Plantar wart. Causes, pathology treatment.

12 January 2021

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

Interesting facts:

According to statistics, the manifestation of plantar warts is most often seen 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 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 types of HPV 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 enter the human body and not show themselves for a long time, thanks to protective properties of the body such as:

immunity;

phagocytosis (is a non-specific defense reaction of the body, which consists in that when a pathological agent enters the body, the phagocytes surround it and destroy it).

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

virus activity in a human carrier;

nature of the contact (direct or indirect contact);

the immunity status of an infected person.

70 - 90% of people are carriers of the human papillomavirus; however, whether a wart appears or not depends on the state of immunity. People whose body resistance is reduced are more prone to warts. Also, the risk of developing warts increases in cases where the body is affected by adverse factors (for example, stress, fatigue, insomnia, poor hygiene), leading 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 loose and the penetration of various infections through it is facilitated);

frequent washing and cleaning (frequent irritation of the skin with various detergents destroys the skin's protective barrier and thus facilitates the penetration of the virus)

microtrauma of the skin or mucous membranes (cracks, scratches, abrasions are the entry point for the infection to enter the body);

uncomfortable and tight shoes that cause friction of the skin of the foot (calluses, abrasions are also a gateway 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 feet come into direct contact with a possibly infected floor surface).

Human skin is made up of the epidermis, dermis, and subcutaneous fat. The human papillomavirus, which penetrates the skin tissue, affects the basal layer of the epidermis. Subsequently, multiplying, the cells affected by the virus ascend through all the layers of the epidermis and are located in the superficial stratum corneum of the epithelium, manifesting externally with rough and keratinized skin.

Human Papillomavirus

HPV is an infection of the papovavirus family that affects the mucous membranes of organs (generally the genitalia), as well as the epithelial cells of the skin. Papillomavirus contains DNA (deoxyribonucleic acid) that, when introduced into a cell in the human body, causes it to produce new virus particles.

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

papillomavirus 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 100 types of human papillomavirus. Plantar warts, as a rule, are caused by the first type of HPV, in some cases its formation can cause the second and fourth types (non-oncogenic papillomavirus).

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

Symptoms and appearance of warts on feet

The tissue-penetrating human papillomavirus 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, not reaching the stratum corneum of the epithelium, so this state does not manifest itselfexternal way.

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 into Photo

Glossy surface Initially, the plantar wart appears as a shiny plaque, then its surface becomes keratinized, becoming rough and rougher.

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 a mother 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 coalesce to form large lesions.

Pain The plantar wart is on the foot, where most of the weight is. The wart is compressed between the sole and the bones, causing the surrounding tissue to harden. These warts, in most cases, are very painful because the wart can compress the nerves of the foot, causing pain when walking.

Color Most warts are light brown or yellowish-white.

Blackheads 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 arethrombosed. This feature is a distinctive feature of the plantar wart from corns and calluses.

Sole wart removal

There are many safe and effective treatments for plantar warts today. However, it should be noted that, in some cases, reliable wart removal is complicated by the fact that the human papillomavirus penetrates the deeper layers of the epidermis (in 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, spots appeared);

there is a rapid growth rate of the wart.

There are the following methods to remove 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 the viruses is destroyed, followed by the 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 have existed for more than six months is reduced to 39%.

The cryodestruction procedure can be performed:

normally (liquid nitrogen is applied until a halo of light with a diameter of two millimeters appears around the wart);

aggressively (after the appearance of a halo of light around the wart, continue to apply liquid nitrogen 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 downside is that it is more painful.

After removal of 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 in the affected area (may contain hemorrhagic or serous fluid), and approximately six to seven days after the bladder dries up, a crust forms on your bladder. Instead, it clears up on its own in two weeks.

After removing the wart, follow these guidelines:

should not open a blister formed at the site of the wart;

the affected area should not be covered with tape;

it is recommended to bandage the exposure site with a sterile bandage without pulling it down to avoid mechanical damage and contamination of the affected area;

it is recommended to treat the affected area with 2% salicylic alcohol twice a day;

try to prevent water from entering the exposure site.

