Plantar Warts

 

Summary

Plantar warts are a common skin condition affecting the sole of the foot, particularly near the base of the toes. They are usually asymptomatic. Plantar warts will often resolve spontaneously over time. They are caused by a virus. If they are symptomatic, they can be treated by local chemicals to eradicate the plantar warts. Occasionally, liquid nitrogen treatment through a health care provider will be necessary.

Clinical Presentation

Plantar warts are a relatively common problem that can afflict the feet. They usually develop on the sole of the foot and present as an essentially painless abnormal thickening of the skin. Occasionally, they can become large and uncomfortable, even leading to an ulcer, although this is unusual. Plantar warts are caused by a virus and will often resolve spontaneously. The virus is felt to be transmitted through moist surfaces, such as walking around in bare feet in a public change room.

Physical Examination

Physical examination reveals an abnormal collection of skin which can be hard but is usually painless to touch. Plantar warts are often located over the sole of the foot, particularly in the area of the forefoot. A plantar wart is often mistaken for a callus that occurs secondary to repetitive overload, such as what is seen in metatarsalgia.

Imaging Studies

Imaging studies are usually not indicated as x-rays in most studies will be normal.

Treatment

Non-Operative Treatment

Treatment is often just the passage of time for small plantar warts that are non-symptomatic. Over time these warts will have a tendency to resolve. For larger warts, over the counter contact treatment that is aimed at dissolving away the warts may be helpful. For larger warts that are persistent, the use of liquid nitrogen by a health care provider will create local death of the skin cells. This often will help resolve the plantar wart. However, this treatment is associated with some discomfort and the wart may reoccur.

Surgical Treatment

Surgical treatment is generally not indicated. In some instances, trimming back the wart and the excessive thickened skin associated with it may be helpful.

 

Edited on September 5, 2017

mf/ 5.21.18