The Center for Podiatric Care and Sports Medicine

Attack of the Plantar Warts: 5 Things You Should Know

Posted by on Friday, January 17th, 2014

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It happened on a cruise ship. I thought it was just a blister or a callus, but a pedicurist informed me, “No, that’s a plantar wart.” ICK! Instantly, my mind flashed back to second grade when a girl in my class first revealed a big old wart on her finger, tucked behind a soggy Band-aid. I was repulsed!

Now, fast-forward: Sitting in my doctor’s office I wondered how could this have happened to me? I should have worn shower shoes and not been so trusting of the posh balcony suite we’d booked for our lavish vacation. I suppose you have to take precautions, no matter where you are. As for my treatment, I just presumed the doc would bust out his high-tech cryogenic laser for 15 minutes and send me on my merry way. “It’s not so simple,” he said, handing me a tub of acid that I would need to apply every day for months. I wanted to ask if he was kidding, but could tell by his dour expression that he was not.

Treatment felt agonizingly long. It was gross. For a while, the place where the wart had been looked like soggy cereal and I could barely stand the sight of it. Finally on a follow-up visit, the doctor said the wart had healed. Unfortunately the skin has never quite the been same and still looks like a callus to me. This is just one tale of battling plantar warts. There are many out there. If this is your first run-in with the despicable foe, let me fill you in on five other wart facts you should know.

foot infection
A hotel or cruise ship bathroom may look amazing, but don’t be fooled! They, too, can harbor viruses on their floors from repeated contact with other bare feet. Image Source: Best-Cruise-Lines.com

1. The black dots give it away.

Sometimes a wart can be hard to tell from a callus. Often, they are rather flat looking due to the pressure they receive from walking on them. Like a callus, warts are a build-up of thick, tough skin. What makes a wart different is the fact that it hurts when squeezed… and there are tiny black dots on its surface (which are actually dilated blood vessels).

2. It’s a virus.

I had always thought of warts as some type of fungus, but — alas — it’s a virus… the human papillomavirus (HPV), to be precise. Yes, it’s part of that same revolting family that brought us strains leading to cervical cancer and genital warts. Thankfully, you’re not at risk of contracting these other maladies if you’ve got the plantar wart strain, but it can still be a real bugger.

3. It needs your cooperation to wreak havoc.

We come into contact with heinous viruses and pathogens all the time. But that doesn’t mean we’ll get sick. To get into your system, the virus needs a break in the skin’s protective barrier. In my case, it infiltrated through dry, cracked skin on my heels. Once inside the body, the virus multiplies rapidly, creating thickened skin growth. To multiply freely, it requires a weakened immune system. A head cold requiring antibiotics was just the sort of window the virus needed to do me in. HPV can incubate for up to 20 months, but it was likely picked up in a hot, moist shower, locker room or pool area.

4. Topical acid is the first line of defense.

Generally, doctors want you to attempt an affordable treatment at home with salicylic acid first. You’ll be required to soak your foot in hot water for a while. Then you’ll need to apply over-the-counter gel or liquid each day and cover it with duct tape.

plantar wart treatments
Cryotherapy is said to be most effective against warts. Image Source: Mountainside-Medical.com

5. Cryotherapy is considered most effective.

One study found that cure rates for patients with common warts were 49% with cryotherapy, 15% with salicylic acid group, and 8% in the wait-and-see group. Another study found a 60% cure rate with cryotherapy. Generally speaking, industry professionals writing in Podiatry Today find cryotherapy to be the best treatment, but every patient is different and requires a customized solution.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.