Plantar wart. Causes, treatment of pathology

12 January 2021

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

Interesting facts:

According to statistics, the most common manifestation of plantar warts occurs 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) make up 70 to 90 percent of the world's population.
Plantar warts are popularly called "thorns". This interpretation is associated with thorns that are painful to step on.
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 such protective properties of the body as:

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

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

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

70 - 90% of people are carriers of human papillomavirus, but whether the 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), which lead to a weakening of the immune system.

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

There are the following predisposing factors for human papillomavirus infection:

sweating of the feet (the skin becomes more relaxed 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 the virus)
microtraumas of the skin or mucous membranes (cracks, scratches, abrasions are the gateway for infection to enter the body);
uncomfortable tight shoes that provoke rubbing of the skin of the feet (calluses, abrasions are also a gateway for infection to enter the body);
diseases that lead to malnutrition of the epithelium of the leg (for example, diabetes, atherosclerosis);
viral infection can occur with pedicure tools (if the devices are not disinfected);
public baths, saunas or swimming pools (places where the feet come into direct contact with any contaminated floor surface).

Human skin consists of epidermis, dermis and subcutaneous fat. Human papillomavirus, which penetrates the skin tissue, affects the underlying layer of the epidermis. Subsequently, as they multiply, the cells affected by the virus rise through all layers of the epidermis and localize to the superficial stratum corneum of the epithelium, appearing externally with rough and keratinized skin.

Human papillomavirus

HPV is an infection of the papovirus family that affects the mucous membranes of the organs (usually the genitals) as well as the epithelial cells of the skin. The papilloma virus contains DNA (deoxyribonucleic acid), which, when introduced into a cell in 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 a hundred types of human papillomavirus. Plantar warts are usually caused by the first type of HPV, in some cases their formation can provoke the second and fourth types (non-oncogenic papillomaviruses).

HPV is common in anyone 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 differ as the most dangerous. It is these types of HPV that can cause papillomas, warts and cancer.

Symptoms and what warts on the legs look like

Human papillomavirus, penetrating the 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, not reaching the stratum corneum of the epithelium, therefore this condition does not manifest itself externally.
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 many symptoms.

Function	Fading	Photo
*Glossy surface*	Initially, the plantar wart appears as a shiny plaque, after which its surface becomes keratinized, becomes rougher and rougher.
*Dimensions*	Plantar warts are one to two centimeters in size and rise one to three millimeters above the surface of the epithelium. Most warts are oval or round. There is also the concept of mother and daughter warts. The mother's wart appears first and is the largest; as a rule, smaller daughter warts may form around it. Over time, warts on the mother and daughter can coalesce to form large lesions.
*Sickness*	The plantar wart is on the foot where most of the weight is. The wart is pressed between the sole and the bones, causing the surrounding tissue to harden. These warts are usually very painful due to the fact that the wart can pinch the nerves in the foot, causing pain when walking.
*Color*	Most warts are light brown or yellowish white.
*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 feature is a hallmark of plantar wart from corns and calluses.

Remove warts on the sole

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 papilloma virus penetrates into the deepest layers of the epidermis (in the base layer).

Wart treatment is necessary if:

the wart hurts;
the wart bleeds;
large wart;
the color of the wart is uneven (for example spots appear in it);
has a rapid rate of wart growth.

There are the following methods to remove plantar warts:

cryodestruction;
laser coagulation;
electrocoagulation;
radio wave operation;
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 skin affected by viruses is destroyed, followed by stimulation of the body's immune system. 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 slight halo around the wart, liquid nitrogen continues to be applied for another five to twenty seconds).

Studies show 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 removal of the wart at the site of exposure there is hyperemia (redness) of the skin, followed by swelling. A few hours later, a balloon 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 instructions:

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 exposure area with a sterile bandage without pulling 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.

Advantages of the method	Disadvantages of the method
tissue heals without scarring	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
removing a wart with this method takes one to two minutes	if deeper burns occur, there is a risk of scarring

Laser coagulation

Laser wart removal 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. Also, when removing a wart, the laser beam simultaneously welds 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 wart is exposed to infrared light (wavelength is 10, 600 nm). The disadvantage of this method of treatment is that the cauterization of the tissues is not selective, ie there is a possibility of damage to healthy tissue. The efficiency of removing plantar warts with the help of 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 epithelialization of tissues. The effectiveness of this method of treatment is 75%.
Pulsed dye laser.This method is characterized by selective energy absorption (wavelength is 586 nm) oxygenated hemoglobin, which causes the destruction of dilated capillaries in the wart, as well as stimulating 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. Peeling is not recommended, as well as lubrication with something (ointments, creams, alcoholic solutions). Also, water at the site of exposure should be avoided for the first few days after the procedure.

Advantages of the method	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

Plantar wart is exposed to high frequency current. Burning of the affected area should be performed under local anesthesia. Thanks to the coagulation circuit 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 soldering of the vessels, which prevents the development of bleeding.

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

After removing the wart, follow these instructions:

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

Advantages of the method	Disadvantages of the method
available procedure price	for small, shallow warts
prevents bleeding	When applied to the deep layers of the skin after tissue healing, a scar may remain
procedure takes from a few seconds to a 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 burning of blood vessels, the use of this method prevents the development of bleeding. After exposure, a crust forms on the affected area of skin, which disappears on its own within seven to ten days.

Contraindicated during the treatment period:

for 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 virtually unaffected	high cost of the procedure
has 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 excision of the affected area, sutures are applied, which are removed after seven to ten days.

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

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

if a crust forms, it should not be touched or torn off;
limiting the penetration of water into the affected area;
after removal of the wart it is impossible to expose the place of exposure to direct sunlight;
cosmetic products (such as cream or lotion) should not be applied to the affected area of skin;
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, the use of vitamins A, C and E is recommended, as they promote rapid tissue regeneration (healing) and stimulate the body's defenses.

Note:If complications occur after removal of 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 for the procedure are:

diabetes mellitus;
presence of malignant tumors;
pregnancy;
infectious and inflammatory diseases near the wart;
exacerbation of herpes;
fever;
high blood pressure (over 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	Application
*Acetic acid*	You need to buy 70% acetic acid, Vaseline and prepare the pipette to apply the right dose.	Before using acetic acid, apply Vaseline on healthy skin around the wart. Then a drop of acetic acid should be applied to the wart with the help of a pipette. Use this method once a day until the wart disappears.
*Garlic tincture*	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 should be filtered and used.	Lubricate the wart area with the resulting infusion once a day until the formation disappears completely.
*Saline*	Dissolve one tablespoon of salt in warm water (100 ml) and add one tablespoon of vinegar (9%). The resulting solution should be mixed thoroughly and then the pulp of one plum should be immersed 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 to a pulp.	The resulting plum paste should be applied to the wart. For a secure fit, wrap your legs and put a sock on it. This compress should remain for two to three hours. The procedure should be repeated every day until the wart disappears completely.
*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 warts are removed.
*Lemon peel infusion*	You need to remove the rind of two lemons and put it in a crushed 1 liter jar. 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, periodically shaking the jar. 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.
*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 on low heat. After cooking, the broth should be cooled and then filtered.	The resulting broth should be applied to 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 healing juice.

Purity has the following healing properties:

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

In the treatment of plantar warts, fresh juice of celandine 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 pumice.

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 crusts;
, 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 treatment for plantar warts, 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 shoes (for example slippers);
for 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 shoes (for example, the right size, natural materials);
in case of excessive sweating of the feet it is necessary to use desiccants, and also to try to choose shoes according to the weather.