A common problem on the foot is a thickening of the skin from a virus infection, called a wart or Verruca. This problem can occur anywhere on the skin, but commonly is encountered on the hands or feet, especially the plantar surface (bottom surface) of the foot. A Plantar Wart is this presentation on the plantar surface of the foot and is often painful or problematic. Although other skin lesions can present in similar areas, this is a common problem that should be evaluated and treated.
Since Verruca Plantaris or Plantar Warts are caused by a virus, treatments are usually more difficult than a standard infection. Some treatments work, others typically fail. Warts on other surfaces, away from the thick plantar surface of the skin, are usually easier to resolve and take less treatment to improve. Remember that treatments that commonly work throughout the skin of the body will often fail on the thick skin of the plantar foot, because the treatments fail to penetrate deep enough without causing futher injury.
- Duct Tape: In a study run in Seattle, Washington, duct tape was shown to improve warts on the feet by one of two mechanisms: 1) Adhesive in duct tape causing viral death of the cells. or 2) Killing the cells (and thus the virus) by suffucation. For either of these to work, however, the tape must be administered carefully as follows:
- Clean area carefully and dry completely.
- Apply Duct Tape to area. This must be large enough to stay on the foot for 3-5 days.
- Don't remove tape for at least 3-5 days to allow time for tape to work. Shorter periods of wear have been shown to be less effective.
- Remove tape and start over. This may take several months 3-5 months to resolve the problem, but has been shown to be effective. You can add other treatments, such as salicylic acid plaster, etc. under the tape to increase the effectiveness.
- Topical Treatments: There are multiple topical treatments including salicylic acid plasters, herbal medications and other over-the-counter remedies. Most are not super effective on Plantar Warts because of the skin thickness. They may also lead to further spread due to injury of the surrounding tissues.
- Chemotherapy Medications: Many people hear about bleomycin or other cancer medications that can be injected into the area and destroy the virus. These are often successful, but cause significant pain during the recovery period and can therefore be problematic. Use care when choosing this option to treat warts on the bottom of the foot.
- Oral Tagamet: In children, high doses of Tagamet have been shown to resolve warts ver a period of several months. This doesn't work in adults, since the dosage can not be sufficient. This care should be undergone with the assistance of your physician, but can be a valid option for your child.
- Antigen Injection: A newer treatment consisting of injection of a candida Ag to stimulate the body to send cells to the foot to fight off the virus. The antigen causes an immune response that calls the immune cells to the area and causes the body to then recognize the virus as abnormal. Although this treatment is painful, it will often resolve the problem in a 4-6 week period without pain (after the shot) and without need for additional treatments. This is a valuable treatment, because it stimulates the immune response an tries to eliminate the virus, not just the wart.
- Burning or Freezing: Although still commonly used, these treatments typically fail on the plantar aspect of the foot due to the thickness of the skin. The treatment may be successful in other areas of the foot or body.
- Laser Treatment: This treatment is a specialized form of burning and when done appropriately can succeed even on the plantar surface of the foot. It will often lead to a period of pain during recovery and may require anesthetic to undergo the treatment. Newer lasers are being used that cause less pain and shorter periods of discomfort.
- Surgical Removal: Excision is often the final step when other treatments fail. It is only recommended after failure of other treatments, because the area will be painful for 2-4 weeks during recovery and will limit regular activities. This option is usually successful, but in a small percentage of treatments, the wart returns.
To help you determine if you have a wart, the following questions should be reviewed:
- Who Gets Warts? - Discussion of the common presentations of verruca or warts.
- Do I Have A Wart? - Discussion of the characteristics to assist in the diagnosis of a wart.
- What Causes A Wart? - Discussion of the causitive virus for warts.
- Do Common Treatment Options Work?