What’s causing that bump on your foot?
One day, you’re putting your socks on before heading out the door. You notice that there seems to be a spot on one of your toes that has a growth on it. It doesn’t hurt, so you don’t think much about it. A few days later, you’re at the doctor for your annual exam and show her your foot. She tells you that you have a plantar wart. How did this happen? Can you get rid of it? Is there a way to prevent it from coming back?
Plantar warts appear on your feet, usually your heels or other weight-bearing areas. They’re caused by the Human Papillomavirus (HPV) entering your body through tiny cuts or breaks in the out layer of the skin of your feet. There are over 100 kinds of HPV, and only a few cause warts on the feet. These versions aren’t highly contagious, so the virus doesn’t transmit easily. It’s more likely to spread in warm, moist environments, such as walking barefoot around swimming pools or in locker rooms.
The main symptoms of plantar warts are a small, fleshy, rough, grainy growth on your foot, usually near the base of your toes or heel. Another sign is hard, thickened skin (callus) in a particular spot (the wart has grown inward). Some individuals have black pinpoints (commonly referred to as wart seeds) that are small, clotted blood vessels. It’s also possible to have pain or tenderness when walking or standing. Sometimes, the discomfort can cause you to alter your normal posture or gait, which can lead to pain in other parts of your body.
Not everyone who comes into contact with the HPV will develop warts. However, certain things can increase your chances of developing them, like be a child/teen, having a weakened immune system, having a history of plantar warts, or walking barefoot in areas where the virus is more likely to survive. You should see your doctor if you have a lesion that bleeds, is painful, or changes in appearance/color; you experience discomfort when participating in activities; you have diabetes/poor sensation in your feet; you have a weakened immune system; you aren’t sure the lesion is a wart; or you’ve tried treating the wart, but it persists, multiples, or recurs.
Most plantar warts are harmless and will go away without treatment, but it can take a year or two. If your warts are painful or spreading, there are over-the-counter treatments available. Often, it takes repeated treatments to get rid of warts, and they may recur later. If these solutions don’t help, your doctor has a variety of options that may.
Salicylic acid removes layers of a wart a little bit at a time and might stimulate your immune system’s ability to fight the wart. Another possibility is cryotherapy, which involves freezing the wart with liquid nitrogen. This must be done at a doctor’s office and is applied via a spray or cotton swab. The result is a blister that comes off in about a week. The process can produce an immune system response to help fight the wart but will need to be repeated every two to four weeks until the wart is gone.
If the previous options don’t work, your doctor may try shaving the wart’s surface and applying trichloroacetic acid with a wooden toothpick. This usually requires repeated treatments every week or so. In between visits, your doctor will likely recommend that you apply salicylic acid to the wart. Another option for stubborn warts is to inject them with antigens or apply a cream to the area that stimulates the immune system. A laser can be used to burn the blood vessels that go to the wart. This requires repeated treatments every three to four weeks until the affected tissue eventually dies and falls off. Your doctor may surgically remove the wart using an electric needle. However, this is painful and has a risk of scarring, so it’s not done unless other treatments have failed.
There are things you can do to prevent plantar warts. The first is avoiding being barefoot in areas such as swimming pools and locker rooms. It’s also vital to keep your feet clean and dry by changing your socks and shoes daily. Avoid direct contact with warts, including your own. This means not picking or scratching a wart and washing your hands thoroughly after touching it. Use a separate emery board, pumice stone, and nail clippers for the area around the wart from the rest of your body.
Plantar warts can be nothing of consequences or painful enough that you end up having other problems resulting from changing your posture. Either way, they can be easily removed. If you have any questions or concerns about plantar warts, please speak with your doctor. If you would like more information, please visit the American College of Foot and Ankle Surgeons’ Plantar Warts page at https://www.foothealthfacts.org/conditions/plantar-wart-(verruca-plantaris)