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Minor Surgery - Verrucae

Plantar Warts (Verruccas)
Plantar Warts (Verruccas)


Single Verruca
Single Verruca

Plantar Warts

Plantar Warts (Veruccas) occur on the sole (plantar surface) of the foot. They can be very painful because the entire weight of the body presses against them continuously when standing or walking. Plantar warts are usually rough, bumpy and spongy, although some may be thick and scaly. Most are grey or brown and have a centre with one or more dark pinpoints. These are tiny capillaries that supply blood to the wart, Scraping the wart may cause it to bleed. Untreated plantar warts may grow up to an inch in circumference and may spread into clusters.

Causes

Warts are benign tumors that can occur anywhere on the skin. The human papilloma virus (HPV), a common organism, causes warts. The virus is often encountered on contaminated surfaces, typically the tile floors of public locker rooms, showers, and swimming pools and invades the body through tiny cuts, breaks or pores in the skin.
Normally antibodies in the blood kill the virus, However some people are more susceptible to the human papilloma virus, particularly if their immune system is under stress. In which case HPV can take refuge in the skin and prove difficult to eliminate.
A Plantar wart is similar in structure to an iceberg. The part on the surface is only a small fraction of the entire lesion. Often the unseen portion of the wart is at least twice as big as the part you can see. Many of these viruses die within a year or two and the warts they produce simply disappear. Podiatrists recommend having them treated if they are painful or spreading.

Treatment

There are several different techniques for removing plantar warts. However patients should be aware that due to its viral nature there is no treatment that is guaranteed to be 100% effective, most treatments are only 60% effective.

Acid

One of the most common methods is to burn off with a mild acid applied topically to the wart. This disintegrates the viral cells and allows healthy skin cell to replace them. Examples of this are salicylic acid prepared by your podiatrist and Duofilm or Posofilm (which contain milder forms of salicylic acid) available at your pharmacy.
 

Cryotherapy

Freezing warts with a very cold solution can kill the virus causing the wart to turn black and fall off within a few days. Cryotherapy is sometimes ineffective on plantar warts because the cold may not penetrate far enough to kill the virus completely.
 

Laser Treatment

Doctors can use lasers to kill the virus. The procedure can be performed in the physicians office and is effective, clean and accurate. It is however quite expensive and some physicians do not use laser treatment for warts because the benefits do not warrant the cost.
 

Surgical Debridement

In this technique, the podiatrist uses a curette to remove the warts under anesthetic. This is often the procedure of choice for well circumscribed warts. It can also be used with acid to ensure the virus is killed and prevent warts from re-growing. As in any normal surgery the procedure involves keeping your foot dry and reduce weight bearing for a period of time until healed.
 

Needling

In this technique, the podiatrist uses a multiple puncture technique to treat the warts under anesthetic. This procedure is by injecting the virus into the subcutaneous tissue to stimulate an auto-immune response which should eradicate the wart within 4-8 weeks. With this procedure there is limited or no scarring and minimal dressing time required though the procedure itself may need repeating 2-3 times if there are multiple mosaic warts.

Complications

Warts can re-grow, indicating that the virus is still growing in the body. The virus that causes plantar warts is relatively benign and cause few problems, but it can spread to other parts of the body. Warts cells can break/flake off and spread to other areas of the foot or other people and can cause a new wart to grow. It is therefore important to take precautions to prevent cross infection or seek professional advise and treatment.

General Advice

 

  • • Keep plantar warts covered with tape or a band aid.
  • • Wears shoes/sandals in public areas, especially gym changing rooms and swimming pools.
  • • See your Podiatrist if you think you have a plantar wart—they will be able to treat it quickly and effectively.
     


 
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