Plantar wart. Causes, treatment of pathology

12 January 2021

Plantarwartsare benign growths of epithelial cells in the form of small growths caused by the human papillomavirus. These manifestations are localized directly on the supporting areas of the foot or toes.

Interesting facts:

According to statistics, the manifestation of plantar warts is most often observed between the ages of 20 and 30 years.
In most cases (more than 50%) plantar warts can heal on their own without any treatment.
According to various sources, carriers of HPV (human papillomavirus) are from 70 to 90 percent of the world's population.
Plantar warts are popularly called "spines". This interpretation is associated with thorns, which are painful to step on.
Most of all HPV types affect the skin.

Causes of warts

A wart is a viral skin disease caused by the human papillomavirus.

There are about a hundred varieties of this virus. They can get into the human body and do not show themselves for a long time, thanks to such protective properties of the body as:

immunity;
phagocytosis (is a nonspecific defense reaction of the body, which is that when a pathological agent enters the body, phagocytes surround it and destroy it).

The risk of contracting human papillomavirus depends on the following factors:

virus activity in a human carrier;
nature of the contact (direct or indirect contact);
the state of immunity of an infected person.

70 - 90% of people are carriers of the human papillomavirus, however, whether a wart occurs or not depends on the state of immunity. People whose body resistance is reduced are more prone to the manifestation of warts. Also, the risk of developing warts increases in cases when the body is affected by adverse factors (for example, stress, fatigue, insomnia, poor hygiene), which lead to a weakening of the immune system.

The papilloma virus can be contracted by contact with a person with warts, for example, through a handshake, shared items (towel, slippers);

There are the following predisposing factors for human papillomavirus infection:

sweating of the legs (the skin becomes looser, and the penetration of various infections through it is facilitated);
frequent washing, cleaning (frequent irritation of the skin with various detergents destroys the protective barrier of the skin and, thereby, facilitates the penetration of the virus)
microtrauma of the skin or mucous membrane (cracks, scratches, abrasions are the entrance gate for infection to enter the body);
uncomfortable tight shoes that provoke rubbing of the skin of the foot (calluses, abrasions are also an entrance gate for infection to enter the body);
diseases that lead to malnutrition of the epithelium of the foot (for example, diabetes mellitus, atherosclerosis);
virus infection can occur through pedicure instruments (if the instruments have not been disinfected);
public baths, saunas or swimming pools (places where the feet come into direct contact with a possibly infected floor surface).

Human skin is composed of the epidermis, dermis and subcutaneous fat. The human papillomavirus, penetrating the skin tissue, affects the basal layer of the epidermis. Subsequently, multiplying, the cells affected by the virus rise through all layers of the epidermis and are localized on the superficial stratum corneum of the epithelium, manifesting themselves outwardly with rough and keratinized skin.

Human papillomavirus

HPV is an infection of the papovavirus family that affects the mucous membranes of organs (usually the genitals), as well as the epithelial cells of the skin. The papillomavirus contains DNA (deoxyribonucleic acid), which, when introduced into a cell of the human body, provokes it to produce new virus particles.

All types of HPV can be roughly divided into two groups:

papillomaviruses with oncogenic properties;
papillomaviruses that do not have oncogenic properties.

Note:oncogenic properties contribute to the formation of malignant tumors.

Today, there are more than one hundred types of human papillomavirus. Plantar warts, as a rule, are caused by the first type of HPV, in some cases their formation can provoke the second and fourth types (non-oncogenic papillomaviruses).

HPV is commonly found in every person who has sex. Every eight out of ten people are infected with this virus. Of all the types of HPV, 6, 11, 16 and 18 are distinguished as the most dangerous. It is these types of HPV that can cause papillomas, condylomas and cancer.

Symptoms and what warts look like on the feet

The human papillomavirus, penetrating into tissues, can be in a passive or active state.

