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 papillomavirus. These manifestations are located directly in the support 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) represent 70 to 90 percent of the world's population.
Plantar warts are popularly called "pimples". This interpretation is associated with thorns, which are painful to step on.
Most of all HPV types affect the skin.

Causes of warts

A wart is a cutaneous viral disease caused by the human papillomavirus.

There are about a hundred varieties of this virus. They can enter the human body and not manifest for a long time, thanks to the protective properties of the body like:

;
phagocytosis (is a nonspecific defense reaction of the body, which occurs when a pathological agent enters the body, phagocytes surround it and destroy it).

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

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 or not warts occur depends on the state of immunity. People whose body resistance is reduced are more prone to the appearance of warts. In addition, the risk of developing warts increases when the body is affected by adverse factors (for example, stress, fatigue, insomnia, poor hygiene), which lead to a weakened immune system.

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

There are the following predisposing factors for human papillomavirus infection:

sweat on the legs (the skin becomes looser and the penetration of various infections 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)
microtrauma of the skin or mucous membrane (cracks, scratches, abrasions are the gateway for infection to enter the body);
uncomfortable tight shoes that cause friction on 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 can occur through pedicure instruments (if the instruments have not been disinfected);
public baths, saunas or swimming pools (places where the feet come into direct contact with the possibly infected floor surface).

Human skin consists of the epidermis, dermis and subcutaneous fat. The human papillomavirus, penetrating the skin tissue, affects the basal layer of the epidermis. Subsequently, when multiplied, the cells affected by the virus rise through all layers of the epidermis and are located in the superficial stratum corneum of the epithelium, manifesting themselves externally with rough and keratinized skin.

Human papilloma virus

HPV is an infection of the papovavirus family that affects the mucous membranes of the organs (usually the genitals), as well as skin epithelial cells. 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 divided into two groups:

papillomavirus with oncogenic properties;
papillomaviruses that do not have oncogenic properties.

Note:the 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 their 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 HPV types, 6, 11, 16 and 18 are distinguished as the most dangerous. These types of HPV can cause papillomas, condylomas and cancer.

Symptoms and how are warts on the feet

The 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 state does not manifest itself externally.
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 various symptoms.

Resource	Fade in	Photo
*Shiny surface*	Initially, the plantar wart appears as a shiny plaque, then its surface is keratinized, becoming rough and coarse.
*Dimensions*	Plantar warts vary in size from one to two centimeters and rise above the surface of the epithelium by one to three millimeters. Most of the time, warts are oval or round. There is also the concept of mother and daughter wart. The maternal wart appears first and is the largest; as a rule, younger daughter warts can form around it. Over time, maternal and daughter warts can come together 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 of the foot and the bones, which causes the surrounding tissue to harden. These warts, in most cases, are very painful due to the fact that they can compress the nerves of the foot, causing pain when walking.
*Color*	Most warts are light brown or yellowish-white.
*Black carnations*	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 bleeding capillaries in this area are thrombosed. This characteristic is a distinctive characteristic of the plantar wart of calluses and calluses.

Removal of warts from the sole

Currently, there are 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 papillomavirus penetrates the deepest layers of the epidermis (in the basal layer).

The treatment of a wart is necessary if:

the wart hurts;
the wart is bleeding;
large wart;
the color of the wart is irregular (for example, spots appear on it);
there is a rapid growth rate of the wart.

There are the following methods for removing plantar warts:

free-destruction;
laser coagulation;
electrocoagulation;
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 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, the removal efficiency is 84%. While the effectiveness of removing warts that have been around for more than six months is reduced to 39%.

The free-destruct 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 light halo 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 site of exposure, there is hyperemia (redness) of the skin, followed by the formation of edema. A few hours later, a blister forms in the affected area (may contain hemorrhagic or serous fluid), and about six to seven days after the bladder has dried, a crust forms in its place, which disappears on its own in two weeks.

After removing the wart, follow these guidelines:

a bubble formed at the wart site must not be opened;
the affected area must not be covered with adhesive tape;
it is recommended to bandage the exposure site with a sterile dressing, 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 exhibition site.

