Warts

Warts (aka Verruca) typically appear on hands and feet. They present as rough small tumors or cauliflower like or a solid blister. The virus that causes plantar warts is not highly contagious but can be transmitted through tiny cuts or breaks in skin. Since everyone has a different immune system, not every person who comes in contact with the virus will develop a wart. The virus is called the human papillomavirus of which there are 100 types.

Plantar warts have increased incidence in children and young adults between 12-16 years old who share dormitories, gym facilities and common bathing areas. Warts can be persistent and new warts can grow as fast as old warts disappear. If wars are untreated they can grow in size or develop clusters called mosaic warts. They can be painful especially if they grow on weight bearing surfaces. Usually the portion of the wart under the skin is two times the size of the wart you see, it tends to grow into deeper layers of skin due to pressure.

You should seek medical advice if:

• Your warts change in size or color
• If they become painful
• If they persist, recur or multiply in spite of home treatment
• If you have diabetes, circulatory problems
• If you cannot confidently identify the lesion.

Simple examination by a podiatrist can let you know if warts are present. The doctor may "pare" the lump (remove the hard outer skin) with a scalpel. Corns and calluses do not have a blood supply and should not bleed but warts have pinpoint bleeding when debrided. If your doctor is unsure or concerned a small sample or biopsy may be sent to a lab for evaluation.

Warts are self limiting and will eventually go away on their own, if you chose to wait. But in the meantime they can be painful, unsightly, and multiply so the advice is to treat them. You can try over the counter remedies which in time will work but this is not the recommended course for anyone who is immuno-compromised, diabetic or pregnant.

Doctors usually use common treatments in combination such as;

Salicylic acid in a 40% concentration. The acid peels off the infected skin a little at a time. This can take months and healthy skin must be protected.

Freezing (cryotherapy) is the most common treatment and usually effective but also requires several applications. The chemical can cause a blister and the wart tissue sloughs off.

Cantharidin is a substance extracted from the blister beetle and has been used for centuries. The beetle juice can cause a blister lifting the wart from the skin.

Duct tape was applied to warts in a study in 2002 where after 7 days the tape was removed, the wart soaked and rubbed with an emery board. It was found that after several months the warts vanished.

• Electrodessication
• Laser surgery
• Immunotherapy
• Imiquinod (Aldara)

None of these treatments should be used without doctors care if you are diabetic, pregnant, breast feeding or immunocompromised. Prevention is the key!

• Do not pick warts that can spread the virus.
• Do not go barefoot in public areas. Wear shoes or sandals at public pools or locker rooms.
• Avoid contact with warts.
• Keep your feet clean and dry.