Plantar warts. Causes, treatment of pathology

12 January 2021

plantarwartsare benign growths of epithelial cells in the form of small increases caused by human papillomavirus. These manifestations are localized directly in the supporting areas of the foot or toes.

Interesting Facts:

According to statistics, the manifestation of plantar warts is most common between the ages of 20 and 30.
In most cases (more than 50%), plantar warts can heal on their own without any treatment.
According to various sources, HPV carriers (human papillomavirus) make up 70 to 90 percent of the world's population.
Plantar warts are called folk spikes. This interpretation is associated with thorns, which are painful to step on.
HPV types affect the skin the most.

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 themselves for a long time, thanks to the body's protective properties such as:

immunity;
phagocytosis (is a non-specific defense reaction of the body, that is, when a pathological substance enters the body, it is surrounded and destroyed by phagocytes).

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

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

70-90% of people carry the human papillomavirus, however, whether a wart occurs depends on the state of immunity. People whose body resistance decreases are more prone to warts. In addition, the risk of developing warts increases when the body is exposed to harmful factors (such as stress, fatigue, insomnia, poor hygiene), which lead to a weakening of the immune system.

The papilloma virus can be infected by contact with a warty person, such as a handshake, common objects (towels, slippers);

The following are predisposing factors for human papillomavirus infection:

(makes the skin looser and makes it easier for various infections to penetrate through it);
frequent washing, cleaning (frequent skin irritation with various cleansers destroys the skin's protective barrier, making it easier for the virus to penetrate)
microtrauma of the skin or mucous membranes (cracks, scratches, abrasions are the gateway for infection to enter the body)
uncomfortable tight shoes that cause the skin of the foot to rub (hardening of the skin, abrasions are also the entrance gate for the infection to enter the body);
diseases that lead to malnutrition of the epidermis of the foot (such as diabetes mellitus, atherosclerosis);
viral infection can occur on pedicure devices (if the instruments have not been disinfected);
public baths, saunas or swimming pools (places where the feet are in direct contact with a potentially infected floor surface).

Human skin consists of the epidermis, dermis, and subcutaneous fat. Human papillomavirus, by penetrating the skin tissue, affects the basal layer of the epidermis. Subsequently, the cells affected by the virus proliferate through all layers of the epidermis and are located on the surface stratum corneum of the epithelium, appearing as coarse and keratinized skin on the outside.

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. Papillomavirus contains DNA (deoxyribonucleic acid), which, when it enters cells in the human body, causes it to produce new virus particles.

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

oncogenic papillomaviruses;
Papillomaviruses that do not have oncogenic properties.

Note:oncogenic properties contribute to the development of malignancies.

There are more than a hundred types of human papillomavirus today. Plantar warts are usually caused by the first type of HPV, and in some cases their development can provoke the second and fourth types (non-oncogenic papillomaviruses).

HPV is commonly found in all people who have sex. Eight out of ten people became infected with this virus. Of all HPV types, 6, 11, 16, and 18 are distinguished as the most dangerous, these HPV types can cause papillomas, condylomas, and cancer.

Symptoms and Warts on the Legs

Human papillomavirus that invades tissues can be passive or active.

The passive state is characterized by the fact that the virus, located in the basal layer of the epidermis, multiplies slowly, does not reach the corneum of the epithelial layer, so this state does not manifest itself outward.
The active state is characterized by the active development of the virus, which rises to the upper layers of the epidermis with a number of symptoms.

Function	Fade in	Photo
*Glossy Surface*	Initially, the plantar wart appears as a glossy plaque, then its surface keratinizes, becoming rougher and rougher.
*Dimensions*	Plantar warts are 1-2 centimeters in size and 1-3 millimeters above the surface of the epithelium. Most often, the warts are oval or round. There is also the concept of maternal and girly warts. First, the maternal wart appears and is the largest; usually minor girl warts can develop around it. Over time, maternal and girly warts combined can form major lesions.
*Pain*	The plantar wart is on the foot where most of the weight is. The wart squeezes between the sole and the bones, causing the surrounding tissue to harden. These warts are very painful in most cases 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 and white.
*Blackheads*	If the corneum layer is removed from the wart surface, dark spots may appear on the bed of the affected area due to the fact that bleeding capillaries in this area are thrombusing. This property is the distinguishing feature of plantar warts from corns and pathological conditions.

