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 papilloma virus. These manifestations are localized directly on the supporting parts of the feet 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 papilloma virus) make up 70 to 90 percent of the world's population.
Plantar warts are popularly called "thorns". This interpretation is related to the thorns on which it is painful to step.
Most all types of HPV affect the skin.

Causes of warts

Warts are a viral skin disease caused by the human papilloma virus.

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

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

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

virus activity on human carriers;
nature of contact (direct or indirect contact);
immune status of the infected person.

70 - 90% of people are carriers of the human papilloma virus, however, whether a wart appears 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 warts increases in cases when the body is affected by adverse factors (, for example, stress, fatigue, insomnia, poor hygiene), which leads to a weakening of the immune system.

Papilloma virus can be infected by contact with a person with warts, for example, handling, common objects (towel, slippers);

There are the following factors that predispose to human papilloma virus infection:

sweating of the feet (the skin becomes looser, and the penetration of various infections through it is facilitated);
frequent washing, cleaning (frequent skin irritation with various detergents destroys the skin's protective barrier and thus facilitates the penetration of viruses)
microtrauma of the skin or mucous membranes (cracks, scratches, scratches are the entrance door for infection to enter the body);
uncomfortable narrow shoes that cause rubbing of the skin of the feet (blisters, scratches are also the gateway for infection to enter the body);
diseases that lead to malnutrition of the foot epithelium (, for example, diabetes mellitus, atherosclerosis);
virus infection can occur with a pedicure tool (if the devices are not disinfected);
public baths, saunas or swimming pools (places where the feet come into direct contact with a potentially infected floor surface).

Human skin consists of epidermis, dermis and subcutaneous fat. The human papilloma virus, penetrating the skin tissue, affects the basal layer of the epidermis. After that, multiplying, the cells affected by the virus rise through all the layers of the epidermis and localize on the surface horny layer of the epithelium, manifesting as externally rough and keratinized skin.

Human papilloma virus

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

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

papilloma viruses with oncogenic properties;
papilloma viruses that do not have oncogenic properties.

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

Today there are more than a hundred types of human papilloma virus. 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 often 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 stand out as the most dangerous. It is these types of HPV that can cause papillomas, condyloma and cancer.

Symptoms and how warts look on feet

The human papilloma virus, penetrating the tissues, can be in a passive or active state.

The passive state is characterized by the fact that the virus, located in the basal layer of the epidermis, multiplies slowly, not reaching the stratum corneum of the epithelium, so this condition does not manifest outward.
The active condition is characterized by the fact that the virus is actively developing and ascending to the upper layers of the epidermis manifests a number of symptoms.

Feature	Fade in	Photo
*Glossy surface*	Initially, the plantar wart appears as a shiny plaque, and then its surface keratinizes, becoming coarser and rougher.
*Dimensions*	Plantar warts are one to two centimeters in size and rise one to three millimeters above the surface of the epithelium. Warts are usually oval or round. There is also the concept of nipples by mother and daughter. The mother's nipple appears first and is the largest; as a rule, smaller daughters can be created around her. Over time, the nipples of mothers and daughters can coalesce and form large lesions.
*Sickness*	The plantar wart is on the foot, where most of the weight. The nipple is squeezed between the sole and the bone, causing the surrounding tissue to harden. These warts are in most cases 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 yellowish white.
*Miteseri*	If the stratum corneum is removed from the surface of the nipple, dark spots may appear on the trough of the affected area due to the fact that the bleeding capillaries in this area are thrombosed. This characteristic is a recognizable feature of the plantar wart from corns and calluses.

Removal of plantar warts

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

Nipple treatment is necessary if:

nipple pain;
nipple bleeds;
large nipple;
the color of the nipple is uneven (for example, spots have appeared in it);
there is a rapid rate of nipple growth.

There are the following methods for removing plantar warts:

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

Cryodestruction

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

The cryodestruction process can be performed:

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

Research has shown that an aggressive way to freeze a nipple is more effective than a conventional one, but the disadvantage is that it is more painful.

