Plantar wart. Causes, treatment of pathology

12 January 2021

plantar wartsare benign growths of epithelial cells in the form of small growths caused by the human papillomavirus. These manifestations are located directly on the support zones 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) represent 70 to 90 percent of the world's population.
Plantar warts are commonly referred to as "thorns". This interpretation is associated with thorns, on which it is painful to walk.
Most of all 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 for a long time, thanks to the protective properties of the body such as:

;
phagocytosis (is a non-specific 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 in a human carrier;
nature of the contact (direct or indirect contact);
the immunity status of an infected person.

70-90% of people carry the human papillomavirus, however, whether or not a wart is present depends on the state of immunity. People with reduced body resistance are more prone to the manifestation of warts. In addition, the risk of developing warts increases in cases where the body is affected by unwanted factors (eg stress, fatigue, insomnia, poor hygiene), which lead to a weakened immune system.

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

There are the following predisposing factors for infection with human papillomavirus:

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, thus, facilitates the penetration of the virus)
microtrauma of the skin or mucous membranes (cracks, scratches, abrasions are the gateway for the infection to enter the body);
uncomfortable tight shoes that cause rubbing of the skin of the foot (calluses, abrasions are also a gateway for the infection to enter the body);
diseases which lead to malnutrition of the epithelium of the foot (for example, diabetes mellitus, atherosclerosis);
viral infection can occur with pedicure tools (if devices 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 made up of the epidermis, dermis and subcutaneous fat. The human papillomavirus, penetrating the skin tissues, affects the basal layer of the epidermis. Subsequently, by multiplying, the cells affected by the virus move up through all the layers of the epidermis and are located on the superficial stratum corneum of the epithelium, manifesting outwardly as rough, keratinized skin.

Human papillomavirus

HPV is an infection of the papovavirus family that affects the mucous membranes of the 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 in the human body, causes it to produce new viral particles.

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

papillomavirus with oncogenic properties;
papillomavirus which does not have oncogenic properties.

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

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

HPV is commonly found in everyone who has sex. All eight in ten people are infected with this virus. Of all the types of HPV, 6, 11, 16 and 18 are considered the most dangerous. These are the types of HPV that can cause papillomas, warts, and cancer.

Symptoms and what warts on the feet look like

The human papillomavirus, penetrating the tissues, can be in the 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, therefore, thiscondition does not manifest itself outwardly.
An active state is characterized by the fact that the virus is actively growing and, rising to the upper layers of the epidermis, is manifested by many symptoms.

Functionality	Fade in	Photo
*Glossy surface*	Initially, the plantar wart appears as a shiny plaque, then its surface is keratinized, becoming rough and coarser.
*Dimensions*	Plantar warts measure 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 girl warts can form around it. Over time, maternal and daughter warts can combine 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 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 points*	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 thisarea are thrombosed. This feature is a distinguishing feature of the plantar wart from corns and calluses.

Sole warts removal

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

Treatment of a wart is necessary if:

the wart hurts;
the wart is bleeding;
big wart;
the color of the wart is uneven (for example, spots have appeared on it);
there is a rapid rate of growth of the wart.

There are the following methods to remove plantar warts:

cryodestruction;
;
;
radio wave surgery;
surgical excision.

Cryodestruction

This method involves exposing the wart to liquid nitrogen at 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, the efficiency of its removal is 84%. While the effectiveness of removing warts that have been around for more than six months is reduced to 39%.

The 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 a slight halo appears 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 downside is that it is more painful.

After removal of the wart at the exposure site, there is hyperemia (redness) of the skin, followed by edema formation. 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 scab forms in its place, which disappears on its own within two weeks.

After removing the wart, follow these instructions:

a blister formed at the site of the wart should not be opened;
the affected area should not be sealed with duct tape;
it is recommended to dress the exposure site with a sterile bandage loosely 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 avoid water infiltration at 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 (re-formation) warts
the procedure is performed without 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 cauterization of the affected area, which allows you to control the depth of exposure. In addition, when removing a wart, the laser beam simultaneously welds the vessels, thereby preventing the development of bleeding at the exposure site.

