Plantar warts, or warts on the bottom of the feet, are caused by a virus. HPV or the Human Papiloma Virus, commonly causes warts throughout the body and is passed only through direct contact. This often occurs in public places (when walking barefoot) such as swimming pools, showers, locker rooms, gymnastics or karate classes. It may also be encountered with poorly cleaned equipment during a pedicure.

The virus is highly contagious and is a common problem encountered primarily by children and adolescents. However, this does not preclude adults (especially the elderly) from also catching the virus. Although warts can not be inherited, the infection often runs in families. This is both because exposure can happen at home and also that certain individuals inherit a tendency for the virus to present as a wart. 

Appearance of Plantar Warts

The diagnosis of plantar warts, or warts elsewhere, is usually not too difficult. The most common signs and symptoms of warts include:

  • Thickening of the Skin: Due to the repetitive stress of walking, plantar warts often resemble calluses and have thick, hard skin covering them.
  • Pain: Warts are often painful, especially with pressure or when sides of the wart is squeezed.This is especially problematic with plantar warts, as walking or standing can be painful.
  • Spreading: Without treatment, plantar warts generally spread to other areas of the feet or form a larger cluster around the original verruca.
  • Black Dots: Often you will hear people say "seed warts" or "my wart has seeds".  These small black dots seen in the thick tissue making up a wart are the most important feature to diagnosis a wart. These black dots are capillaries (small blood vessels) in the skin that supply the wart.   When the top of the wart is removed, little areas bleed (often called "pin-point bleeding") and confirms the diagnosis.

Treatment Options

Duct Tape. Topical Creams. Burning Off. Freezing Off. Laser Treatments. Everyone you talk to has their own remedy for how to get rid of warts. And if you walk down the aisle of a local pharmacy, you will find even more. The problem is that many over-the-counter and medical treatments utilized elsewhere on the body, will often fail when dealing with the thicker skin on the bottom of the foot.

When plantar skin is penetrated by topical treatments, including burning or freezing the area, it is often not strong enough to fully eliminate the virus. And as long as the virus exists, the wart can recur in the same spot or a different area of the foot.

If treatment is insufficient in time (including frequency of treatments required), depth (unable to get through layers of plantar skin) or only some of the lesions are treated, warts are likely to recur. And injury to surrounding tissue during any treatment can cause spreading and may even produce new warts to present.

Therefore, when dealing with plantar warts, it is crucial to kill the virus. A yeast injection to the biggest wart is often enough, to stimulate healing in the body and have it fight off the virus itself. Over the course of a couple weeks, warts are usually eliminated and because of the resistance the body has built up, aren't likely to come back.