Plantar wart

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

A plantar wart is a wart caused by the human papilloma virus (HPV). It is a small lesion that appears on the sole of the foot (hence the name, from Latin planta pedis, the sole of the foot) and typically resembles a cauliflower. A plantar wart may have small black specks within it that ooze blood when the surface is shaved; these are abnormal capillaries. Though the name plantar wart describes specifically HPV infection on the sole of the foot, infection by the virus is possible anywhere on the body and common especially on the palm of the hand, where the appearance of the wart is often exactly as described above for plantar warts. Because of pressure on the sole of the foot, a layer of hard skin forms over the wart. A plantar wart may or may not be painful. It can be spread in communal showers, around swimming pools, by sharing shoes, etc.

The human papilloma virus types 1, 2, 4, or 63 are classified as clinical (visible symptoms). The virus attacks the skin through direct contact, entering through possibly tiny cuts and abrasions in the stratum corneum (outermost layer of skin). After infection, warts may not become visible for several weeks or months. Because of pressure on the sole of the foot, the wart is pushed inward and a layer of hard skin may form over the wart. A plantar wart may be painful. Warts may spread through autoinoculation, by infecting nearby skin or by infecting walking surfaces. They may fuse or develop into clusters called mosaic warts.

Plantar warts are benign epithelial tumors caused by infection by human papilloma virus types 1, 2, 4, or 63. All warts can spread from one part of your own body to another. They may spread from one person to another, but this is uncommon. Infection typically occurs on moist walking surfaces such as showers, swimming pools, or shoes. The virus can survive many months without a host, making it highly contagious.

It is estimated that 7-10% of the US population is infected. Plantar warts tend to affect only 0.29% of people who have never worn shoes.^[1]

Common warts tend to cause no discomfort unless they are in areas of repeated friction or pressure. Plantar warts, for example, can become extremely painful. Large numbers of plantar warts on the foot may cause difficulty walking or running. Some warts will disappear without treatment, although it can sometimes take a couple of years. Treated or not, warts that go away often reappear.

The typical wart is a raised round or oval growth on the skin with a rough surface. Compared with the surrounding normal skin, warts may appear light, dark, or black (rare). Most adults are familiar with the look of a typical wart and have little trouble recognizing it. Unusual warts with smooth surfaces or flat warts in children may be more difficult for parents to recognize.

No treatment in common use is 100% effective. The most comprehensive medical review found that no treatment method was more than 73% effective and using a placebo had a 27% average success rate. All warts can spread from one part of your own body to another. Unsightly or painful warts can be treated. Warts around and under your nails are much more difficult to cure than warts in other places.

Although immunization is available for the HPV and strains causing cervical cancer and venereal warts, there is currently no vaccination treatment for plantar warts.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Different types of warts include:

• Common warts usually appear on the hands, but can appear anywhere. They usually do not cause pain unless they are repeated rubbed against.
• Flat warts are generally found on the face and forehead. They are common in children, less common in teens, and rare in adults.
• Genital warts (condyloma) are usually found on the genitals, in the pubic area, and in the area between the thighs, but they can also appear inside the vagina and anal canal.
• Plantar warts are found on the soles of the feet. They can be very painful. Many of them on the foot may cause difficulty walking or running.
• Subungual and periungual warts appear under and around the fingernails or toenails.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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The human papilloma virus types 1, 2, 4, or 63 are classified as clinical (visible symptoms). The virus attacks the skin through direct contact, entering through possibly tiny cuts and abrasions in the stratum corneum (outermost layer of skin). After infection, warts may not become visible for several weeks or months. Because of pressure on the sole of the foot, the wart is pushed inward and a layer of hard skin may form over the wart. A plantar wart may be painful. Warts may spread through autoinoculation, by infecting nearby skin or by infecting walking surfaces. They may fuse or develop into clusters called mosaic warts.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Plantar warts are benign epithelial tumors caused by infection by human papilloma virus types 1, 2, 4, or 63. All warts can spread from one part of your own body to another. They may spread from one person to another, but this is uncommon. Infection typically occurs on moist walking surfaces such as showers, swimming pools, or shoes. The virus can survive many months without a host, making it highly contagious.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Plantar warts, can often be differentiated from helomata, corns, by close observation of skin striations. Feet, like hands, are covered in skin striae, which are more commonly called fingerprints. With plantar warts, the skin striae go around the lesion; if the lesion is not a plantar wart, the cells’ DNA is not altered and the striations continue across the top layer of the skin. Plantar warts tend to be painful on application of pressure from eithe side of the lesion rather than direct pressure. Helomata tend to be painful on direct pressure rather than pressure from either side.

The difference between plantar warts and warts elsewhere on the body is that warts are generally outgrowth lesions, but on the bottom of the foot, they are pushed inward by the pressure of walking. Since the skin on the bottom of the foot tends to be thicker than elsewhere, the treatment of plantar warts is more difficult.

Your doctor may want to cut into a wart (called a biopsy) to confirm that it is not a corn, callus, skin cancer, or other similar-appearing growth.

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It is estimated that 7-10% of the US population is infected. Plantar warts tend to affect only 0.29% of people who have never worn shoes.^[1]

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• Spread of warts
• Return of warts that disappeared
• Minor scar formation if the wart is removed
• Formation of keloids after removal

If a wart is being treated professionally and does not seem to improve in a reasonable period of time, the growth should be excised and biopsied.

Warts are generally harmless growths that often go away on their own within 2 years. They can be contagious, but transmission from person to person is uncommon. Warts may be unsightly or cause discomfort, especially on the feet. Warts may spread, develop into clusters or fuse to become a mosaic wart. Plantar warts can be painful making it difficult to walk and run. Over-aggressive treatment may lead to scarring. Others may be infected.

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