Warts are potentially painful sores on the skin that are seen across all age groups and levels of activity. Sometimes mistaken for simple calluses, having one or more warts can be a persistent problem that rarely resolves on its own. Common warts are found all over the body, including the hands and feet. Warts found on the bottom of the feet are called plantar warts (not ‘planter’ warts as often misspoken), and can be quite painful to walk on depending on their location and relative size. Many people wait years before seeking treatment, and in that time the wart may spread and become more resistant to treatment.
Warts are caused by a skin virus that enters the body through a break or crack in the skin. Often this occurs in the foot when one steps on a shed skin cell containing the virus. The viral infection results in a hard, callus type mass on the foot often with a cauliflower-like appearance. The virus also may lie dormant in the skin surrounding the wart, hidden from view. Warts are spread when people are barefoot together, including locker rooms, shower stalls, bathrooms, and other public places. Unfortunately the body’s immune system does not respond to the virus presence on its own as the infection is limited to the top layers of the skin. Other viruses will circulate throughout the body in the blood stream and trigger some type of defense mechanism in the body’s immune system. A skin wart will not generally incite this reaction, and treatment is usually necessary to create this immune reaction and eradicate the wart.
There is no medicine that on its own cures foot warts, and the virus can be hardy. However, the immune system is more than equipped to kill this virus if given the right nudge. Therapy involves removing the calloused skin and applying acids or other chemicals that either dissolve the warty material or increase skin exfoliation. This will result in a local skin inflammation process that activates the body’s immune system. Eventually, tit will recognize the virus and eradicates it by creating circulating antibodies. These eventually will seek out and destroy the virus. Freezing the skin can cause the same reaction, but requires a direct, potentially painful application of pure liquid nitrogen to freeze the thicker foot skin. Other less common treatment can include the use of immune system modifying topical medications, off-label use use of Tagamet (an anti-acid medication) in children and young adults, as well as injection therapies. Surgical removal with tissue burning or laser application to the wart base may also be considered, but a potentially high reinfection rate can seen due to the presence of untreated dormant virus in the skin surrounding the treated wart as an immune response is not generally created by surgical excision.
Once the immune reaction is successful, most people become permanently cured of the viral infection. Unfortunately, there are over fifty different strains of virus that can cause warts, and the immunity granted by the treatment will apply only to the specific strain of virus infecting our patients at the time of treatment. Fortunately, wart viruses are not as easily spread as a cold virus, and the chance of contracting another infection is not terribly high.