by Tracey Meyer (Master Podiatrist)
G'day, I'm Tracey, one of the Foot Doctors at Irymple Foot Clinic! Today I’m going to give it to you straight, no jargon about plantar warts.
Plantar warts, Papilloma, Verucca, plantar verrucae or verrucae pedis they are all the same thing. Even though “plantar” means “bottom” of the foot the term plantar warts is used to refer to warts anywhere on the feet. They can be singular, multiple or form a mosaic type pattern. They are the same as warts on other parts of the body but can look a bit different under the foot as they are a bit like an iceberg – there is more underneath than on top because it gets pushed up into the foot.
Warts are caused by a virus. The virus can live outside the body however it needs a break in the skin (which can be a microscopic crack, not necessarily a cut) for it to get in. The virus causes a deeper layer of the skin to come to the surface dragging blood vessels (these create little black/brown dots as they break) and the nerve endings as well come to the surface, this is why they can be tender to walk on. If the wart is on the bottom of the foot the wart will usually be very flat and there will be more below the skin surface than above.
The skin on the bottom of the foot is the thickest in the whole body so it is really hard to get rid of warts in this area. The most common signs and symptoms we see are a lumpy area that looks like a little cauliflower with brown dots in it. People usually complain that they start off feeling like they had a splinter or prickle but they just can’t dig it out. You may hear that one of the symptoms is that if you squeeze the wart it is sore – but if you squeeze anything hard enough it is going to hurt.
There are many treatments for warts however the two main ones that most podiatrists use are either a chemical paste or freezing. The paste has a strong acid in it that kills the wart slowly so it is generally not painful at all. You will need to come back weekly to have the dead skin removed and more paste applied until it is gone. The downside with the paste method is that you have to keep it dry for the full week until you come back in so your foot can get a bit smelly. If the dressings come off you will notice white water logged skin, don’t be grossed out, this is what it is meant to look like. It may take several visits to completely get rid of the wart.
Freezing can be a little painful however you don’t have to keep it dry until you come back in. Generally 3 to 4 visits will be enough with the freezing to kill the wart but sometimes the little blighters can be stubborn! There are a lot of old wives tales about selling them, using banana skin and duct tape etc. however there is no evidence to support them. They have probably come about because warts can just spontaneously disappear!
Prevention of warts is a bit harder as if you are a child or an elderly person your immune system may be not what it should be and so you are more likely to get warts. Obviously looking after your general health is important. It is thought that the virus needs a wet area to be transmitted so wearing thongs in common bathing and change areas may be a good idea.