Warts (Verruca Plantaris)

Plantar warts (Verrucae plantaris) are a common problem affecting the feet. They are caused by a viral infection within the skin. The virus enters the skin directly and is typically transmitted by close contact. Swimming pools, bathrooms, and locker rooms are common areas associated with the spread of plantar warts.

Warts reach their peak incidence between the ages of 12 and 16, then decline in frequency. Many treatments are available and they all share one characteristic: there is a 10% recurrence rate. Although the actual mechanism is unknown, approximately 30 % of warts may spontaneously disappear within a period of three though six months. On the other hand, without treatment warts may persist for years, often increasing in size and number. Because warts are contagious they are infectious not only for the individual, but for the family and community as well.

Pain is typically felt clinically from side to side palpation. Upon debridement, multiple pinpoint bleeding sites are observed which are pathognomonic. This condition is called papillomatosis and results from cutting the ends of multiple capillaries that have proliferated from within the papillary layer of the dermis into the verruca.

Prevention of plantar warts is much enhanced by careful hygiene and the use of personal sandals or aqua socks when utilizing facilities that me a source of the virus. Walking without shoes is often the initiating event of this problem, as well as many other foot disorders and injuries. Wearing shoes without socks or stockings can result in reinfection.

This common, yet bothersome and persistent problem can be well controlled by professional treatment. The treatment that your physician recommends will be based upon your age, occupation and expectations. Topical acid creams or plasters combined with debridement are the main forms or treatment. Occlusal (salicylic acid in a flexible base) works very well and has high patient acceptance. Blunt enucleation with application of phenol to or electrical desiccation of the base of the verruca is a quick definitive approach that can be used as a primary or secondary treatment. The use of Vitamin A and Zinc has been beneficial in treating warts and is also useful to prevent recurrence. These supplements are present in many multi-vitamin preparations or they can be purchased separately and are found in the nutrition section of many large grocery stores.


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