Planter Warts

Call your doctor if simple home therapy fails to resolve the problem. Usually a primary care doctor can adequately treat plantar warts. If treatment under a physician's care fails to work satisfactorily, a referral to a dermatologist (a skin specialist) may be necessary.

Warts will appear over a relatively short period of time in an area where no callus tissue has been noted before. Corns and calluses usually develop very gradually over several years. It is wise to consult a physician when you are unsure whether you have a plantar wart or another condition, such as a corn, callus, mole, or skin lesion.

Most such growths are harmless, but some can become cancerous. It is also possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as a wart.

Seek medical attention for these conditions:

• You or your child have warts and want them removed.
• Severe pain, redness, swelling, bleeding, or large lesions develop.
• After removal by a physician by various methods, including freezing or burning, signs of infection appear at the treatment site. If the area becomes red, hot, painful, and tender after treatment, an infection may have set in.
• After treatment, fever develops.
• Warts don't disappear completely after treatment.
• Other warts appear after treatment.

Plantar warts are rarely an emergency; however, the complications of aggressive therapy can be. Bleeding, severe pain, inability to walk, redness, swelling, streaking, and boil or abscess formation can all indicate an emergency.

Self-Care at Home

Warts   generally go away on their own within months or years. Because of the discomfort associated with plantar warts, removing them is usually the best course of action.

• For temporary relief of pain, place a doughnut-shaped piece of moleskin around the wart. You can buy this at the drug store.
• Plantar warts thrive on moisture, so keep your feet very dry. Wear socks made of a moisture-wicking synthetic such as polypropylene (or you can use cotton and change socks frequently). Change your socks twice a day and apply a medicated foot powder such as Reabsorb.

To remove warts yourself, you may try home treatments usually applied directly to the wart. Note that all of these methods can take considerable time to work, often months. Treatment should continue until the wart has disappeared or complications such as pain or infection occur.

Salicylic acid

To kill the wart, apply an over-the-counter salicylic acid preparation, available at the pharmacy in liquid, gel, pad, or ointment. Some familiar brand names are Dr. Scholl's Wart Remover, Compound W, Free zone, and Wart-Off. Be sure to follow package directions because over application of these products can burn the skin. Periodically sand and re-treat the wart. It can take several months to get rid of a large one. Warts can spread, so monitor your feet closely and treat warts when they are small.

• Soak the affected area in warm water for 5 minutes before applying the salicylic acid. This will enhance the effects of the medications .
• Remove any loose tissue with a brush, washcloth, or emery board and dry thoroughly. It is also important to file away as much of the overlying callus tissue as possible so that the medication can penetrate the wart properly.

In general, you should see improvement in 1-2 weeks. If such treatment does not yield results after several weeks, you should see your doctor for more aggressive methods of wart removal.

The prolonged use of this medications is not recommended, especially in infants, people with diabetes  , and others with impaired circulation.

Do not use salicylic acid on moles, birthmarks, or warts with hair growing from them, genital or facial warts, or warts on mucous membranes, irritated skin, or any area that is infected or reddened.

A commercial preparation containing about 17% salicylic acid and 17% lactic acid in a fast-drying solution (for example, Duo film or Dermatitis Wart Treatment) is applied daily after showering. The preparation is allowed to dry and the wart covered with waterproof tape, which is removed after the next shower or bath. You can pare the wart once a week with a sharp blade (or a family member can do it for you). It may take many months to clear the wart with this method.

A mixture of 20% Formalin in aqueous solution, available by prescription, is applied daily after showering. The wart is pared once a week with a sharp blade. It may take many months to clear the wart.

Hot water or hyperthermia treatment

The affected area is immersed in hot water for 90 minutes daily. It may take many months to clear the wart.

Vitamin A

Another option is to apply vitamin A once a day by breaking open a capsule and squeezing the liquid onto the wart. It can take anywhere from 1-9 months for warts to disappear using this method.

Follow-up

Follow your physician's directions. Overuse of prescribed medicines can lead to damaging results.

Prevention

• Avoid walking barefoot, except on sandy beaches. Use shower thongs or sandals, particularly in public shower rooms.
• Change shoes and socks daily.
• Keep your feet clean and dry.
• Check children's feet periodically.
• Avoid direct contact with warts from other people or from other parts of the body. Don't touch warts on other people. To keep from spreading warts, don't scratch them. Warts spread readily to small cuts and scratches
• Do not ignore growths on, or changes in, your skin.
• Prevention consists of avoiding sharing socks, shoes, and showering facilities.
• Protect the skin from injury and wash hands frequently. Warts should be covered with waterproof tape in wet environments such as showers and swimming pools to avoid infecting yourself or others.

Outlook

Regardless of the home treatment or medical treatment used, a cure is not guaranteed. Warts may reappear at any time. Most therapies require several treatments and strict adherence to them. Work with your doctor or dermatologist to determine which therapy is right for you.

• In up to 60% of cases, plantar warts go into "spontaneous remission." The wart subsides and disappears because of the action of the body's immune system  . However, plantar warts, left untreated, can (rarely) lead to precancerous lesions.
• Untreated, plantar warts may grow up to an inch across and spread into clusters.
• A painful scar on the sole of the foot can pose an even more severe problem, which is why surgery is not the first choice of treatment.
• Many of these viruses die within 1-2 years, and the warts they produce simply disappear. While they last, though, the warts are ugly, irritating, and often painful. For these reasons, many podiatrists (foot specialists) recommend having plantar warts removed.
• Warts can grow back. This indicates a virus is still in the body and growing. However, this is not cause for undue alarm. The virus that causes plantar warts is relatively harmless and causes few problems. Warts can spread to other parts of the body, particularly if scratching a wart causes it to bleed. Blood from a wart contains the virus and can cause a new wart to grow in an area that it touches. Therefore, it is important that warts be treated so they can be eliminated as quickly as possible.
• Infection, pain, and scarring may result from overly aggressive home therapy penetrating beneath the skin surface or epidermis. Pain can spread to other sites, and warts can be transmitted to others because of ineffective treatment.