Warts on the feet are called plantar warts or “Verruca plantaris”. Like any other wart it is caused by the HPV infection and appear on the sole of the foot, toes and also quite often on other parts of the foot which you put pressure on. Plantar warts will eventually disappear by themselves, but they can be very long lived. Not seldom a plantar wart will endure for several years. Treatment is highly recommended if you are uncomfortable with your warts, as well as to reduce the symptoms and lower the risk of transferring HPV to others around you.

What the plantar warts often look like and what symptoms they cause:

•Thickened skin. Often a plantar wart, a foot wart, generates a layer of thickened skin which, sometimes to an astonishing degree, looks like any callus because of its tough, thick tissue. It is sometimes said that plantar warts have the shape of a cauliflower.
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•Small, black spots. The small, black spots, the size of a needle point, can sometimes be seen on the surface, but are most often recessed in the centre of the wart. A good way to differentiate a wart and a callus is to look for exactly these spots. The spots themselves are caused by dried-up blood in the capillaries (small blood vessels) at the skin surface near or under the wart.
•Clusters of warts. Plantar warts can spread over the sole of the foot and develop into a cluster of many small warts, known as mosaic warts. This is not terribly uncommon and will naturally cause increased infectious spreading, discomfort and pain.
•Pain. Walking and standing can be painful, especially if the wart is large and appears just on a pressured surface where a lot of weight is applied, i.e. the heel. Sideways pressure on the wart may also cause pain, though often in a lesser amount. One good tip is to use shoes with soft insoles to reduce the pain. Wart treatment can affect the pain both ways, but in general the smaller warts hurt less.

This is how you get infected
Infection of plantar warts most commonly happens when walking on moist surfaces such as shower rooms and by pools. It is not completely improbable that most people are infected with HPV in changing rooms and showers at schools and in compounds. HPV is a robust virus which sadly can survive for months and months outside of a host or human body. It is not really easy to get infected by exposure, but as the virus survives for a long period of time on tiles we are constantly exposed to the risk of infection – and susceptibles will eventually get infected. The risk of infection will increase with abrasions or cuts and is transmitted by direct contact with HPV. After being infected it may take weeks or even months before the warts have grown sufficiently to be visible to the naked eye. Children are overly represented as carriers, but in time and after being infected the immune system will develop defences against the virus as they grow older. Even adults will experience warts, but much less often – and most often the infection is considerably milder.

Prevent infection from HPV
It is possible to prevent a plantar wart infection and a solid tip is simply to walk barefoot a lot where there is no risk of infection. The skin will develop a thick protective skin on the sole of the foot which makes it hard for the virus to penetrate. Other measures to prevent infection of plantar warts are to not share shoes and socks with others, avoid direct contact with warts found other places on your body and avoid touching other peoples warts. You should also scrub the soles of your feet in the shower to reduce the risk of being infected.

As warts are contagious there are safety measures to induce for those infected. Three good tips are:

1. Use flip flops/sandals in shower and changing rooms.
2. Cover your warts with plasters if you do not want to wear sandals.
3. Do not share your towel, shoes or socks.

Treat plantar warts
There is a wide array of different kinds of treatments for plantar warts. In general, the foot wart is harder to treat than any other kind of warts. The reason for this may be that it is placed under the footpad, it does not get enough air and gets plenty of sweat to help it grow. The plantar warts are regarded as tougher because they have to penetrate the thick skin under the foot, and when it finally has found its way it is firmly in place. There are different types of medications and treatments which can remove plantar warts. Some people with major issues of pain sometimes opt for a surgical solution to remove the wart structure. Mostly, if you have the patience, the wart will succumb if you treat it tenaciously with wart medications.

Medications for warts
•Medications and treatments based on salicylic acid that dissolves and destroys the tissue of the wart are available both with and without prescription. The prescription medications have a higher concentration of acid than the non-prescription ones. Reportedly 12 weeks of daily treatment with salicylic acid has shown to result in a complete healing of warts in 10-15% of the cases.
•Cantharidin, also known as Blister beetle extract. This is a substance for doctors to apply to a wart, which will produce a blister after 4-6 hours. This process is aiming for destroying the tissue of the wart. The treatment is very often effective but results in a wound that will cause pain after the treatment. The procedure might have to be repeated to kill the somewhat persistent virus.
•Immunotherapy. This treatment consists of antigens injected into a new wart to stimulate a reaction from the patients immune system towards the wart. The aim of provoking this reaction is to remove and heal the wart. Immunotherapy is nowadays recommended as a second choice treatment. This treatment is not commonly used in the UK.