Advantages of the method Disadvantages of the method

tissue heals without leaving scars if exposure to liquid nitrogen occurs superficially, there is a high probability of recurrence (new formation) of 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 treatment methods today. This method is characterized by layer-by-layer cautery of the affected area, allowing you to control the depth of exposure. In addition, when removing a wart, the laser beam simultaneously welds the vessels, thus preventing the development of bleeding at the site of exposure.

There are the following laser coagulation methods:

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 the cauterization of the tissue is non-selective, that is, there is a possibility of damaging healthy tissues. The removal efficiency of plantar warts with a carbon dioxide laser is 70%.

Erbium laser.This method is characterized by a shorter wavelength of 2940 nm, which significantly reduces the probability 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 of 586 nm) of oxygenated hemoglobin, in which the dilated capillaries in the wart are destroyed, as well asstimulation of the immune system, which promotes effective healing. The effectiveness of this treatment method is approximately 95%.

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

Advantages of the method Disadvantages of the method

tissue heals without leaving scars the disadvantages of this method include only the high cost of the procedure

rapid 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 electrical current is applied to the wart, causing its death. In addition, the action of high temperatures leads to the welding of the vessels, which prevents the development of bleeding.

After the procedure, a dense scab forms at the site of exposure, which disappears on its own in 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 crust formed must not be touched or pulled off;

In the first seven to ten days, it is recommended to treat the exposure site with an antiseptic once or twice a day.

Advantages of the method Disadvantages of the method

available cost of the procedure for small, shallow warts

avoid indentation when applied to the deep layers of the skin after tissue healing, a scar may remain

the procedure takes a few seconds to a minute superficial removal of warts can cause recurrence

Radio Wave Surgery

This treatment method consists of using a special electrode that emits high frequency radio waves (3. 8 - 4. 0 MHz). Exposure to high temperatures in 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 hemorrhages. After exposure, a scab 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 moxibustion site;

peel off the crust within seven to ten days.

Advantages of the method Disadvantages of the method

when exposed to the affected area, healthy tissue is practically unaffected 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 removing the wart with a scalpel under local anesthesia. After removal of the affected area, stitches are applied, which are removed after seven to ten days.

Advantages of the method Disadvantages of the method

is used to remove large warts after removing the stitches, the affected area may have scars

there is a risk of remission (disappearance of symptoms) warts

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

if a scab forms, it should not be touched or pulled;

limit the entry of water to the affected area;

after removing the wart, it is impossible to expose the exposure site to direct sunlight;

cosmetic products (such as creams or lotions) should not 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 wart removal;

after removing the wart, it is recommended to use vitamins A, C and E, as they promote rapid regeneration (healing) of the tissues and also stimulate the body's defenses.

Note:In case of complications (inflammation of the affected area, prolonged scarring, scarring) after wart removal, you should contact your doctor as soon as possible.

For all treatment methods, the contraindications for the procedure are:

diabetes mellitus;

presence of malignant tumors;

pregnancy;

infectious and inflammatory diseases near the wart;

herpes exacerbation;

increase in body temperature;

high blood pressure (above 140 per 100 millimeters of mercury).

Treatment of warts without surgery

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

Name of the tool used Cook Apply

Acetic acid You must buy 70% acetic acid, petroleum jelly and prepare a pipette to apply the correct dose. Before using acetic acid, apply petroleum jelly to healthy skin around the wart.
Then, with a pipette, a drop of acetic acid should be applied to the wart. Use this method once a day until the wart is gone.

Garlic infusion It is necessary to mince three cloves of garlic, and then pour the resulting mass of boiling water (50 ml). After an hour, the resulting infusion must be filtered and used. Lubricate the wart area with the resulting infusion once a day until the formation completely disappears.

Saline solution Dissolve a tablespoon of salt in warm water (100 ml) and add a tablespoon of vinegar (9%). The resulting solution must be shaken well, and then immerse the pulp of a plum and infuse it for two hours. After the time has elapsed, it is necessary to remove the plum from the solution and grind it into mush.
The resulting plum porridge should be applied to the wart.
For a secure fit, wrap your 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 completely disappears.

Wormwood infusion Add three tablespoons of dried absinthe 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 appear.

Lemon peel infusion It is necessary to remove the peel of two lemons and place it in a 1 liter jar, crushed. Then add 100 ml of 9% table vinegar to the container and close the jar with a tight lid. The contents should be infused for a week, shaking the bottle 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.

