The What, Where, Why and How of Warts

Do your feet look like this?Do you see little rough, almost cauliflower-like lesions? If so, you may have verruca pedis or plantar warts.  Skin warts are growths on the skin that are caused by a virus called Human Papillomavirus (HPV). HPV infection is quite common are there are several types of warts with plantar warts (warts on the bottom of the foot) being the most common a podiatrist will treat.

HPV life cycle

The HPV life cycle post infection can be up to 8 months before first signs of infection have occurred. This is where the virus enters the skin via any portal such as a break in the skin and enters the basal layer of the skin (the deepest epidermis layer) and incubates up to 8 months, after this period the virus invades the skin cells (keratinocytes) and changes DNA structure within that cell in order to make replicas of itself, this in turn triggers proliferation of the skin cells which are then expanded with fluid (meaning each keratinocyte has a multitude of these viruses and filled with fluid), this occurs via desquamation (shedding of skin cells) through the four layers of the epidermis it becomes bigger and bigger and it is this that physically alters the appearance epidermis, this is when we see the wart. During this time of travelling through the different layers of the skin cells it releases anti-inflammatory cells (help fight infections) and alters Langerhans cells which are the only immune cells we have in the epidermis which causes immune ignorance therefore, leading to the wart developing.

Who gets plantar warts?

They are most common in children and adults. People with a weakened immune system may have extensive warts or warts that are difficult to control.  People can become infected with the virus that causes warts by touching another person’s wart. HPV is most likely to infect unhealthy or injured skin but can infect healthy skin as well. They commonly spread via communal areas such as swimming pools or change rooms.

Signs of plantar warts

Plantar warts are found on the soles of the feet. Plantar warts often begin as a small, round area of rough or thickened skin but may grow to involve larger areas in a mosaic appearance. On close examination of a plantar wart will show that it interrupts the normal skin lines that are found on the soles of the feet. Small, clogged blood vessels, which look like black dots can be seen.

Treatment for plantar warts

Liquid Nitrogen (Dry Ice)

Treatment for warts depends on where the wart is located and how much discomfort it is causing you. Treatment is not required in all cases. For example, most skin warts in children resolve on their own within two years without treatment. However, during this time the wart may enlarge, or new warts appear. Small warts are easier to treat than larger warts, for this reason most people choose to treat warts.

Below are common treatment remedies we use to treat warts:

  1.  Nitric acid: This is a caustic which burns through by chemical destruction of the tissues. This may cause some discomfort but is highly effective in the treatment of plantar warts. Again, this may take several treatments
  2.  Liquid nitrogen: This treatment involves freezing the wart, this may take several treatments on a weekly basis. Liquid nitrogen can cause some discomfort to the patient.
  3.  Silver nitrate: This is used to chemically cauterize the skin effectively permanently destroying the unwanted wart tissue and is not painful.
  4.  Salicylic acid: This is the least invasive of the treatments of plantar warts and removes the wart by exfoliating the skin cells until the wart is gone. This in turn may also promote the immune cells around the wart to start producing healthy skin cells.

All the chemical treatments mentioned are dressed afterwards and we advise the patient to leave on for 2-3 days.  If necessary, we may use padding after the treatment on the painful warts to deflect or offload specific areas to reduce any discomfort.

If you or someone you know suffers with painful warts on your feet then we would love to help! You can easily book online >>HERE<< or give our friendly admin team a call on (03) 9711 7562.

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