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All About Warts

By Danielle Bannerman, BSc (Hons), DPodM

One of the most common complaints seen in a chiropody office is plantar warts. These are non-cancerous growths are caused by the Human Papilloma Virus (HPV). Different strains for this virus will result in different types and patterns of warts. While they may die naturally within two years, they may need to be removed sooner if they are irritating, painful, or continue to multiply. Because the incubation period for warts is 1-20 months, it is impossible to tell exactly when the virus was introduced into the body.

Anyone can contract the HPV, but plantar warts are most often seen in children and young adults. Incidence is also higher in people who share common bathing areas, such as gym members and swimmers.

In essence, HPV invades the body through tiny cuts or breaks in the skin. Normally, antibodies in the blood will destroy the virus, but sometimes it takes refuge in the skin resulting in a plantar wart. Therefore, a plantar wart is more likely to develop with repetitive HPV exposure, or a weakened immune system from of certain drugs or illness.

Warts can be firm, rough, bumpy lesions with tiny pinpoint dark spots inside or they can have a smooth surface with a grey-yellow or brown appearance. They can occur anywhere but those located on areas of pressure or bony prominences tend to be the most irritating. Some strains will result in clusters called mosaic warts.

Most often, a healthcare professional will apply a mild topical acid to treat plantar warts. This may include salicylic acid or cantharidin. These treatments usually require multiple applications over the course of several weeks. They work by disintegrating viral cells to allow healthy tissue to replace them. Cryotherapy involves freezing the wart with a very cold solution such as liquid nitrogen (sodium nitride). This destroys the virus, causing it to turn black and fall off within a few days. This treatment is ineffective in some cases, as the solution cannot penetrate deep enough to completely destroy the virus. Other treatments include laser therapy, debridement, and immunotherapy. With any wart, expect a minimum of three treatments, as they can be very persistent. The sooner a wart is treated, the better the treatment success.

Many simple habits can help prevent contracting a wart. Avoid walking barefoot whenever possible, especially in public shower rooms where your exposure to HPV is higher. Check children’s feet periodically. Avoid direct contact with warts on other people or other body parts. Do not ignore growths or changes in the skin. Keep a strong immune system with a balanced diet, adequate sleep, non-smoking, and good stress management techniques.