September 2010 – Patient Sympathy

August 2010 – Back to School Shoewear

July 2010 – Womens Shoewear

June 2010 – Summer Foot Care

May 2010 – Skin

April 2010 – Ingrown Toenails

March 2010 – Barefoot Running

February 2010 – Pediatric Flatfoot

January 2010 – Being a Compliant Patient

December 2009 – Raynaud’s Disease

November 2009 – NA

October 2009 – Shin Splints

September 2009 – Dealing with Corns and Callouses

August 2009 – Relieving Painful Gout

July 2009 – Caring for Plantar Warts

June 2009 – Bunions

May 2009 – Children's Heel Pain

March/April 2009 – Heel Pain

February 2009 – Shoe Fitting

January 2009 – Nail Fungus

December 2008 – Neuroma

November 2008 – Diabetic Foot Care

PLANTAR WARTS

July 2009 - Foot Issues by James J. DeLorenzo, DPM

Published in - Healthy Lifestyles

In spite of the name, plantar warts or verruca plantaris, has nothing to do with a garden, plants, flowers or even vegetables, for that matter. The word “plantar” means the bottom, or sole, of the foot. Wart is another word for virus. In particular, a plantar wart is a Human Papilloma Virus, or HPV, which is a benign (non-cancerous) soft tissue tumor or mass, relegated to the epithelium of the sole of the foot.

Like any virus that causes a cold, the flu, herpes or even HIV, there has to be a way for the virus to get into our bodies to set up shop, as it were. If a virus does happen to get through the skin, it may not show up for weeks or months later, or at all. And just like the flu or a cold, you need to be susceptible to the virus for it to grow, develop and spread. This is also the case with plantar warts. And spread they will, if not cared for promptly and completely.

The skin is our first line of defense from the outside world. Without it we would succumb to an endless array of injuries, bacteria and other insults that would cause us humans to perish quickly. Our skin layers (dermis and epidermis) really are quite amazing in protecting us. Think of all the things we do that put a tremendous amount of stress and strain on our skin. Run around barefoot during the summer on concrete or sand, or step on some gravel or twigs? It does seem to hold up pretty well for such a thin layer of protection.

So what does a plantar wart look or feel like? For the most part they resemble a corn or a callous both in look and feel and can be quite uncomfortable, or outright painful. All three cause a thickening of the skin usually on a weight-bearing surface or areas of high pressure or friction. The balls of the feet and heels are typically the sites since this is where the sole or plantar aspect of the foot comes into contact with the ground. A wart will typically have black, pinpoint spotting within the center of the lesion. These are tiny thrombosed blood vessels that bleed easily.

Frequently, when new pediatric patients come into the office for a complaint of a painful callous, it usually isn’t a callous. Nine times out of ten, it’s a plantar wart. Most children do not develop callouses or corns. Adults, on the other hand, usually do have callouses and not warts. (Callouses and corns develop due to pressure or friction over bony spots or areas of decreased padding). Warts can crop up in various places, although usually on weight-bearing surfaces. This is mainly due to the increased shearing forces at these sites from walking, running or rubbing against ill-fitting shoewear.

Stepping on anything that gets into or through the skin opens up a pathway for bacteria, foreign bodies, and yes, even some viruses. All are ubiquitous in the environment. Most of the time there is no concern for alarm and there is no need to be running into our office to be checked. Unless, of course, it is a piece of glass, or other foreign bodies which need to be removed pronto to avoid any infection.

The best protection are sandals, water shoes or flip-flops. Flip-flops? A podiatrist that recommends flip-flops? He must be a heretic. Hey, if it’s the only thing I can get you to wear to protect yourself, I’m all for it.

Please keep in mind that being in or around a pool is not a guarantee for contracting plantar warts. It is the moist environment that the soles of your feet are constantly in that contribute to the possibility of becoming infected. The constantly wet/ moist skin is ideal for entry of any of a number of foreign bodies to penetrate and cause a problem.

Plantar warts can also be picked up from your shower at home, from someone else in the household, sweaty feet in the same sneakers or shoes day after day. Locker rooms at the gym, playing sports in sweaty cleats, borrowing sandals, running shoes etc, are all possible areas that are ideal for entry of a virus. Please remember that Athlete’s foot, a fungus, also love a moist, dark warm environment to proliferate.

Although I’m not against using Over-The-Counter medications as a rule, there really needs to be a judicious use of them when treating plantar warts, or any other condition. There are many ways, as you will find or hear, to treat warts and each may work in varying degrees. I just ask that you be careful in doing so on your own. If you find you’re not getting any results soon to contact a podiatrist. We are the physicians that specialize in all conditions of the feet and ankles. Feet, it’s what we do all day, everyday.

VARIOUS TREATMENTS

Over The Counter Medications
Compound W
Duct Tape
An Old Irish Witches Remedy
A multitude of home remedies
Cryotherapy
Homeopathic remedies
Prescription Medications
Topical
Oral
Sandals, Water shoes, Flip-Flops
LASER Surgery