Remove the sole wart

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

Wart treatment is needed if:

hurts the wart;
the wart bleeds;
large wart;
the color of the wart is uneven (spots have appeared in it, for example);
the wart grows rapidly.

There are the following methods to remove plantar warts:

cryodestruction;
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 destruction of the area of skin affected by the viruses when the wart freezes, followed by stimulation of the body's immune systems. It should be noted, however, that if the wart appears and exists for up to six months, its removal efficiency is 84%. While the effectiveness of removing warts that persist for more than six months is reduced to 39%.

Cryodestruction procedure can be performed:

in general (liquid nitrogen is applied until a light halo with a diameter of two millimeters appears around the wart);
aggressively (liquid nitrogen is applied for an additional five to twenty seconds after the appearance of a light halo around the wart).

Research has shown that an aggressive method of freezing a wart is more effective than a traditional method, but has the disadvantage of being more painful.

After removal of the wart, skin hyperaemia (redness of the skin) at the site of exposure) occurs and edema develops. A few hours later, a bubble forms in the affected area (may contain bleeding or serous fluid), and about six to seven days after the bladder dries, a crust forms at its site, which disappears on its own within two weeks.

After removing the wart, follow these guidelines:

The 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 that the exposure site be bandaged with a sterile bandage without straining to prevent mechanical damage and contamination of the affected area;
it is recommended to treat the affected area with 2% salicylic acid alcohol twice a day;
Try to avoid water entering the exposure area.

Method Benefits	Disadvantages of this method
tissue heals without scarring	if liquid nitrogen exposure occurs superficially, there is a high probability that the warts will recur (recur).
The procedure is performed without the use of local anesthesia	local hypo- or hyperpigmentation may occur after the procedure
It takes 1-2 minutes to remove this wart	there is a risk of scarring if deeper cauterization occurs

Laser coagulation

Laser wart removal is one of the most common treatments today. This method is characterized by layer-by-layer cauterization of the affected area, which allows the depth of exposure to be controlled. When the wart is removed, the laser beam simultaneously solders the vessels, preventing 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 10, 600 nm). The disadvantage of this method of treatment is that the tissue cauterization is not selective, i. e. there is a possibility of damage to healthy tissues. The efficiency of the removal of 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 treatment method is 75%.
Pulsed dye laser.This method is characterized by selective energy absorption (wavelength 586 nm) of oxygen-treated hemoglobin, in which wart dilated capillaries die, and stimulation of the immune system, which contributes to effective healing. The efficiency of this treatment method is about 95%.

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

Method Benefits	Disadvantages of this method
tissue heals without scarring	The disadvantages of this method are only the high cost of the procedure
rapid tissue healing
low risk of recurrence (recurrence)
has little effect on healthy tissues

Electrocoagulation

The plantar wart is exposed to high frequency current. The affected area should be cauterized under local anesthesia. Due to the coagulation loop applied to the affected area of the skin, an electric current is applied to the wart, leading to death. In addition, the effect of high temperatures leads to soldering of the vessels, which prevents the formation 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 guidelines:

during the healing period, try to avoid getting water or soap on the affected skin surface;
the formed bark must not be touched or torn;
It is recommended that the exposure site be treated with an antiseptic once or twice daily for the first seven to ten days.

Method Benefits	Disadvantages of this method
available cost of the procedure	for small, shallow warts
prevents bleeding	After tissue healing, a scar may remain on the deep layers of the skin
procedure takes a few seconds to a minute	Superficial wart removal may cause recurrence

Radio wave surgery

This treatment method uses a special electrode that emits high frequency radio waves (3, 8 - 4, 0 MHz). Exposure to plantar warts at high temperatures 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 in the affected area of the skin, which disappears on its own within seven to ten days.

Contraindicated during the recovery period:

The moxibustion site should not be wetted for the first two days after the procedure;
Peel off the bark within seven to ten days.

