A plantar wart can spread if you touch, scratch, or pick at it. Sometimes, they form clusters on one or both feet. Plantar warts can go away suddenly after months or years.
This article will go over what causes plantar warts, how they are treated, and ways you can prevent them.
What Are Plantar Warts?
Plantar warts are growths on the foot that are caused by HPV.
Several plantar warts may appear in a group. It’s also possible to have one wart at first, but more form over time.
Plantar warts have grainy, finger-like fibers that have a hardened callus around them. If a plantar wart is trimmed back, you’ll see some black dots. These dots are capillaries that have hardened, making them bigger.
Anyone can get a plantar wart, but they are most common in children, teens, and young adults.
Plantar Warts vs. Corns
Plantar warts look like corns but they have some key differences. Plantar warts have a different structure than corns. They also form in different places on the foot.
Corns are commonly found on the top surfaces of the small toes, especially over a joint. Plantar warts are more likely to pop up on the heel or weight-bearing parts of the bottom of the feet (the soles).
Plantar Wart Symptoms
Plantar warts may not hurt. However, if a wart presses on sensitive tissue and nerve endings in the foot, it can cause pain.
Plantar warts usually grow inward because when you walk or stand, it puts pressure on them. Warts that are growing inward and warts on the skin folds of the toes tend to hurt the most.
Larger plantar warts can split open. When the sensitive tissue underneath gets irritated, it can cause pain and bleeding.
Causes
All warts are caused by HPV. It’s the same virus that causes genital warts. There are more than 100 strains of HPV. The HPV-1 strain is the most common cause of plantar warts. However, HPV types 2, 4, 60, and 63 have also been known to cause plantar warts.
The HPV virus lives best on moist surfaces. The virus is easily spread through tiny breaks in the outer part of the epidermis called the stratum corneum.
Once they’ve been infected with HPV, the skin cells begin to multiply rapidly. As they build up, the cells form a wart.
However, a wart may not develop for several weeks or months after an infection occurs. Once the wart has appeared, the virus can move from the first overgrowth to nearby breaks in the skin.
Not everyone exposed to HPV will get a wart. It’s more likely to happen to:
People with weak immune systemsPeople who frequently walk barefoot on moist surfaces (like locker room floors)People who have sweaty feet
Diagnosis
Healthcare providers can usually tell if a skin growth on your foot is a plantar wart just by looking at it. If they’re not sure, they can cut a piece of the growth off to look for the black dots inside that are a clue it’s a plantar wart.
A provider can also take a skin scraping called a shave biopsy. The piece of tissue is sent to the lab where it can be looked at more closely. If the growth is not a plantar wart, the biopsy can help your provider figure out what it is.
Growths on the feet could be other conditions like molluscum contagiosum, squamous cell carcinoma, or a complication of tuberculosis called verrucosa cutis.
Treatment
Smaller growths may go away on their own without treatment. Some warts can be treated at home with an over-the-counter (OTC) product.
Bigger or painful warts may need medical treatment. The two most common ways to treat a plantar wart are by freezing it off (cryotherapy) or cutting it out (surgical excision).
If a plantar wart is small and not bothering you, you can probably manage it on your own. However, you should always see your provider if a wart:
Is bleedingIs making it hard for you to walkStarts to feel or look differentGets worse after treatment
If you have diabetes, it’s even more important that you pay close attention to your feet. Even a small wart can trigger neuropathic pain or lead to a diabetic foot infection.
Home Remedies
How well over-the-counter (OTC) treatments work depends on how big the wart is and how well you stick to doing the treatment. A larger wart is less likely to go away with OTC treatments alone.
Most OTC wart treatments have an ingredient called salicylic acid in them. It’s a substance that’s good at getting the skin to shed dead cells.
There are a few different kinds of OTC wart products, such as:
Liquids you put on your skin with a dropper or swabAdhesive bandages that cover the wartAerosol sprays that “freeze” and kill the tissue
Debriding Foot Skin
If you’re using a product with salicylic acid, it will help to get rid of the dead skin cells between treatments. This is called debridement. You can use a callus file or pumice stone to debride the skin.
Try not to be too aggressive when you are debriding. If you’re too rough, it can cause bleeding, pain, or a boil or abscess.
Always make sure to clean your skin, your hands, and any tools you use very well when you’re done.
Prescriptions
When a wart doesn’t get better from OTC treatment, it’s called a recalcitrant wart. If you have a wart that hasn’t gone away with at-home treatment, you might need a prescription treatment.
