PLANTAR
WARTS
By: Corinne Gehegan, DPM
 Plantar warts are skin lesions that develop on the sole of the foot
and/or toes after direct contact with the virus HPV (human
papillomavirus). There are several strains of HPV which are responsible
for the development of plantar warts. Plantar is an anatomic term that
refers to the sole (bottom) of the foot. The medical term for plantar
wart is verruca plantaris.
Exposure is by means of direct contact with a contaminated surface. The
virus has the ability to remain active on surfaces for several months.
The virus may enter through tiny openings/breaks in the skin. Examples
of commonly contaminated surfaces include public showers (including
hotel showers), the area around swimming pools, and mats used publicly
at gyms including those used for yoga, Pilates, martial arts, and dance.
Caution should also be taken if renting equipment such as bowling shoes
and kayaks.
Pressure from walking may push the lesion inward. The portion of the
lesion that is not visible can be twice the size of what is actually
seen. The wart may look spongy and often appears to be peppered or have
splinter like structures. These dark areas are the tips of thrombosed
blood vessels which supply the virus with a lifeline. The lesions may
not cause any discomfort at all. Lesions may grow to one inch in
diameter or several lesions may cluster together forming a mosaic wart.
Lesions may be self limiting and resolve on their own or they may spread
to other parts of the foot or body. Multiple treatments exist as no one
treatment is optimal. Over the counter treatments are available
including cryo kits to freeze the lesion, however, they tend to be
ineffective as plantar warts are deep and require periodic debridement
(shaving) of the lesion at the doctor’s office. Professional treatment
may involve various prescription topical preparations, surgical
excision, electocautery, injectable medication, and laser therapy. The
doctor will discuss the risks, benefits, costs, and efficacy of the
various treatment options to help you to determine which is right for
your particular case. Certain individuals may be more susceptible to
plantar wart development due to previous exposure or a weakened immune
system. Even after clinical resolution of the lesions, they may recur
due to the virus lying dormant in healthy skin.
Article written by Dr. Corinne Gehegan
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