After removal of the wart at the site of exposure, hyperemia (redness) of the skin occurs, followed by the formation of edema. A few hours later a blister forms in the affected area (may contain hemorrhagic or serous fluid), and approximately six to seven days after the bladder dries, a crust forms in its place that disappears on its own within twoweeks.

After removing the wart, follow these guidelines:

the blister formed at the site of the nipple must not be opened;
the affected area should not be taped;
it is recommended to wrap the site of exposure with a sterile bandage without pulling 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 penetration at the exposure site.

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

Laser coagulation

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

The following laser coagulation methods are available:

Carbon dioxide (CO2) - laser.The nipple is exposed to infrared light (wavelength is 10, 600 nm). The disadvantage of this method of treatment is that the cauterization of the tissue is not selective, ie there is a possibility of damage to healthy tissues. The efficiency of removing 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 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) of oxygenated hemoglobin, in which the destruction of dilated capillaries in the nipple occurs, as well as the 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 that disappears on its own within seven to ten days. It is not recommended to tear the bark, as well as lubricate with something (ointments, creams, alcoholic solutions). Also, water should be avoided at the site of exposure for the first few days after the procedure.

Advantages of the method	Method Disadvantages
scar tissue heals	The disadvantages of this method include only the high cost of the procedure
fast tissue healing
low risk of recurrence (recurrence)
severely affects healthy tissue

Electrocoagulation

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

After the procedure, a thick crust is created 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 applying water or soap to the affected area of skin;
the formed crust should not be touched or torn off;
For the first seven to ten days, it is recommended to place the antiseptic once or twice a day.

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

Radiowave 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 cells affected by the papilloma virus to evaporate. 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 skin that 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 bark within seven to ten days.

Advantages of the method	Method Disadvantages
when exposed to the affected area, healthy tissue is virtually 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 the removal of the wart with a scalpel under local anesthesia. After excision of the affected area, sutures are applied that are removed after seven to ten days.

Advantages of the method	Method Disadvantages
used to remove large warts	scars may remain on the affected area after suture removal
	there is a risk of remission (disappearance of symptoms) warts

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

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

Note:If complications occur after removal of the wart (inflammation of the affected area, prolonged healing, scarring), 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 nipple;
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, the use of traditional treatment methods is recommended.

Name of the tool used	Cooking	Apply
*Acetic acid*	You need to buy 70% acetic acid, vaseline and prepare a pipette to apply the correct dose.	Apply Vaseline to healthy skin around the nipple before using acetic acid. Then, using a pipette, one drop of acetic acid should be applied to the nipple. Use this method 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 nipple with the resulting infusion once a day until the formation is completely gone.
*Saline*	Dissolve one tablespoon of salt in warm water (100 ml) and add one tablespoon of vinegar (9%). The resulting solution must be thoroughly mixed, and then the pulp of one plum should be dipped in 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 a pulp.	The resulting plum puree must be applied to the nipple. For a secure grip, wrap the foot and put a sock on it. This compress should be left for two to three hours. The procedure should be repeated every day until the wart completely disappears.
*Wormwood Infusion*	Add three tablespoons of dried 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 nipples move away.
*Lemon peel infusion*	You need to peel two lemons and put them in a 1 liter jar, crushed. Then add 100 ml of 9% vinegar to the bowl 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 on the nipples twice a day until they disappear completely.
*St. John's wort decoction*	Add one tablespoon of chopped St. John's wort to one glass of water (250 ml) and simmer for 15 minutes on low heat. After cooking, the broth must be cooled and then filtered.	The resulting broth should lubricate the nipples three to four times a day until they disappear completely.
Note:In case of any side effects, contact 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 (causes death of hidden microorganisms);
anti-inflammatory;
spasmolytic;
choleretic;
antivirus;
wound healing;
antipruritic;
celandine also contains vitamins A and C.

In the treatment of plantar warts, fresh celandine juice is used, which must 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 nipple with blue.

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

helps reduce walking pain;
accelerates wart drying and crust formation;
, due to the content of vitamins A and C, stimulates the local immune response.

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

To improve the effectiveness of plantar wart treatment, the following recommendations should be followed:

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