Treatment of Warts (Verrucae)
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What are plantar warts?
Warts are one of several soft tissue conditions of the foot
that can be quite painful. They are caused by a virus, which generally
invades the skin through small or invisible cuts and abrasions. They can
appear anywhere on the skin, but, technically, only those on the sole are
properly called plantar warts.
Children, especially teenagers, tend to be more susceptible to warts than
adults; some people seem to be immune.
Identification Problems
Most warts are harmless, even though they may be painful.
They are often mistaken for corns or calluses—which are layers of dead skin
that build up to protect an area which is being continuously irritated. The
wart, however, is a viral infection.
It is also possible for a variety of more serious lesions to appear on the
foot, including malignant lesions such as carcinomas and melanomas. Although
rare, these conditions can sometimes be misidentified as a wart. It is wise
to consult a podiatric physician when any suspicious growth or eruption is
detected on the skin of the foot in order to ensure a correct diagnosis.
Plantar warts tend to be hard and flat, with a rough surface and
well-defined boundaries; warts are generally raised and fleshier when they
appear on the top of the foot or on the toes. Plantar warts are often gray
or brown (but the color may vary), with a center that appears as one or more
pinpoints of black. It is important to note that warts can be very resistant
to treatment and have a tendency to reoccur.
Source of the Virus
The plantar wart is often contracted by walking barefoot on
dirty surfaces or littered ground where the virus is lurking. The causative
virus thrives in warm, moist environments, making infection a common
occurrence in communal bathing facilities.
If left untreated, warts can grow to an inch or more in circumference and
can spread into clusters of several warts; these are often called mosaic
warts. Like any other infectious lesion, plantar warts are spread by
touching, scratching, or even by contact with skin shed from another wart.
The wart may also bleed, another route for spreading.
Occasionally, warts can spontaneously disappear after a short time, and,
just as frequently, they can recur in the same location.
When plantar warts develop on the weight-bearing areas of the foot—the ball
of the foot, or the heel, for example—they can be the source of sharp,
burning pain. Pain occurs when weight is brought to bear directly on the
wart, although pressure on the side of a wart can create equally intense
pain.
Tips for Prevention
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Avoid walking barefoot, except on sandy beaches.
Public showers and pools are a major source of the wart virus.
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Change shoes and socks daily.
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Keep feet clean and dry.
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Check children's feet periodically.
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Avoid direct contact with warts—from other persons or from other parts
of the body.
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Do not ignore growths on, or changes in, your skin.
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Visit your podiatric physician as part of your annual health checkup.
Self Treatment
Self treatment should be done with caution.
Over-the-counter preparations contain acids or chemicals that destroy skin
cells and you need to be careful to destroy the abnormal skin cells (warts) without also
destroying surrounding healthy tissue. Self treatment with such medications
especially should be avoided by people with diabetes and those with
cardiovascular or circulatory disorders. Never use them in the presence of
an active infection.
Professional Treatment
It is possible that your podiatric physician will prescribe
and supervise your use of a wart-removal preparation, such as
salicylic acid
containing preparations, canthrone or "freezing" of the warts. Another option may be removal of warts by a
simple surgical procedure (with or without laser), performed under local anesthetic.
Prescription Aldara cream is frequently used by physicians in conjunction
with other treatments.
Lasers have become a common and effective treatment. A procedure known as
CO2 laser cautery is performed under local anesthesia either in your
podiatrist’s office surgical setting or an outpatient surgery facility. The
laser reduces post-treatment scarring and is a safe form for eliminating
wart lesions.
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