The papilloma or plantar wart, a cutaneous proliferation similar in appearance to a cauliflower, is one of the most common infections of the foot caused by the human papillomavirus (HPV).
This viral infection affects the first two layers of the skin, dermis and epidermis, and if the host’s immunological conditions are inadequate (stress, nutritional deficits, immunosuppression…), the virus replicates. Plantar warts disappear spontaneously if we do not treat them, although this requires a long time.
For this reason, whether they hurt or not, it is important to treat them as soon as possible, since while they are on our feet we will be a source of infection for other people.
Plantar warts can have an incubation period of up to 6 months.
It is very common to confuse plantar warts with hyperkeratosis (calluses). Therefore, it will be especially important to know the differences between the two in order to make a good differential diagnosis.
Differences between hyperkeratosis and plantar warts
- Corns always appear in areas of pressure, while plantar warts are not always located in these areas.
- The plantar wart causes rupture of the epidermis and, therefore, a loss of skin lines.
- Pain on transverse pressure. The stabbing pain we feel when pinching a plantar wart is very characteristic, while the callus will hurt more on pressure.
- Presence of small black dots that feed the plantar wart.
Types of plantar warts
1. Single or solitary plantar warts
Endophytic (inward) growth occurs, conditioned by the pressures to which the lesion is subjected. If, on the other hand, the warts do not receive pressure, they will tend to grow outwards.
2. Mosaic plantar warts
The growth of this type of warts is usually more in extension than in depth. They generally remain asymptomatic and, due to the large skin surface they cover, we cannot be as aggressive with the substances used for their treatment.
Risk factors associated with plantar warts
- People with nutritional deficiencies
- Children and adolescents
- Frequenting public baths and swimming pools
- People suffering from hyperhidrosis of the feet (excess perspiration).
- Humidity and heat
- Cracks or cuts that facilitate the entry of HPV.
Is it possible to prevent its appearance?
- Wear flip-flops in swimming pools and public baths, especially if we have a wound or crack.
- Dry our feet very well and do not share towels.
- Control hyperhidrosis with astringent powders.
- If you already have a plantar wart or live with someone who has one, that person should shower last.
It is also recommended to clean the shower tray with bleach to ensure that it is not transmitted to others.
Treatment
The main treatment will consist of cauterizing the capillaries that feed the plantar wart. Different methods are available for this purpose:
- Immunotherapy and nutrition.
- Chemical burn. It is performed by applying acids such as nitric or salicylic acid and the procedure is practically painless.
- Thermal burn. The capillaries of the wart are cauterized by means of the burn produced by the laser.
- Surgery.