Your provider may have you try a prescription-strength salicylic formulation to apply at home. It’s similar to the OTC treatments, just stronger.
5% 5-FU Cream
Recalcitrant warts can also be treated with a topical 5% 5-fluorouracil (5-FU) cream. Your provider will write you a prescription for this medication.
The cream is typically put on twice a day. Your provider will tell you how long you need to use it. The treatment can cause mild redness, peeling, and a burning sensation when you put it on.
Research has shown that 5-FU cream can be an effective way to treat warts:
In 2006, a small clinical trial showed that 5-FU cream was effective when it was used with the duct tape method. Of the 20 people in the study, the warts of 19 people went away completely after 12 weeks of treatment. A 2009 study looking at using 5-FU to treat warts in kids showed the treatment was about 41% effective.
Is 5% 5-FU Approved to Treat Warts?
Currently, 5% 5-FU cream is approved to treat solar keratosis and a type of skin cancer called basal cell carcinoma. It’s not approved to treat warts.
However, providers can still prescribe 5% 5-FU cream “off-label” to treat warts. Therefore, you should only use the cream for a wart if it’s given to you by a dermatologist.
Medical Procedures
If you’ve tried OTC and prescription treatments but they haven’t worked, you might need to have the wart taken off by a provider.
Here are a few procedures that can be used to remove plantar warts.
Cryotherapy uses liquid nitrogen to freeze and kill the affected tissue. It’s generally safe when performed by a healthcare provider, but you might need to have it done more than once. Trichloroacetic acid is a strong acid that needs to be applied by a provider. It might take several treatments for the wart to go away. Pulsed-dye laser therapy burns a wart. This process is called cauterization. You may have a lot of pain after the procedure. To make sure the wart goes away, you might need to have it done several times over three to four weeks. Electrosurgery and curettage is a procedure where a provider uses an electric device to burn the cells. Then, a tool called a curette is used to scrape them off. Your foot will be numbed with a local anesthetic, so you won’t feel pain during the procedure. However, it might be very painful after the anesthetic has worn off. Bleomycin is a chemotherapy drug. The medication can be used off-label with electrosurgery to treat recalcitrant plantar warts. A small study in 2017 reported that an injection of bleomycin in the foot combined with electrosurgery led to 78% of warts going away. When only bleomycin was used, only 16% of warts went away. Surgery can also be done to remove warts. After you are given a local anesthetic, a provider uses a tool called a scalpel to cut the wart out of your foot. You usually need to have stitches to close the hole. After surgery, you might need to stay off your foot for a few days. This will help prevent infection and keep the wound from opening. Cantharidin is a substance that causes blisters to form. If it’s injected under a wart, the blister pushes the wart up until it’s separate from the skin, dries up, and falls off. Cantharidin is not approved for use in the United States. Immunotherapy uses medications like diphencyprone (DCP) to get rid of HPV infection. It is usually only used for severe cases of plantar warts. Some people have an allergic reaction to immunotherapy, which could be life-threatening.
Prevention
While there are vaccines to prevent genital warts caused by HPV, these vaccines won’t prevent plantar warts. The Gardasil, Gardasil 9, and Cervarix vaccines don’t target the strains of HPV that cause plantar warts.
For some warts, medical treatments like cryotherapy or surgery are necessary. Treatment may need to be done more than once to make sure the wart is gone for good.
However, you can still take steps to prevent plantar warts:
Keep your feet clean. Wash and dry your feet well. You can also use a little talcum powder to help absorb moisture and sweat. Cover your feet when you’re walking in places where people go barefoot. If you get pedicures, make sure the salon you visit is clean (for example, sanitizing basins and tub liners). You might want to bring your own tools to the salon to help prevent infection. If you get a wart, change your shoes and socks regularly. This will help keep the virus from spreading.
Summary
Plantar warts are caused by HPV. They usually appear on the bottom of the feet. You may have a single wart of a group of them. The warts are also easily spread.
Plantar warts may not hurt. If they’re on a sensitive part of the foot, they can be painful. In some cases, they may make it hard to walk.
There are over-the-counter and prescription treatments for plantar warts, though they might need to be done several times to work. Plantar warts can be prevented with good foot hygiene.
A Word From Verywell
If you have a plantar wart, you might be able to manage it at home with some OTC remedies. If it doesn’t go away or it’s causing you pain, talk to your provider. There are other ways to treat plantar warts, such as prescription medications and surgery.
There are also things you can do to prevent plantar warts. One of the best approaches for foot health is to keep your feet clean and dry.
