What Is A Wart, And Do I Have One?

Very often, a patient comes into our office complaining of some hard skin with tiny black dots in the middle of it, stating that they might have a plantar’s wart on the bottom of their foot.  How do they know if it is a wart?  Well, they figure there is a bump with thickened skin, so it must be a wart, what else could it be?  As podiatrists, we are the experts in treating ailments of the foot, including all types of dermatologic ailments, including warts.  But how can you be sure that what you have on the bottom of your foot is indeed a wart?


What Exactly Is A Wart?

The technical term for a wart is “verruca plantaris.”  It is actually a virus, originating from the Huma Papilloma Virus (HPV.)  Your skin, considered the largest “organ” in the human body, consists of 7 layers: 3 layers of the epidermis and 4 layers of the dermis.  The virus actually lives between the dermal layer and the epidermal layer.  As it proliferates and multiplies, it appears as small tiny black dots, which are actually small blood capillaries.  It can appear as a cauliflower type lesion covered with a thick layer of callused skin.  If it appears on pressure areas, your body tries to protect itself by producing more layers of skin on top of more layers of skin, eventually producing a hard callus that may be painful with pressure.  Often pain is what brings a patient in, as they wonder that callus is causing so much pain! In addition, there may be an absence of skin lines through the wart, as we all have skin lines along the bottom of our feet just as we have fingerprints on our fingers.  There may also be pain with side to side palpation, not just direct pressure.  If you tried to scrape the hard skin off with a file, you may see pinpoint bleeding occur. 


How did I get it?

The virus is ubiquitous, meaning it is everywhere.  Contrary to popular belief, it really has little to do with hygiene, but rather how often you are exposed to the virus and the ease at which your foot is infected.  The virus thrives in moist, damp environments such as the side of a pool, a gym mat,  locker room or shower/bathroom floor.  There has to be some sort of break in skin on the bottom of your foot in order for it to enter the skin.  The opening may be ever so tiny, something as small as a paper cut or a scrape, and the virus enters.  If it finds the environment of the bottom of your foot favorable, it thrives.  Because your body does not detect this virus as something that should not be there, it does not mount an immune response. 

You may not notice it at first as it is not detectable by the naked eye, but will thrive between the dermis and epidermis and then eventually break through the dermis where you can see it.  It may also multiply and spread to other parts of the feet or toes.  It may also spread to other parts of the body, such as fingers, elbow, or knees.

What Else Could It Be?

The best way for you to receive a proper diagnosis is to visit our doctors at Prairie Path Foot and Ankle Clinic.  We will go through a thorough exam and determine if it is indeed a wart or not.  It is possible that the lesion on the foot could be a corn or callus, a clogged sweat gland or porokeratosis.  In some cases, it could be a foreign body or something called an inclusion cyst, or a cyst that forms around a foreign body.  If the lesion looks suspicious, our doctors may decide to take a biopsy and send it to a special dermatopathology lab to determine if it is indeed a wart.  In most cases, our patients are relieved that they finally have a proper diagnosis and can start on a treatment plan.

How Do I Get Rid Of It?

Many patients have self-diagnosed and tried an over the counter medicine for warts.  This may range from topical drops to a “freezing” spray.  Or, they may have looked up on the internet “natural ways to get rid of a wart” and have tried everything from natural oils to apple cider vinegar to duct tape.  When any of those treatments fail, then parents will take their children to their pediatrician where she may treat it with a “freezing spray” of nitrous oxide.  At Prairie Path Foot and Ankle Clinic, we have tried various different treatments and have found that our treatment plan works the best.  Our treatment plan is painless and consists of an in-office treatment on the wart approximately every 2 weeks.  In between visits, we give instructions to the patient to treat the wart at home.  The instructions include the use of a pumi bar daily (dispensed in our office)  to decrease the skin build up and a topical medication (also dispensed in our office) to apply daily. 

Our Treatment Accomplishes Two Main Objectives:

  1. It “burns down the house that the wart lives in.  The treatments make the skin around the wart less favorable for the wart to thrive.  It actually changes the environment that attracted the virus to your foot in the first place. This is why after several treatments, the virus leaves to find a more favorable environment, preferably NOT on your body!
  2. It activates your own immune system.  Now this doesn’t mean that you as a patient have a weak immune system necessarily, however, the wart virus is existing “incognito,” meaning your body doesn’t realize that it is supposed to be fighting it off.  When the treatment is performed by the Dr. in the office, the skin around the wart is irritated.  This activates the body to mount an immune response responding to the “irritation” it detects.  Thus, the body helps fight off this “invader.” Both of these methods insure that your body will treat itself from the inside out.  There are other alternatives, but in our experience, this is the safest, most efficient, least painful, and most convenient way to get rid of warts. 

Do I Have To Treat It?

In a word – yes.  If it is not treated, the condition could become worse.  That tiny lesion on your foot can become bigger, it can spread to other toes or to the other foot, or even worse, can spread to other parts of the body. 

Is It Contagious?

Warts are everywhere – it just needs the right environment to survive and thrive.  If your foot is the right environment to house the wart, then it just needs to find another host in order to survive.  So yes, it is contagious – under the right circumstances.

How Do I Prevent It From Coming Back?

Once you go through our treatment plan and the wart is gone, there are several measures to prevent it from returning:

  1. Be aware of being barefoot in areas where warts are known to hide – like was mentioned before: the side of a pool, gym floors/gym mats, locker room floors, gymnastics floors
  2. Prevent your feet from becoming an environment where the warts will thrive.  Change socks often, beware of sweating feet, don’t wear other people’s shoes
  3. Examine your feet daily, and any sign of the return of the wart, start the treatment plan immediately.


The most important caveat from this information is to understand that any time you have a question about your foot, whether it be something on your skin to any pain in the muscle, tendons, or bones of the foot, make an appointment to see your podiatrist.  Here at Prairie Path Foot and Ankle Clinic, we will do a thorough exam and formulate a treatment plan for you.