Verruca and Warts

Plantar warts or verrucas are a common problem affecting the foot. Plantar warts usually present on the plantar (bottom) aspect of the foot or on the sides of the toes.

Plantar warts are caused by a blood-borne virus called the human papilloma virus (HPV). The two most common strains of this virus that cause plantar warts are the HPV 2 and the HPV 4. The virus finds its way into the body via a site of trauma and then grows on skin cells called keratinocytes. The wart virus then causes the skin cells to mutate and grow. This virus thus manifests itself in a verrucous tumour that we commonly know as a wart.

The appearance of plantar warts is usually soft, white spongy lesions that will break into pinprick haemorrhages when traumatised. Some plantar warts on the plantar aspect of the foot are covered by calluses or hard skin, which will make their appearance vary.

The main difference between plantar warts on the soles of the feet and warts in other locations of the body is that the pressure associated with standing on the wart causes the wart to grow inwards instead of outwards.

Diagnosis of a wart is usually made on its physical appearance or, if there is a substantial amount of callus tissue covering the wart, this is debrided and then examined. One simple diagnostic test for a wart it to apply lateral pressure to the wart (pinch it). If there is a sharp stabbing pain the lesion is most likely a wart.

There are many options to consider when treating plantar warts. Usually the treatment will consist of your podiatrist debriding any dead, warty tissue that may be covering the wart. Then your podiatrist will apply a strong keratolytic preparation (usually salicylic acid). This process will be repeated approximately once per week until the wart is removed.

Other options such as freezing, surgical removal of the wart and electrocautery are also available. The type of treatment will depend greatly on the patient and the location of warts on the body.