Warts
The medical term for this lesion is Verruca. Specifically on the foot it is a Verrucae Pedis. The specific virus that causes this Human Papillomavirus.Warts can be located anywhere on the body. The virus infected the skin, specifically a layer called the Stratum Spinosum, which causes thickening and possibly, pain. Common places one may pick up a wart is from a communal location, such as a pool, public change room or a pedicure salon. The virus can spread to other areas of the body.
Here are a few different strains that cause warts.
- HPV 1 – single / deep plantar warts
- HPV 2 Mosaic warts
- HP2 , 4 , 60 are raised warts
What are Deep and Single Plantar Warts ?
These can sometimes be mistaken for corns on the feet. They usually have a layer of skin that is cauliflower like in presentation and can have black dots located in them. The black dots are the capillaries in the skin being interrupted by the virus. When pinched there is pain and can throb when first standing
Mosaic Warts
These are warts that are a bit more superficial but coalesce to form a mass of warty tissue. These tend to be quite painful and people are often concerned about their appearance.
How to Treat Plantar Warts
Pain and appearance are reasons people come to our Downtown Chiropody and Podiatry office. Normally how we go about deciding the best treatment options for our patients is by giving them all the options, conservative and aggressive and allowing the patient to pick what treatment they would like.
Treatment Options Conservative
Cryotherapy– this is where liquid nitrogen burns the wart by using very cold temperatures. It aches and hurts for a short period of time. This is the most commonly used in doctors offices.
This can be a lengthy process.
Salicylic Acid – Is found to be more successful than cryotherapy in Cochrane reviews. This treatment can come in various strengths, but does take time to resolve. It also requires frequent check ups with your foot specialist, every 2 weeks so they can debride and expose the virus. This medication should be applied weekly. Sometimes this is combined with other treatments and is one of the more painless treatment options for athletes.
Laser Treatment- This is where the area is burned off with a laser. It can be quite a painful treatment, however does not require much downtime.
Needling – this is a procedure that requires a local anaesthic to the area. Then the area is punctured multiple times to penetrate the virus into the bloodstream. The downtime feels like a bruising but not as painful as surgical removal.
Aggressive Treatment Options
Canthacur – I place this one in aggressive as it does cause downtime for the patient. It causes a blister to form on the area that can be quie debilitating. Patients need to be aware of how painful this treatment option is. From patient feedback, I have heard the excision of the wart to be less painful than the cathacur treatment.
Surgical Excision- This is where the warty tissue is surgically excised. The base of the wart will be burned with a chemical or a hyfrecator .
All of these treatment options should be done with some home care to help prevent complications such as infections. Soaking the area in salt or some antibacterial soap will help drain and clean the area. Sterile bandage with appropriate antibiotic ointment will also help the healing process.
I, chiropodist Laura Desjardins, enjoys discussing treatment options that best suit a patient’s needs and lifestyle. However, it is known the longer a wart has been on the foot, the more resistant it is. The more resistant warts do respond better to aggressive treatment options.
