Foot Warts: Treatment Options For Long Lasting Relief - By: Scott Kilberg DPM

Warts are potentially painful sores on the skin that are seen across all age groups and levels of activity. Sometimes mistaken for simple calluses, having one or more warts can be a persistent problem that rarely resolves on its own. Common warts are found all over the body, including the hands and feet. Warts found on the bottom of the feet are called plantar warts (not ‘planter’ warts as often misspoken), and can be quite painful to walk on depending on their location and relative size. Many people wait years before seeking treatment, and in that time the wart may spread and become more resistant to treatment.

Warts are caused by a skin virus that infects the body through a break or crack in the skin. The infection source can come from viral cells left over on microscopic skin shedding from other infected individuals. It is not breathed in or otherwise contracted from basic human contact. Warts on the foot are particularly painful as they form a thick callus that receives constant pressure with walking. The virus directs skin cells to create more viruses, as well as the thick callus tissue which folds in and out, creating a cauliflower-like appearance. The virus also may lie dormant in the skin surrounding the wart, hidden from view. This fact is important for treatment reasons, and it will be discussed later in this article. As stated above, warts may potentially spread to other people, as the most common areas of infection are locker rooms, shower stalls, bathrooms, and other public places barefoot individuals are present. The body does not generally react to the presence of the virus on its own as the infection is limited to the top layers of the skin, Most viruses will circulate throughout the body, which will trigger some type of defense mechanism in the body’s immune system. A skin wart will not generally incite this reaction, and treatment is usually necessary to create this immune reaction and eradicate the wart.

Currently there is no true medical cure for foot warts. They may be extremely resistive to treatment. However, the body has an excellent mechanism for destroying the virus once it is stimulated into responding. Therapy involves removing the calloused skin and applying acids or other chemicals that either dissolve the warty material or increase skin exfoliation. This activity causes a generally painless local skin inflammation that activates the body’s immune system. Eventually, the body’s immune system recognizes the virus and eradicates it by creating circulating antibodies, which will destroy the virus. Freezing the skin can also be beneficial, although it is generally less effective than similar treatment for hand warts and requires a direct, potentially painful application of pure liquid nitrogen to freeze the thicker foot skin. Other less common treatment can include the use of immune system modifying topical medications, the potential off-label use use of Tagamet (an anti-acid medication) in children and young adults, as well as injection therapies. Surgical excision with cauterization or laser therapy to the wart base may also be considered, but a potentially high reinfection rate can seen due to the presence of untreated dormant virus in the skin surrounding the treated wart as an immune response is not generally created by surgical excision.

With an effective immune response, most patients are permanently cured of the viral infection, as the body circulates antibodies to the virus which will immediately destroy the virus once it is encountered. Unfortunately, there are over fifty different strains of virus that can cause warts, and the immunity granted by the treatment will apply only to the specific strain of virus infecting our patients at the time of treatment. The good news is that exposure to a wart virus is uncommon, unlike contracting a common cold virus, and simple precautions like wearing sandals in public showers or locker rooms will help prevent exposure. If a wart is noticed on the foot, it is better to have it treated early on as longevity can make the wart more resistant to treatment, and spreading along the foot can occur easily.

About the Author

Dr. Kilberg provides compassionate and complete foot and ankle care to adults and children in the Indianapolis area. He is board certified by the American Board of Podiatric Surgery, and is a member of the American Podiatric Medical Association. He enjoys providing comprehensive foot health information to the online community to help the public better understand their feet. Visit his practice website at http://www.inpodiatrygroup.com

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