Skip the home remedies for wart removal. Proper treatment of plantar warts requires the expertise of your healthcare provider.
by The Iowa Clinic on Tuesday, August 18, 2020
Nose, fingers, toes and everywhere in between, warts can show up anywhere on your skin. They are one of the most common skin conditions. They’re also quite contagious.
Warts are more than an abnormal growth. They’re the result of an infection, specifically a virus more often associated with cervical cancer than a bump on the skin: human papillomavirus (HPV).
HPV enters your body through a cut or break in your skin. Then, it forms that ugly, rough bump. Since warts are caused by a viral infection, they are easily spread through contact. Anything that has had contact with a wart — your hand, a towel, a sock, the floor — can spread it.
And when warts show up on your feet, they can be as painful as they are unsightly.
What makes a wart on your foot worse than a wart somewhere else?
Warts don’t usually present problems. They are on your skin until they go away on their own or by removal. Warts on the bottom of your feet, known as plantar warts, are the most likely type to give you any other trouble or symptoms.
Because of their location — the soles, heels, toes and balls of your feet — plantar warts send you a painful reminder of their presence with every single step. It feels like you’re walking with a rock in your shoe. Even if you’re barefoot.
Plantar warts are most common on the parts of the foot that receive the most pressure when you’re standing or walking. Since those are two things you can’t avoid, additional standing and walking increase the pressure on the wart and send it further inward, deep into your skin.
All that pressure also flattens the plantar wart. It ends up looking less like a wart and more like a callus. If you can’t tell the difference by looking at it, give it the squeeze test. A plantar wart is painful when squeezed; a callus is not.
It’s an important test. Many people rub calluses with abrasive objects like pumice stones, nail files and emery boards to remove the thick, rough skin. And that is not recommended for removal of plantar warts.
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Then what’s the best treatment for plantar warts?
Best case scenario, no treatment is necessary. Just leave it alone. Like other warts, most plantar warts eventually go away on their own. It might just take a year or two.
If your plantar warts are painful or spreading to other areas of your feet, waiting is not an option. You need immediate relief.
Many people buy a topical wart remover from the pharmacy, thinking it’s a cure for all kinds of warts. But over-the-counter wart removal creams and liquids are ineffective. Plantar warts are too deep in the skin. You may be able to remove the outer layer, but the seed of the wart is deep in the sole of your foot and it will come back again.
Over-the counter wart removers can actually do more harm than good. They contain acids and chemicals that destroy the skin they touch. You can easily apply too much, damage the surrounding area and open your skin up to further infection, causing plantar warts to spread.
Instead of trying to remove plantar warts at home, see your primary care provider.
Usually, a foot examination is all that’s needed to diagnose plantar warts. Sometimes, your provider will need to trim a tiny portion of the skin to see if it bleeds — a clear signal that it’s a wart and not a callus.
From there, they can recommend the best treatment from a variety of removal options. All of them are designed to get rid of the wart as well as stimulate the immune system to identify the virus and prevent warts from reforming.
Prescription-Strength Wart Medication
Wart removal medicines available over-the-counter work less than half the time. Stronger medications available by prescription only are a better solution. They work the same as the widely available options, peeling away a plantar wart layer by layer. You can apply a prescription-strength medication to your plantar warts at home and follow up with your provider to make sure the wart is entirely removed.
Plantar Wart Freezing
Freezing a wart using cryotherapy is an effective wart removal option. Liquid nitrogen is applied to the plantar wart with a spray or cotton swab. This destroys the tissue and causes a small blister to form over the spot. In a week or so, the dead skin will be gone.
It’s more painful to freeze off plantar warts than regular warts. They are deeper and harder to reach with the chemical. Multiple treatments spaced two to four weeks apart may be needed to remove the entire wart.
Immunotherapy for Warts
Plantar warts are your immune system’s response to an HPV infection. Immunotherapy uses medications or solutions to kickstart an immune reaction to fight off plantar warts. When other treatments don’t work, your provider can inject a substance into the wart or apply a topical solution to stimulate your immune system to aid in treatment.
Plantar Wart Removal Surgery
If every other treatment fails and you’re still troubled by painful plantar warts, surgery is needed. With surgery, there’s always a chance for scarring, which is why it’s a last resort for removing plantar warts.
There are many different types of wart removal surgery. Your provider will choose the best option for your case.
- Electrosurgery – Using an electric needle, your provider cuts out the infected wart tissue.
- Curettage – The plantar wart is dug out with a small spoon-like instrument.
- Laser surgery – Laser treatments burn the tiny blood vessels inside the plantar wart. Eventually, the infected tissue dies and the wart falls off. There is less potential for scarring than other surgeries.
How do you prevent warts from coming back?
Anyone can get plantar warts. But once you’ve had them, you’re more likely to get them again. You may not be able to prevent a recurrence entirely, but you can reduce your risk by following a few basic hygiene tips:
- Don’t touch a wart! This is how they spread. Don’t pick, scratch or touch them at all. Avoid direct contact with someone else’s warts too. If you do come in contact with a wart, wash your hands thoroughly along with any other body part or surface you touched before you washed up.
- Stay clean and dry. Moisture invites bacteria. Follow good foot hygiene by washing your feet regularly and drying them thoroughly after. Change your shoes and your socks when they feel wet.
- Protect the soles of your feet. HPV invades through cuts and breaks in the bottom of your feet. Wear shoes to protect your feet from abrasions or to keep existing cuts safe from infection. HPV spreads more easily at swimming pools, locker rooms and other public places people regularly walk barefoot. Wear flip flops or other shoes in these areas.
Children and teenagers frequent these public places more often and are less likely to practice proper foot hygiene. Check your own feet and your children’s regularly to spot plantar warts early before they spread and contact your provider as soon as you have a concern.