Decoction of St. John's wort For a glass of water (250 ml) add a tablespoon of chopped St. John's wort and simmer for 15 minutes. After cooking, the broth must be cooled and then filtered. The resulting broth should be applied to warts three to four times a day until they disappear completely.

Note:In case of any side effect, you should immediately consult your doctor.

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

Celandine has the following medicinal properties:

bactericidal (causes the death of hidden microorganisms);

anti-inflammatory;

antispasmodic;

choleretic;

antiviral;

wound healing;

cauterization;

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 or three times a day until the warts disappear completely. Before applying celandine, it is recommended to thoroughly steam your feet with 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 reduce pain when walking;

accelerates the drying process of the wart and the formation of a scab;

, due to the content of vitamins A and C, stimulates local immune responses.

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

To improve the efficacy of plantar wart treatment, the following recommendations should be observed:

perform daily hygiene procedures for the feet;

vitamins should be used regularly to strengthen the immune system (for example, vitamins A, E, C);

use individual footwear (for example, house slippers);

with dry skin of the feet, it is necessary to regularly use moisturizing and nourishing foot creams;

in public places (bath, sauna or pool) personal slippers should be worn and bare feet should be avoided;

choose the right footwear carefully (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 the shoes according to the weather.

Feature	Fade into	Photo
*Glossy surface*	Initially, the plantar wart appears as a shiny plaque, then its surface becomes keratinized, becoming rough and rougher.
*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 a mother 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 coalesce to form large lesions.
*Pain*	The plantar wart is on the foot, where most of the weight is. The wart is compressed between the sole and the bones, causing the surrounding tissue to harden. These warts, in most cases, are very painful because the wart can compress the nerves of the foot, causing pain when walking.
*Color*	Most warts are light brown or yellowish-white.
*Blackheads*	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 arethrombosed. This feature is a distinctive feature of the plantar wart from corns and calluses.

Advantages of the method	Disadvantages of the method
tissue heals without leaving scars	if exposure to liquid nitrogen occurs superficially, there is a high probability of recurrence (new formation) of 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

Advantages of the method	Disadvantages of the method
available cost of the procedure	for small, shallow warts
avoid indentation	when applied to the deep layers of the skin after tissue healing, a scar may remain
the procedure takes a few seconds to a minute	superficial removal of warts can cause recurrence

Advantages of the method	Disadvantages of the method
when exposed to the affected area, healthy tissue is practically unaffected	high cost of the procedure
there is minimal risk of scarring after tissue healing
low risk of remission after treatment (two to five percent)

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

Name of the tool used	Cook	Apply
*Acetic acid*	You must buy 70% acetic acid, petroleum jelly and prepare a pipette to apply the correct dose.	Before using acetic acid, apply petroleum jelly to healthy skin around the wart. Then, with a pipette, a drop of acetic acid should be applied to the wart. Use this method once a day until the wart is gone.
*Garlic infusion*	It is necessary to mince three cloves of garlic, and then pour the resulting mass of boiling water (50 ml). After an hour, the resulting infusion must be filtered and used.	Lubricate the wart area with the resulting infusion once a day until the formation completely disappears.
*Saline solution*	Dissolve a tablespoon of salt in warm water (100 ml) and add a tablespoon of vinegar (9%). The resulting solution must be shaken well, and then immerse the pulp of a plum and infuse it for two hours. After the time has elapsed, it is necessary to remove the plum from the solution and grind it into mush.	The resulting plum porridge should be applied to the wart. For a secure fit, wrap your 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 completely disappears.
*Wormwood infusion*	Add three tablespoons of dried absinthe 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 appear.
*Lemon peel infusion*	It is necessary to remove the peel of two lemons and place it in a 1 liter jar, crushed. Then add 100 ml of 9% table vinegar to the container and close the jar with a tight lid. The contents should be infused for a week, shaking the bottle 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.
*Decoction of St. John's wort*	For a glass of water (250 ml) add a tablespoon of chopped St. John's wort and simmer for 15 minutes. After cooking, the broth must be cooled and then filtered.	The resulting broth should be applied to warts three to four times a day until they disappear completely.
Note:In case of any side effect, you should immediately consult your doctor.