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

Removal of warts with a laser beam is one of the most common treatment methods today. This method is characterized by cauterization layer by layer of the affected area, which allows to control the depth of the 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 treatment method is that tissue cauterization is not selective, that is, there is a possibility of damage to healthy tissues. The efficiency of removing plantar warts with carbon dioxide laser is 70%.
Laser Erbium.This method is characterized by a shorter wavelength of 2940 nm, which significantly reduces the likelihood of scarring after tissue epithelization. The effectiveness of this treatment method is 75%.
Pulsed dye laser.This method is characterized by the selective absorption of energy (wavelength is 586 nm) oxygenated hemoglobin, in which the destruction of the enlarged capillaries in the wart occurs, as well as the stimulation of the immune system, which contributes to an effective cure. The effectiveness of this treatment method is approximately 95%.

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

Advantages of the method	Disadvantages of the method
the tissue heals without scarring	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 electric current is applied to the wart, which leads to 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 exhibition site, which disappears on its own in ten days.

After removing the wart, follow these guidelines:

during the healing period, avoid spilling water or soap on the affected area of the skin;
the formed crust must not be touched or pulled out;
For 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 and superficial warts
prevents bleeding	when applied to the deep layers of the skin after tissue healing, a scar may remain
the procedure takes from a few seconds to a minute	superficial wart removal 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 cells affected by the papilloma virus to evaporate. In addition, 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 the skin, which disappears on its own in seven to ten days.

Contraindicated during the healing period:

for the first two days after the procedure, you should not wet the moxibustion site;
remove the crust in 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
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 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 scarred
	there is a risk of remission (disappearance of symptoms) warts

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

if a crust forms, it should not be touched or pulled out;
limits the entry of water into the affected area;
after removal of the wart, it is impossible to expose the site of exposure to direct sunlight;
no cosmetic product (such as cream or lotion) should be applied to the affected area of the skin;
It is not recommended to visit public saunas, baths or swimming pools for one to two months after removing the wart;
After removing the wart, the use of vitamins A, C and E is recommended, as they promote rapid regeneration (cure) of the tissues, in addition to stimulating the body's defenses.

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

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

diabetes mellitus;
presence of malignant tumors;
pregnancy;
infectious and inflammatory diseases close to the wart;
exacerbation of herpes;
increased body temperature;
high blood pressure (above 140 per 100 millimeters of mercury).

Treatment of warts without surgery

For simple and superficial 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, petroleum jelly and prepare a pipette to apply the correct dosage.	Before using acetic acid, apply petroleum jelly to the 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 cut three cloves of garlic and then pour out 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 solution*	Dissolve a tablespoon of salt in warm water (100 ml) and add a tablespoon of vinegar (9%). The resulting solution should be stirred well, and then the plum pulp should be immersed in it and infused for two hours. After the time, it is necessary to remove the plum from the solution and grind it until it becomes porridge.	The resulting plum porridge should be applied to the wart. For a secure fit, roll up your 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 is completely gone.
*Absinthe infusion*	In a glass of hot water (250 ml) add three tablespoons of dry absinthe, cover and leave 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 gone.
*Lemon peel infusion*	You need to remove the skin of two lemons and place them in a crushed 1 liter jar. Then add 100 ml of 9% table vinegar to the container and close the bottle with a tightly closed lid. The contents should be infused for one week, shaking the bottle 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 are completely gone.
*St. John's wort decoction*	For a glass of water (250 ml), add a tablespoon of chopped St. John's wort and cook for 15 minutes over low heat. After cooking, the broth must be cooled and filtered.	The resulting broth should be applied to the warts three to four times a day until they completely disappear.
Note:In case of any side effects, you should immediately consult your doctor.

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

Celandine has the following medicinal properties:

bactericidal (causes the death of hidden microorganisms);
;
;
;
;
wound healing;
cauterization;
;
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 steam your feet well 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 to reduce pain when walking;
speeds up the wart drying process and the formation of a crust;
, 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 effectiveness of plantar warts treatment, the following recommendations should be observed:

to perform daily foot hygiene procedures;
vitamins should be used regularly to strengthen the immune system (for example, vitamins A, E, C);
wear individual shoes (for example homemade slippers);
with dry skin on the feet, regular use of moisturizing and nourishing foot creams is necessary;
in public places (bath, sauna or pool) personal slippers should be worn and bare feet 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 drying agents, and also try to choose the shoes according to the climate.