treatments as recommended by your podiatrist. These products can be found at a pharmacy such as chemist warehouse.
Lastly, prevention is a much better treatment strategy than cure when it comes to warts. Tips to avoid being exposed to warts include:
- Good hand hygiene habits.
- Avoid being barefoot in communal areas such as pools, gyms, sporting clubs and public bathrooms. Ensure you use thongs or sandals when using these facilities.
- Use a separate towel for the feet when showering and do not share personal belongings.
- Avoid coming into direct contact with warts.
- If you have a wart avoid picking or scratching it which may cause the infection to spread.
- If barefoot, ensure warts are covered to prevent spread.
If you suspect you have a wart or would like more information please contact the clinic to make an appointment.
