Plantar Verrucae

A wart is a small growth in the skin that develops after contact with a wart-producing virus.  While a wart may develop anywhere on the foot, it most commonly occurs on the bottom of the foot.  When this happens, it is known as a plantar wart.  Plantar warts are most commonly seen in children and the elderly, but may effect anyone of any age. 

Two patterns of plantar wart growth are commonly seen.  Solitary warts may be seen as isolated warts on the bottom of the foot.  This type may grow in size, and can eventually lead to other warts along the bottom of the foot, commonly referred to as “satellite” warts.  Mosaic warts are another growth pattern, which is a large cluster of smaller warts.  These are often much more painful, and are more difficult to treat than single, solitary warts. 

Plantar warts, whether they are solitary or mosaic, are caused by direct contact with a particular strain of human paplloma virus (HPV).  This virus can cause warts on other body parts, but plantar warts will stay on the foot or hands.  They do not spread to other body parts. 

Plantar warts may appear as an area of thickened skin on the bottom foot.  They can be quite painful, particularly when squeezed from side to side.  Small black dots may be seen within the wart.  These dots are bits of dried blood from the capillaries of the skin.  The wart “steals” blood supply from the deeper skin, and the capillaries will grow into the skin. 

A podiatrist may diagnose a plantar wart through physical examination, as well as taking an account of the symptoms.

There is a large variety of treatment for plantar warts.  Topical treatments may include strong acids, laser therapy, cryotherapy (freezing the wart), or other forms of cautery.  For very large and difficult warts, surgical excision may be required. 

Some advocate oral therapy to help in the treatment of warts, including vitamin supplementation.  Some anti-viral medications have also been used. 

Many home remedies have been discussed, including covering the wart with duct tape.  These methods may work in some cases, however, the natural history for a plantar wart is to eventually resolve.  So, it is unclear whether it is the duct tape that is working, or simply giving the body time to clear up the wart on its own. 

Occasionally, a wart will be very resistant to treatment.  If a wart has an atypical treatment, or is unresponsive to various treatments, a biopsy may be warranted to rule out other causes of skin growth. 

Plantar warts should be managed by a podiatrist, as home treatment can result in injury.  Particularly in diabetic patients, home use of strong acids or other methods of removal can lead to dangerous complications.  

Central Florida Foot and Ankle Center 
101 6th St Nw 
Winter Haven, Fl 33881 
Phone: (863) 299-4551 
www.FLFootandAnkle.com