The passive state is characterized by the fact that the virus, being in the basal layer of the epidermis, multiplies slowly, without reaching the stratum corneum of the epithelium, therefore, this state does not manifest itself outwardly.
An active state is characterized by the fact that the virus is actively developing and, rising to the upper layers of the epidermis, manifests itself with numerous symptoms.

Feature	Fade in	Photo
*Shiny surface*	Initially, the plantar wart appears as a glossy plaque, then its surface is keratinized, becoming rough and coarser.
*Dimensions*	Plantar warts range in size from one to two centimeters and rise above the surface of the epithelium by one to three millimeters. Most often, warts are oval or round. There is also the concept of maternal and daughter wart. The maternal wart appears first and is the largest; as a rule, smaller daughter warts can form around it. Over time, maternal and daughter warts can join together to form large lesions.
*Soreness*	The plantar wart is on the foot, where most of the weight is. The wart is compressed between the sole and bones, which causes the surrounding tissue to harden. These warts, in most cases, are very painful due to the fact that the wart can compress the nerves in the foot, causing pain when walking.
*Color*	Most warts are light brown or yellow-white in color.
*Black dots*	If the stratum corneum is removed from the surface of the wart, dark spots may appear on the bed of the affected area, which are formed due to the fact that the bleeding capillaries in this area are thrombosed. This symptom is a distinctive feature of the plantar wart from calluses and callosities.

Removal of warts of the sole

There are currently many effective and safe treatments for plantar warts. However, it should be noted that in some cases, reliable removal of the wart is complicated by the fact that the human papillomavirus penetrates into the deepest layers of the epidermis (into the basal layer).

Treatment of a wart is necessary if:

the wart hurts;
the wart is bleeding;
large wart;
the color of the wart is uneven (for example, blotches appeared in it);
there is a rapid growth rate of the wart.

There are the following methods for removing plantar warts:

cryodestruction;
laser coagulation;
electrocoagulation;
radio wave surgery;
surgical excision.

Cryodestruction

This method involves exposing the wart to liquid nitrogen with a temperature of minus 196 degrees. Cryodestruction is characterized by the fact that when the wart is frozen, the area of the skin affected by viruses is destroyed, followed by stimulation of the body's immune forces. However, it should be noted that if the wart appears and exists for up to six months, then the effectiveness of its removal is 84%. While the effectiveness of removing warts that exist for more than six months is reduced to 39%.

Cryodestruction procedure can be performed:

usually (liquid nitrogen is applied until a light halo with a diameter of two millimeters appears around the wart);
aggressively (after the appearance of a light halo around the wart, liquid nitrogen continues to be applied for another five to twenty seconds).

Research has shown that the aggressive method of freezing the wart is more effective than the conventional method, but the disadvantage is that it is more painful.

After removing the wart at the site of exposure, there is hyperemia (redness) of the skin, followed by the formation of edema. A few hours later, a bubble forms on the affected area (may contain hemorrhagic or serous fluid), and about six to seven days after the bladder dries, a crust forms in its place, which disappears on its own within two weeks.

After removing the wart, follow these guidelines:

a blister formed at the site of the wart should not be opened;
the affected area should not be covered with adhesive tape;
it is recommended to bandage the site of exposure with a sterile bandage without pulling it down to prevent mechanical damage and contamination of the affected area;
it is recommended to treat the affected area with salicylic alcohol 2% twice a day;
try to avoid water ingress at the site of exposure.

Method Advantages	Disadvantages of the method
tissue heals without scarring	if exposure to liquid nitrogen occurs superficially, there is a high likelihood of recurrence (re-formation) warts
the procedure is performed without the use of local anesthesia	local hypo- or hyperpigmentation may occur after the procedure
removing a wart with this method takes one to two minutes	if deeper cauterization occurs, there is a risk of scarring

Laser coagulation

Removing warts with a laser beam is one of the most common methods of treatment today. This method is characterized by layer-by-layer cauterization of the affected area, which allows you to control the depth of exposure. Also, when removing a wart, the laser beam simultaneously solders the vessels, thereby preventing the development of bleeding at the site of exposure.

