Plantar Warts: Diagnosis, Prevention, Treatment

Definition

Plantar warts are small skin protuberances, often painful and annoying, which can develop in any area of ​​the sole of the foot or involve only the toes.

Similarly to other types of warts, plantar warts are also caused by the papilloma virus: penetrating the skin through micro-lesions, the pathogen manifests all its virulence, producing tiny skin growths that take on the typical yellow-greyish color and a characteristic round shape.

Diagnosis

The diagnosis for plantar warts is fairly straightforward and consists of a simple physical examination of the lesion. At sight, the wart has a structure comparable to that of a miniature cauliflower, with punctate petechiae inside; on the surface there are particular skin striae that resemble fingerprints. Sometimes, plantar warts are so small that they are mistaken for a simple callus or callus.
Unlike corns, however, plantar warts tend to be painful, especially as a result of pressure exerted on them.
If in doubt, the doctor can take a sample of suspect tissue by scraping, for subsequent cytological (cellular) control in the laboratory.

Treatment

Although plantar warts tend to self-resolve in a short period, drug therapy is necessary when the lesions negatively affect the quality of life of the victim. In fact, some plantar warts cause sores so annoying and expanded as to compromise posture and walking. Do not forget, then, the very high percentage of relapses and the real risk of permanent scars forming at the points where the warts have arisen. To reduce these possibilities, the advice is to contact a specialized center as soon as possible to undertake a solution therapy early.
When plantar warts are small in size, the doctor can opt for a specific podiatry treatment, which is essentially based on the use of substances such as salicylic acid, trichloroacetic acid, nitric acid and liquid nitrogen. As shown by a study reported in the journal Health technology assessment, after 12 weeks of daily treatment with salicylic acid (known chemical exfoliating-keratolytic agent), applied in the form of a cream directly on the lesions, 10-15% of patients suffering from warts recover completely.
Otherwise, larger warts or multiple warty lesions require more invasive therapy. In such circumstances, the most appropriate treatment is surgical removal, a simple procedure - quick and not very painful - which takes place in the clinic.
The alternatives to classic surgery are:

• Cauterization: the destruction of the plantar wart occurs by burning with caustic substances
• Electro-drying: the wart is removed by surface drying and subsequent curettage (scraping)
• Laser-surgery: painful and rather expensive operation, indicated for large warts and difficult to treat with other methods

Please note
The most appropriate choice for the treatment of this disorder depends on the area where the warts have arisen, their depth, the number and extent of the skin area involved.

Prevention

Analyzing the scientific statistics, it is easy to discover how people who walk without shoes - see for example indigenous peoples - are (almost) immune to plantar warts. According to this, it seems that walking without shoes is an effective stratagem to prevent the papilloma virus from taking root on the skin of the feet, therefore from originating warts. Walking barefoot, in fact, the skin of the feet becomes thicker and more resistant, such as to protect the feet from similar injuries. Conversely, it seems that the humidity of the foot enclosed in the shoe creates the ideal conditions for the replication of the papilloma virus at the level of the feet.
Considering that in modern society it is almost impossible to constantly walk barefoot, the advice is to take off shoes and socks after walking in common and damp places such as changing rooms or gyms. Alternatively, you can wear simple flip flops until your feet have dried completely.
Considering, then, that plantar warts are an extremely contagious phenomenon, it is evident how important it is to take the necessary precautions to avoid contracting (or transmitting) the papilloma virus by direct contact. For this purpose, the most important precautionary lines to limit the spread of the infection are:

1. Wear flip-flops when using communal bathrooms, showers, and changing rooms
2. Avoid mixed use of toiletries such as towels and socks
3. Cover plantar warts with a special adhesive bandage during swimming
4. Change your socks every day
5. Air your shoes after wearing them
6. Keep your feet clean and dry
7. Don't touch other people's warts
8. Do not scratch the plantar warts to minimize the risk of spreading the infection
9. Wash your hands often
10. Protect the micro cuts on the feet with sterile gauze or patches

Today, an effective vaccine for the prophylaxis of plantar warts has not yet been identified: as we know, in fact, these lesions can be caused by numerous and different strains of Papilloma virus (which makes it difficult to isolate an effective vaccine for the prevention of plantar warts). .

Curiosity

Vaccines used for the prevention of papilloma virus (eg Cervarix, active against HPV strains 16 and 18) are generally administered to prevent both precancerous lesions in the cervix and cervical cancer; Gardasil vaccines ( active against HPV strains 6, 11, 16 and 18), Gardasil-9 and Silgard also protect against the development of genital warts (genital warts).
Considering that plantar warts are generally induced by strains 1, 2, 4 and 63 of the papilloma virus, it is understandable why the vaccines currently marketed against this virus (Cervarix and Gardasil) are not effective in protecting against plantar warts.