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Different ways to treat warts on the foot

Do your feet look like this (photo) where these little rough, almost cauliflower look appearance to them? They are called Verruca pedis or warts.

Skin warts are growths on the skin that are caused by a virus called Human Papillomavirus

(HPV). HPV infection is quite common are there are several types of warts with plantar warts

(warts on the bottom of the foot) being the most common a podiatrist will treat.

In order to know how to treat warts, we need to know how the wart develops in the first place. Below is a quick guide to how warts develop in our skin.

HPV lifecycle

The HPV lifecycle post infection can be up to 8 months before first signs of infection has occurred. This is where the virus enters the skin via any portal such as a break in the skin and enters the basal layer of the skin (the deepest epidermis layer) and incubates up to 8 months.

After this period the virus invades the keratinocytes (skin cells) and changes DNA structure within that cell in order to make replicas of itself, this in turn triggers proliferation of the skin cells which are then expanded with fluid (meaning each keratinocyte has a multitude of these viruses and filled with fluid). This occurs via desquamation (shedding of skin cells) through the four layers of the epidermis it becomes bigger and bigger and it is this that physically alters the appearance epidermis. This is when we see the wart.

During this time of travelling through the different layers of the skin cells it releases anti-inflammatory cells (help fight infections) and alters Langerhans cells which are the only immune cells we have in the epidermis which causes immune ignorance therefore, leading to the wart developing.

Who gets warts?

They are common in both children and adults. People with a weakened immune system may have extensive warts or warts that are difficult to control.

Individuals can become infected with the virus that causes warts by touching another person’s wart. HPV is most likely to infect unhealthy or injured skin but can infect healthy skin as well.

They are commonly spread via communal areas such as swimming pools or change rooms.

Treatment for warts

· Depends on where the wart is located and how much discomfort it is causing you. Treatment is not required in all cases. For example, most skin warts in children resolve on their own within two years without treatment. However, during this time the wart may enlarge, or new warts appear. Small warts are easier to treat than larger warts, for this reason most people choose to treat warts.

  • Swift microwave therapy. This works by facilitating the immune system to recognising the HPV. It does this by transforming the virally infected cells into a state of stress by heating the tissue to 42-45 degrees. Usually 3-4 treatments are required to be most effective.

  • Nerve block and needling. This involves administering a local anaesthetic which will numb the area where the wart is present. Then a sterile syringe needle is probed into the wart tissue several times, depending on the size of the wart. This induces our natural immune cells to kick in and fight the HPV.

  • · Sharps debridement of the lesion top to induce an inflammatory response via a pin prick bleed then the following nitric acid, silver nitrate and salicylic acid can be used. All these treatments can take several weeks (4-8)

  • · Nitric acid is a caustic which burns through by chemical destruction of the tissues. This may cause some discomfort but is highly effective in the treatment of plantar warts.

  • · Silver nitrate is used to chemically cauterize the skin effectively permanently destroying the unwanted wart tissue and is not painful to the patient

  • · Salicylic acid is the least invasive of the treatments of plantar warts and removes the wart by exfoliating the skin cells until the wart is gone. This in turn may also promote the immune cells around the wart to start producing healthy skin cells.

  • · Liquid nitrogen, involves freezing the wart, this may take several treatments on a weekly basis. Liquid nitrogen can cause some discomfort to the patient.

  • · All the chemical treatments mentioned are dressed afterwards and we advise the patient to leave on for 4-7 days between visits and most warts need between 4-7 visits to resolve.

  • · Felt padding with apertures can be used on the painful warts to deflect or offload specific area.

  • · Patient may be advised to try treatment at home, purchase duo film from a pharmacy and apply once daily between consults (Do not apply over healthy skin)

If you or someone you know has a wart or thinks they have a wart, come in and see us here at Foot Body Sole.

CLICK below to make a booking or call (03) 8648 7678 to speak with our lovely front of service and our team of practitioners.

108 Bridport Street, Albert Park 3206

Victoria Australia

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