The following laser coagulation methods are available:

Carbon dioxide (CO2) - laser.The wart is exposed to infrared light (the wavelength is 10 600 nm). The disadvantage of this method of treatment is that tissue cauterization is not selective, that is, there is a possibility of damage to healthy tissue. The efficiency of removal of plantar warts using a carbon dioxide laser is 70%.
Erbium laser.This method is characterized by a shorter wavelength of 2940 nm, which significantly reduces the likelihood of scarring after tissue epithelialization. The effectiveness of this method of treatment is 75%.
Pulsed dye laser.This method is characterized by the selective absorption of energy (wavelength is 586 nm) oxygenated hemoglobin, in which the destruction of dilated capillaries in the wart occurs, as well as stimulation of the immune system, which contributes to effective healing. The effectiveness of this method of treatment is approximately 95%.

After laser treatment, a crust forms on the affected area, which disappears on its own within seven to ten days. It is not recommended to tear off the crust, as well as to lubricate with something (ointments, creams, alcohol solutions). Also, in the first few days after the procedure, water should be avoided at the site of exposure.

Method Advantages	Disadvantages of the method
tissue heals without scarring	the disadvantages of this method include only the high cost of the procedure
fast tissue healing
low risk of recurrence (recurrence)
hardly affects healthy tissue

Electrocoagulation

A plantar wart is exposed to a high frequency current. Cauterization of the affected area should be done under local anesthesia. Thanks to a coagulation loop applied to the affected area of the skin, an electric current is applied to the wart, which leads to its death. Also, the action of high temperatures leads to the soldering of the vessels, which prevents the development of bleeding.

After the procedure, a dense crust forms at the site of exposure, which disappears on its own within ten days.

After removing the wart, follow these guidelines:

during the healing period, try to avoid getting water or soap on the affected skin area;
the formed crust should not be touched or torn off;
In the first seven to ten days, it is recommended to treat the site of exposure with an antiseptic once or twice a day.

Method Advantages	Disadvantages of the method
available cost of the procedure	for small, shallow warts
prevents bleeding	when exposed to deep layers of the skin after tissue healing, a scar may remain
the procedure takes from a few seconds to one minute	superficial wart removal may cause recurrence

Radio wave surgery

This method of treatment consists in the use of a special electrode that emits high frequency radio waves (3. 8 - 4. 0 MHz). Exposure to high temperatures on the plantar wart causes the evaporation of cells affected by the papilloma virus. Also, due to the cauterization of blood vessels, the use of this method prevents the development of bleeding. After exposure, a crust forms on the affected area of the skin, which disappears on its own within seven to ten days.

Contraindicated during the healing period:

in the first two days after the procedure, you should not wet the site of moxibustion;
peel off the crust within seven to ten days.

Method Advantages	Disadvantages of the method
when exposed to the affected area, healthy tissue is practically not affected	high cost of the procedure
there is minimal risk of scarring after tissue healing
low risk of remission after treatment (two to five percent)

Surgical excision

This method is characterized by the removal of the wart with a scalpel under local anesthesia. After excision of the affected area, stitches are applied, which are removed after seven to ten days.

Method Advantages	Disadvantages of the method
is used to remove large warts	after removing the stitches, the affected area may be scarred
	there is a risk of remission (disappearance of symptoms) warts

General principles of caring for the affected skin area after wart removal:

if a crust forms, it must not be touched or torn off;
limit water ingress to the affected area;
after removing the wart, it is impossible to expose the site of exposure to direct sunlight;
no cosmetic products (such as cream or lotion) should be applied to the affected skin area;
it is not recommended to visit public saunas, baths or swimming pools for one to two months after the removal of the wart;
after removing the wart, it is recommended to use vitamins A, C and E, as they promote rapid regeneration (healing) of tissues, and also stimulate the body's defenses.

Note:If complications arise after removing the wart (inflammation of the affected area, prolonged healing, scarring), you should contact your doctor as soon as possible.

