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Johns Hopkins Symptoms and Remedies

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Plantar Warts

What is it?

Plantar warts are noncancerous skin growths that develop on the soles of the foot. Like all warts, they are caused by a virus (human papillomavirus). Various features set plantar warts apart from so-called common warts (which typically form raised domeshaped skin lesions on the fingers and other areas) and genital warts. First, plantar warts arise exclusively on the bottoms of the feet. Pressure from body weight tends to make plantar warts grow inward, just beneath the skin's surface, and a rough, thickened layer of skin (callus) typically grows around and over the wart. A plantar wart may feel like a pebble in the shoe; however, in some cases it causes intense pain, particularly if it lies on the heel or ball of the foot. Second, plantar warts do not tend to spread to other sites on the body. They usually appear singly, although a variant, the mosaic wart, consists of multiple small, merging lesions. Finally, unlike genital warts, which have been linked to serious health problems such as genital cancer, plantar warts pose no such risks.

What Causes It?

  • Plantar warts, like other warts, are caused by the human papillomavirus. The virus incubates in the skin for several months before causing a wart.
  • The incidence is highest among adolescents, likely due to going barefoot in public recreational and shower facilities.

Prevention

  • Wear footwear in public places.

Diagnosis

How to Treat It

  • Treatment is certainly warranted if the wart is painful and interferes with walking. However, many of these warts will go away without treatment.
  • Home treatment can be attempted, although plantar warts (unlike common warts) tend to be rather difficult to treat and often require professional care. One approach involves nightly applications of salicylic- acid plasters, which are available in drugstores.
  • Warts that fail to respond to self-treatment and those that develop in people with diabetes require a physician's or podiatrist's care. Usually, the doctor will cut away any thickened skin over the wart before treating it with any of several techniques. Paring down the callus to keep it thin will often make the pain go away even if the wart persists. (Do not cut off warts or the calluses that cover them on your own; it may lead to infection.)
  • Liquid nitrogen may be applied to the wart (cryosurgery), which may cause it to blister and fall off within a couple of days or weeks. Alternatively, the wart may be destroyed using acidic chemicals or surgically removed with a beam of electric current (electrocautery) or laser light. These approaches are generally quite painful, and, for warts requiring electrocautery or laser surgery, may necessitate local anesthesia. Several treatment sessions may be necessary because the thickness of the plantar surface makes it more resistant to treatment, and because the wart virus may be very resistant to destruction.

When to Call a Doctor

  • Warts that don't cause pain can be observed and/or treated at home.
  • See a doctor or podiatrist if you have diabetes and develop a plantar wart, if the wart is painful and interferes with walking, or if the wart does not respond to self-treatment.