Plantar warts are non-cancerous lesions caused by the human papillomavirus (HPV). Early treatment and removal of wart is crucial to eliminate the virus and reduces risk of transmission. We offer topical (non-surgical) and surgical wart treatment options​. However, Long lasting, unresolveable wart may indicate squamous cell carcinoma (benign SCC cancer)

• Warts are Contagious! Hence, do not touch them with bare hands

  • Transmitted through person to person or person to environment contact

  • Often in swimming pools and enter through a portal of entry in skin (ex. A cut) 

• May be self-limiting and it can resolve on its own in few months or it can spread and multiply 

Pathophysiology:

HPV infect keratinocytes within the stratum spinosum, can go into stratum basale and dermal epidermal junction, but does not go deeper than epidermis 

Common signs:

Disturbed normal skin epidermal lines, pinpoint bleeding on surface (most common after debridement), "black dots" within lesion that signify blood vessels that have risen from dermal layer to epidermal layer 

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Stages of Development: 

1. Stage 1

• HPV enters stratum spinosum and invades the keratinocytes and other cells, causing them to divide abnormally (acanthosis)

2. Stage 2 

• Stratum spinosum thickens, skin raises, verrucae are now on skin surface 

• Dermal-epidermal junction is gone, This causes dermal papillae to invade epidermis 

3. Stage 3 

• Sensory nerves and dermal papillae (capillaries) will be in lesion - this causes it to be painful and pinpoint bleeding can be present (seen as black dots) 

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Prevention:

1.  Avoid walking barefoot in public spaces such as washrooms, changerooms, playgrounds, fitness centres 

2. Change your socks after activity and wear clean socks daily 

3. if you suspect a lesion to be a wart, have it examined and do not touch with your bare hands to prevent contamination 

4. Lower your stress levels. There have been studies indicating a correlation between increased stress levels and outbreak of wart on surfaces of skin as a result of weakened immune response 

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Treatment

1. Debridement:

• sharp debridement with a blade helps with the physical removal of viral particles​

2. Topical Treatment options - involves to use of topical medications targeted at destroying viral particles 

• Cantharone (Cantharidin based products) - first line treatment options for kids and adults

• Silver nitrate 75% stick

• Salicylic acid application 

• Actikerall medication

• Fluorouracil cream  

3. Needling Procedure - invasive procedure involving physically pushing the viral particles from the epidermis to the deeper skin layers. This helps activate the immune response required to help the body fight against the wart 

4. Surgical Excision - invasive procedure involving excision of the wart lesion

 Seek immediate advise from Chiropodists at Podera Health if you suffer from this issue!