WARTS, PLANTAR

About Your Diagnosis
All warts including plantar warts are caused by the family of viruses called the human papillomavirus (HPV) group. Certain HPV viruses are more likely to
infect one area of the body than the other. In the case of plantar warts, the HPV virus infects the bottom of the foot. Anyone can get warts; they are very common in the United States. The most likely group of individuals to get warts are those between the ages of 10 and 20 years. Plantar warts are often obtained by walking barefoot in public locker rooms, showers, and pool areas. Individuals with plantar warts leave the virus behind on the moist floor, which is then picked up by bare feet. Plantar warts can be a big problem because they are on the bottom of the foot. When we stand on them, the warts are like a big lump in our shoe and it hurts. The pain can become so severe that simply standing becomes difficult.

Living With Your Diagnosis
A plantar wart begins as a thickening of the skin on the bottom of the foot. At first this may seem like a small callous or bunion, but over time the plantar wart becomes larger, hurts, and takes on a very sharp border. It is flat, usually flesh colored, but can bleed and become brown or blackish. The plantar wart will often grow and make walking, running, and even standing very painful. A large number of plantar warts will go away on their own; more than 65% of all warts will go away in 2 years with no treatment.

Treatment
Because the plantar wart forms on the sole of the foot, it is often covered by thick skin. After soaking in a shower or bath, gentle abrasion with a coarse cloth or pumice rock will remove some of this thick skin. This will help the medication to get to the wart but not go too deeply and cause soreness or bleeding. The usual medication placed on a plantar wart is 40% salicylic acid in plaster form (Duoplast). Salicylic acid ointment can also be applied and covered with an occlusive tape. The premade plaster (Duoplast) is easier to use. The plaster is cut to the size of the plantar wart and applied once a week. The acid will kill the wart and the skin around it. Each time the plaster is taken off, the underlying whitish dead skin must be removed. Sometimes the plaster will cause inflammation and tenderness. If this occurs you should stop the treatment for 2 or 3 days. Treatment should be continued until the wart is gone. This may take several weeks. If the plantar wart does not go away, or if it becomes very sore with treatment, you need to call your doctor. Your doctor has other treatments that may be more successful. Warts can come back even after a cure. You must remember to avoid reinfection if at all possible.

The DOs
• Do treat plantar warts early; waiting makes treatment more difficult.
• Do wear protective footwear (flip flops, sandals) in public showers, locker rooms, and pool areas.
• Do gently remove dead skin overlying the wart.
• Do use salicylic acid plasters or ointment on plantar warts.
• Do wash hands after touching your plantar warts.

The DON’Ts
• Don’t cut, dig, or pick at your plantar warts.
• Don’t put your feet in contact with warts on other parts of the body.
• Don’t cause your warts to bleed.
• Don’t continue treatment of your plantar warts if they become painful or sore.

When to Call Your Doctor
• If your wart does not go away with salicylic acid treatment, or if it becomes worse.