Causes and Removal of Plantar Warts

What Are Plantar Warts?

Plantar warts are fleshy skin growths found on the soles of the feet. These flat, noncancerous growths usually develop beneath the pressure points in the feet such as the heels. Pressure on these warts may cause inward growth beneath a callus, which is a thick layer of hard skin.

Plantar warts can grow singly or in multiples, which may form a large cluster called a "mosaic wart."  They can appear on children and adults. They are referred to as solitary (single warts) or mosaic (multiple warts).

The warts are often caught when walking barefoot in a public place such as a gym locker room or swimming pool. The warts can also be passed between users of the same bathroom such as family.

4 examples of plantar warts on feet
Plantar Warts; Top: Large Plantar Warts, Cluster, Wart Starting to Form

Plantar Wart on Foot

Single Plantar Wart on FootSingle Plantar Wart on Foot

Causes

Plantar warts are caused by a viral infection on the top layer of the skin. The virus is called HPV or human papillomavirus. Many strains of the virus exist, and plantar warts are usually caused by HPV types 1 (most common cause), 2, 4 and 63, which are not the same as those that cause genital warts.

Warts spread from one person to another, either directly or indirectly. Anyone can get plantar warts, but they are most common among teenagers and rare in the elderly. The risk of getting a wart from another person varies, and people who have a weakened immune system are more likely to be susceptible. People who use communal showers and walk barefoot in public places are at risk. Viruses usually enter broken skin, so those who have open wounds are likely to catch the virus.

Mosaic Plantar Warts on FootMosaic or Multiple Plantar Warts on Foot

Symptoms

Plantar warts can grow in any part of the foot. They are usually flat and about the size of a pencil eraser. However, some warts can grow bigger or they may grow in clusters. Some warts have tiny black dots, which some people call “seed” warts. These dots are small clotted blood vessels that grow into the warts. These lesions may disrupt the normal lines and ridges found on the feet.

Calluses or corns may be mistaken for plantar warts. However, plantar warts can grow beneath the skin surface, where a thick layer of tough skin similar to a callus develops over it. These usually occur on the heel or ball of the feet. Pressure from standing or walking on these warts can cause pain, which is similar to walking with a tiny pebble inside the shoe.

Plantar warts are usually harmless, but you should see a doctor if:

  • They interfere with daily activities
  • They are painful
  • They change in color or appearance
  • They persist, recur, or multiply in spite of home treatments
  • You have diabetes
  • You have nerve damage or neuropathy in the feet
  • You have a weakened immune system (HIV/AIDS, other immune system disorders)
  • You doubt that it is a wart

Another sign is skin thickening.

Picture of 3 Plantar Warts on Foot3 Plantar Warts on Foot

Diagnosis

Doctors can usually tell if a lesion is a wart just by looking at it. However, the doctor may exclude other problems by taking a skin scraping and sending it to a laboratory for pathological examination.

plantar wart on footSingle Plantar Wart on Foot

Treatment

Home Treatment

Plantar warts may eventually go away without treatment. You can use some home treatments if they bother you, such as:

  • Applying a small strip of duct tape on the wart and leaving it on for six days. The tape is then removed, and the foot is soaked in water. The wart may be gently scrubbed off using an emery board or pumice stone.
  • Using over-the-counter wart removers to peel off or treat the wart such as Duofilm.  When using liquid treatments, let them dry for at least 5 minutes so that when covered, the liquid does not spread to wart free skin areas.
  • Placing a doughnut-shaped plaster around the wart for temporary pain relief such as Dr. Scholl's Foot and Shoe Padding with cut holes where the moles are located.
  • Remove any wart tape in the morning. Tip: if the tape tears at the skin use some nail-polish remover and apply it between the tape and the skin with a Q-tip.

Home treatments may take up to a few months to work. The warts will begin to turn color (a grayish hue) as the treatments begin to work. After a shower or bath scrape off any gray tissue using the a nail file point every 2 to 3 days. Removing all of the dead wart tissue will allow the medicine to penetrate those areas that still need to be treated.  Stop treatment if the wart feels sore for 2 to 3 days.

If you see healthy skin starting to appear in the wart area, then you know treatment is working.  It can take up to 4 months for warts to go away.  Always see a Doctor if warts become infected or are causing pain.

Plantar Warts CryotherapyCryotherapy (Freezing) Plantar Warts Treatment

Treating Stubborn Warts

Plantar Wart SurgeryPlantar Wart Surgery

If warts remain after 2 to 3 week, leave the tape on past the morning to noon time or later. Try keeping the tape on for 5 days to see if you can make any progress. After the 5 day period do not treat for 2 days, followed by another 5 day stretch.  Always defer to the manufacturers directions.

A physician may recommend home treatment, laser therapy, cryotherapy (freezing) or surgical removal.  Cryotherapy uses liquid nitrogen to freeze the wart. Surgical removal is done in-office and starts with a numbing of the area followed by a cutting of the area around the wart.

If these treatments do not work, a biopsy of the wart can indicate another cause. 

Plantar Wart Removal with Surgery


Example of surgical removal of a plantar wart using an in-office procedure.
 
 

Recurring Warts

Foot warts may also reappear even with successful removal. If they cause too much pain, you may ask a doctor to remove them. Medical treatment may consist of injections, laser treatment, cryotherapy, or minor surgery.

Brochures

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References

WebMD. Plantar Warts and Palmer Warts. 

Cole, G. Plantar Warts. eMedicinehealth.com.

Mayo Clinic. Plantar Warts

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