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Plantar warts

Plantar warts (or warts affecting the sole of the feet) are one of the most common viral infections of the skin. They are very infectious and can easily be transferred from one person to another in public swimming pools, sports centres and gymnasia.

There can be considerable variations in the appearance of plantar warts. In the early stages they may be mistaken for hard corns or small areas of callous, but warts have a much more rapid development than corns and they can occur at any site whereas corns mainly occur on sites of compression and friction.

Warts can occur as single or multiple infections (mosaic warts). The mosaic wart tends to be shallow and pain-free while the deep plantar wart can be extremely painful.

Normally there is an immunological response of the body to this infection leading to a spontaneous regression of the wart or warts usually within 6 to 8 months of onset. Persistence of the wart beyond this time or pain or disability are indications that an active treatment should be undertaken by a podiatrist. Some people have been shown to have a defect of cell immunity and for them treatment may last longer than usual.

Treatment of Warts

Treatment consists in destructive techniques to destroy the virus infected tissue and thus remove the lesion. The two main techniques for destroying the wart are chemical and cryosurgical.

Chemical cautery: different types of acids can be used by the podiatrist. It is extremely important that the surrounding normal skin be carefully masked so as not to be burned with the acid when applied to the wart which can be best done by a podiatrist. It is essential to see the podiatrist within a week or so for him to gently remove the destroyed tissue under antiseptic conditions. Another or several further applications of acid may be necessary until the wart becomes necrotic.

Cryosurgical technique: with this technique the podiatrist will freeze the wart or warts. The applicator which is held in contact with the skin, reaches a temperature of -55°C. The affected area will turn white and temporary, visible changes in the intensity of pigmentation may occur following treatment. Cryotherapy sometimes gives rise to blisters. Some infections may require a series of fortnightly treatments. With cryotherapy the uppermost layer of the skin, together with the infected tissue, will disappear and will be replaced by a new, healthy layer of skin in 10 to 14 days.

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