Method Benefits	Disadvantages of this method
When exposed to the affected area, healthy tissues are virtually unaffected	high cost of the procedure
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, stitches are applied, which are removed after seven to ten days.

scars may remain in the affected area after stitches are removed danger

Method Benefits	Disadvantages of this method
is used to remove large warts
	there is a remission (disappearance of symptoms) wart

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

if a crust is formed, it should not be touched or torn;
restricts the entry of water into the affected area;
it is impossible to expose the exposure site to direct sunlight after removing the wart;
No cosmetic product (such as cream or lotion) should be applied to the affected skin surface;
It is not recommended to visit public saunas, spas or swimming pools for a month or two after the wart has been removed;
is recommended to use vitamins A, C and E, as they promote rapid tissue regeneration (healing) and also stimulate the body's defenses.

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

All contraindications to the procedure are contraindications:

diabetes mellitus;
presence of malignancies;
pregnancy;
infectious and inflammatory diseases near the wart;
exacerbation of herpes;
increased body temperature;
hypertension (over 140/100 millimeters of mercury).

Treatment of warts without surgery

For single and shallow plantar warts, it is recommended to use traditional treatment methods.

Name of the device used	Cooking	Apply
*Acetic Acid*	You need to buy 70% acetic acid, Vaseline, and make a pipette for proper dosing.	Before using acetic acid, apply Vaseline to healthy skin around the wart. Then use a pipette to apply a drop of acetic acid to the wart. Use this method once a day until the wart disappears.
*Garlic Infusion*	Three cloves of garlic should be chopped and the boiling water of the resulting mass poured (50 ml). After one hour, the resulting infusion should be filtered and used.	Lubricate the wart area with the infusion you receive once a day until it disappears completely.
*Brine*	Dissolve one tablespoon of salt in warm water (100 ml) and add a tablespoon of vinegar (9%). The resulting solution should be mixed thoroughly, then the pulp of one of the plums should be dipped in and infused for two hours. After the time has elapsed, the plum should be removed from the solution and ground to crush.	The resulting plum crumb should be applied to the wart. Wrap your feet and put on socks for a secure fit. This compression should be left for two to three hours. The procedure should be repeated every day until the wart is completely gone.
*earthworm infusion*	Add three tablespoons of dry wormwood to a glass of hot water (250 ml), cover and refill for two hours.	The resulting solution should be applied three to four times a day to the affected areas of the foot until the warts come off.
*Lemon Peel Infusion*	You need to remove two lemon peels and put them in a 1 liter jar crushed. Then add 100 ml of 9% table vinegar to the jar and close the jar tightly. The contents should be administered for one week, shaking the container regularly. At the end of the period, the infusion should be filtered.	The resulting infusion should be moistened with warts twice daily until they disappear completely.
*St. John's wort decoction*	Add a tablespoon of chopped St. John’s wort to a glass of water (250 ml) and simmer for 15 minutes on low heat. After cooking, the broth should be cooled and then filtered.	The resulting broth should be smeared three to four times a day until they completely disappear.
Note:If you get any side effects, talk to your doctor immediately.

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

Celandine has the following medicinal properties:

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

Treatment of plantar warts uses fresh celandine juice, which should be rubbed two to three times a day on the affected skin until the warts are completely gone. Before applying celandine, it is recommended to steam your feet thoroughly in hot water and remove the keratinized part of the wart with pumice stone.

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

helps reduce pain while walking;
accelerates wart dehydration and crust formation;
stimulates local immune responses due to its vitamin A and C content.

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

In order to improve the effectiveness of the treatment of plantar warts, the following recommendations should be followed:

perform daily hygiene procedures for the feet;
Vitamins should be used regularly to strengthen the immune system (such as vitamins A, E, C);
use custom footwear (such as homemade slippers);
moisturizing and nourishing foot creams should be used regularly with dry foot skin;
Personal slippers should be worn in public places (bath, sauna or swimming pool) and avoided barefoot;
carefully choose the right footwear (eg right size, natural materials);
In case of excessive sweating of the feet, use desiccants and try to choose shoes according to the weather.