For all methods of treatment, contraindications to the procedure are:

diabetes mellitus;
presence of malignant tumors;
pregnancy;
infectious and inflammatory diseases near the wart;
exacerbation of herpes;
increased body temperature;
high blood pressure (above 140 per 100 millimeters of mercury).

Treatment of warts without surgery

For single and shallow plantar warts, it is recommended to use traditional methods of treatment.

Name of the tool used	Cooking	Apply
*Acetic acid*	You need to purchase 70% acetic acid, petroleum jelly, and prepare a pipette to apply the correct dosage.	Before using acetic acid, apply petroleum jelly to healthy skin around the wart. Then, using a pipette, one drop of acetic acid should be applied to the wart. This method should be used once a day until the wart disappears.
*Garlic infusion*	It is necessary to chop three cloves of garlic, and then pour the resulting mass of boiling water (50 ml). After one hour, the resulting infusion must be filtered and used.	Lubricate the wart area with the resulting infusion once a day until the formation disappears completely.
*Saline solution*	Dissolve one tablespoon of salt in warm water (100 ml) and add one tablespoon of vinegar (9%). The resulting solution must be thoroughly stirred, and then the pulp of one plum should be dipped into it and infused for two hours. After the time has elapsed, it is necessary to remove the plum from the solution and grind it into gruel.	The resulting plum gruel must be applied to the wart. For a secure fit, wrap the foot and put a sock on it. This compress should be left on for two to three hours. The procedure should be repeated every day until the wart disappears completely.
*Wormwood infusion*	Add three tablespoons of dry wormwood to a glass of hot water (250 ml), cover and infuse for two hours.	The resulting solution should be applied to the affected areas of the foot three to four times a day until the warts come off.
*Lemon peel infusion*	You need to peel two lemons and place it in a 1 liter jar, crushed. Then add 100 ml of 9% table vinegar to the vessel and close the jar with a tight lid. The contents should be infused for one week, shaking the jar periodically. At the end of the period, the infusion must be filtered.	The resulting infusion should be moistened with warts twice a day until they disappear completely.
*St. John's wort decoction*	For one glass of water (250 ml) add one tablespoon of chopped St. John's wort and simmer for 15 minutes over low heat. After cooking, the broth must be cooled and then filtered.	With the resulting broth, you need to lubricate the warts three to four times a day until they disappear completely.
Note:In case of any side effects, you should immediately consult your doctor.

Currently, celandine is also effectively used in the treatment of plantar warts. This plant has a yellow-orange medicinal juice.

Celandine has the following medicinal properties:

bactericidal (causes the death of hidden microorganisms);
anti-inflammatory;
antispasmodic;
choleretic;
antiviral;
wound healing;
cauterizing;
antipruritic;
celandine also contains vitamins A and C.

When treating plantar warts, fresh celandine juice is used, which should be rubbed on the affected skin two to three times a day until the warts disappear completely. Before applying celandine, it is recommended to thoroughly steam your feet in hot water and remove the keratinized part of the wart with a pumice stone.

In the treatment of plantar warts, celandine has the following therapeutic effects:

helps to reduce pain while walking;
speeds up the drying of the wart and the formation of a crust;
, due to the content of vitamins A and C, stimulates local immune responses.

Celandine also contains various acids (ascorbic, succinic, malic, citric), to which HPV is sensitive.

To improve the effectiveness of the treatment of plantar warts, the following recommendations should be observed:

carry out daily hygiene procedures for the feet;
vitamins should be regularly used to strengthen the immune system (for example, vitamins A, E, C);
use individual footwear (for example home slippers);
with dry skin of the feet, it is necessary to regularly use moisturizing and nourishing foot creams;
in public places (bath, sauna or swimming pool) personal slippers should be used and barefoot should be avoided;
carefully choose the right footwear (for example, the right size, natural materials);
in case of excessive sweating of the feet, it is necessary to use drying agents, and also try to select shoes according to the weather.