Verrucae: The common plantar wart

What are Verrucae?

Verrucae, commonly known as plantar warts, are small viral lesions that can appear anywhere on your feet. They are most common in weight-bearing areas, on the soles of your feet and on the tip of your toes. Unless you are checking your feet regularly, they can be present for some time without your knowledge, until they are large enough in size or numbers to become painful and noticeable. Typically, warts in weight-bearing areas tend to vary from causing mild discomfort to extreme pain.

What causes plantar warts?

Verrucae or plantar warts are caused by the human papilloma virus (HPV) which prospers in warm, moist environments. Communal facilities including showers, swimming pools, change rooms and gyms are examples of such environments.

Direct skin contact with the virus in these environments can be enough to contract a wart. It is easier for the virus to penetrate if you have an open cut, scratch or wound on your foot. Children and those with reduced immunity are at greater risk.

Verruace signs and symptoms

Signs and symptoms of verrucae can include:

• A growth of hard skin on the sole of your foot on a specific spot
• A soft, fleshy growth on the sole of the foot
• A lesion that interrupts your regular skin striations (skin lines)
• Pain when standing or walking

Is treatment required?

In healthy people, warts rarely pose a major threat. However, there are risks and complications when neglecting treatment of a plantar wart.

These risks may include:

• Pain, particularly when the wart is on a prominent weight-bearing area of the foot (balls of feet, heels, toes)
• Thick overlying callus build up and resultant scarring
• Spreading to other areas of the foot
• Formation of smaller clusters of multiple warts
• Spreading to other family members
• Unattractive appearance
• Increased treatment resistance
• Walking compensations which can result in other areas of pain and further injuries

Sometimes our immune system finds it difficult to detect warts. Therefore, mounting an appropriate and strong immune response can take considerable time (in some cases over 6 months for children, and years for adults), by which time you may be experiencing one or more complications.

Treatment options for plantar warts

Initial treatment is diagnosis and ensuring you are dealing with a wart and not another pathology such as corns, callus, blisters or a foreign body lesion. This diagnosis can be made during an initial consultation by a podiatrist with visual examination of the area of concern.

Treatment is normally started by debriding (removal) of any overlying callus (hard skin) and exposing the wart. After this, the best treatment option will depend on various factors including the location, size and depth of the wart.

Common podiatry options for treatment at our Melbourne clinic include salicylic acid application, cryotherapy (liquid nitrogen) and silver nitrate application.

Tips for verrucae prevention include:

• Having good basic foot hygiene
• Treating any tinea/athlete’s foot
• Drying feet well – especially in-between toes
• Wearing thongs in communal areas
• Avoiding touching and picking at the wart (to reduce chances of spreading)

You should visit one of our Melbourne podiatrists if you suspect you may have a plantar wart. Early treatment for plantar warts can reduce treatment length, minimise pain and more importantly help prevent the wart from spreading.