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 plantar warts removal using a carbon dioxide laser is 70%.
Laser Erbium.This method is characterized by a shorter wavelength of 2940 nm, which significantly reduces the risk of scarring after tissue epithelialization. The efficiency of this method of treatment is 75%.
Pulsed dye laser.This method is characterized by the selective absorption of oxygenated hemoglobin (the wavelength is 586 nm), 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 efficiency of this treatment method is about 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 the scab, nor to lubricate with anything (ointments, creams, alcoholic solutions). In addition, 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 only include 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 high frequency current. Cauterization of the affected area should be performed under local anesthesia. Through a coagulation loop applied to the affected area of the skin, an electric current is applied to the wart, resulting in 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 crust forms at the exposure site, which disappears on its own within ten days.

After removing the wart, follow these instructions:

during the healing period, try to avoid putting soap or water on the affected skin area;
the crust formed must not be touched or torn off;
During 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
prevents bleeding	when exposed to deep layers of skin after tissue heals, a scar may remain
the procedure takes from a few seconds to a minute	superficial removal of warts can cause recurrence

Radio wave surgery

This method of treatment consists of using a special electrode that emits high frequency radio waves (3, 8 - 4, 0 MHz). Exposure to high temperatures on the plantar wart causes evaporation of cells affected by the papilloma virus. In addition, due to cauterization of blood vessels, the use of this method prevents the development of bleeding. After exposure, a scab forms on the affected area of the skin, which disappears on its own in 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 hardly affected	high cost of the procedure
the risk of scarring is minimal after tissue scarring
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.

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

General principles of care of the affected skin area after wart removal:

if a scab forms, it should not be touched or pulled off;
limit water infiltration into the affected area;
after removing the wart, it is impossible to expose the exposure site to direct sunlight;
no cosmetic product (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 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 the tissues and also stimulate the body's defenses.

Note:In case of complications (inflammation of the affected area, prolonged scarring, scarring) after removal of the wart, 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;
hypertension (greater than 140 per 100 millimeters of mercury).

Treatment of warts without surgery

For simple, shallow plantar warts, traditional treatment methods are recommended.

Name of the tool used	Kitchen	Apply
*Acetic acid*	You need to buy 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, 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 chop three cloves of garlic, then pour the resulting mass of boiling water (50 ml). After an hour, the resulting infusion should be filtered and used.	Lubricate the wart area with the resulting infusion once a day until the formation disappears completely.
*Saline solution*	Dissolve a tablespoon of salt in lukewarm water (100 ml) and add a tablespoon of vinegar (9%). The resulting solution should be thoroughly stirred, then the pulp of a plum should be immersed in it and infused for two hours. After the time has passed, it is necessary to remove the plum from the solution and grind it into a porridge.	The resulting plum grits should be applied to the wart. For a secure fit, wrap the foot and put a sock on it. This compress should be left in place for two to three hours. The procedure should be repeated every day until the wart disappears completely.
*Absinthe infusion*	Add three tablespoons of dry wormwood to a glass of hot water (250 ml), cover and let steep 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 them in a 1 liter jar, crushed. Then add 100 ml of 9% table vinegar to the container and close the jar with an airtight lid. The contents should be infused for a week, shaking the jar periodically. At the end of the period, the infusion should 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 over low heat. After cooking, the broth should 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 side effects, you should consult your doctor immediately.

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

Celandine has the following medicinal properties:

bactericidal (kills hidden microorganisms);
;
antispasmodic;
choleretic;
antiviral;
wound healing;
cauterization;
antipruritic;
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 the 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 reduce pain when walking;
accelerates the drying 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 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:

perform daily hygiene procedures for the feet;
to strengthen the immune system, vitamins should be used regularly (for example, vitamins A, E, C);
use individual shoes (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 swimming pool) personal slippers should be used and bare feet should be avoided;
carefully choose the right shoes (for example, the right size, natural materials);
in case of excessive sweating on the feet, it is necessary to use drying agents, and also try to select shoes according to the weather.