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Plantar Warts (Verruca Plantaris)

Wart is a skin condition that is very commonly found on different parts of the skin. If the wart is present on the bottom of the foot, it is called Plantar wart, plantar means the bottom. This is present especially at the weight-bearing areas like the heels and the balls on the foot. The technical name for warts is Verruca Plantaris, but they are more ordinarily referred to as Plantar Wart, as the term "plantar" refers to the bottom of the foot. A wart appears as thick, rough, callus- like thickenings that grow on the soles of the feet; it develops when the skin is infected by a virus. It is estimated that 7-10% of the US population are currently affected with warts.

There are two particular types of warts: solitary and mosaic. When warts are presented as a solitary lesion, they are known as solitary warts. It often increases in size and may eventually multiply, forming additional "satellite" warts. In contrast to solitary warts, mosaic warts are a cluster of several small warts growing closely together in one area. Evidently, mosaic warts are more difficult to treat than solitary warts. However, with Dr. Ravaei's years of experience with patients, he is capable of treating any case of the warts easily and doing the best to get rid of this condition.

Undoubtedly, Plantar Warts affect both males and females, as both men and woman are carriers of HPV. Over the years, Dr. Ravaei has seen patients with the case of Plantar Warts in all age groups, but it is has been more commonly seen among children and adolescents between the ages of 12-16.

Warts are viral in nature. They are the manifestation and growth of a contagious virus known as HPV (the Human Papillomavirus). It invades the skin through small cuts on its surface. Once they are internal through the skin, the virus can grow and spread to other locations on the body, stimulating the rapid generation of cells on the surface of your skin. There are over 60 different strains of HPV; HPV 1, 2, 4, 63 belong to the Plantar Wart. One can self-spread the lesions. Plantar Warts commonly begin in areas of traumatized skin. They are also contracted from communal areas such as locker rooms, bathrooms, and hotel rooms. In order to decrease the spreading of warts to others while in such areas, the use of disinfectants and sandals is encouraged.

PREVENTION

In order to reduce the risk factors of Plantar Warts, Dr. Ravaei recommends that you do the following:

  1. Avoid direct contact with warts.
  2. Make sure to actively keep your feet clean and dry and remember to change your socks daily.
  3. Resist going barefoot in public areas: public pools, saunas, and locker rooms. Remember to wear sandals.
  4. Restrain from picking your warts as they can spread to other areas.
  5. Wash your hands carefully after touching your warts.

TREATMENT

To diagnose a plantar wart, Dr. Ravaei will examine the patient's foot and look for signs and symptoms of a wart. Because a wart is a virus, the goal of the professional is to remove the affected area that contains the warty skin cells, while keeping damage to the surrounding tissue to a minimum. In this case, Dr. Ravaei may choose one of several possible methods. Here are a few techniques that Dr. Ravaei utilizes. It needs to be mentioned that he will examine the patient and based on their condition, he will use the best technique to once and for all rid of this disfiguring condition. One of the methods is cryotherapy. Cryotherapy is when an extremely cold solution is used to freeze the wart and thus kill the virus. This treatment has been around for a while and it may require the patient to return to the office for a few treatments. Another common treatment is applying acid to the wart. The way this treatment works is very similar to the cryotherapy. First the lesion is identified and the solution is applied to the area. The solution usually kills the virus but this one as well requires for the patient to come back few times for a follow up.

Dr. Ravaei may choose to inject the wart with a drug that will attack the virus. Bleomycin and interferon-alpha have been used with success in these applications. Bleomycin is an antibiotic produced by the bacterium Streptomyces verticillus and acts by inhibiting DNA synthesis in cells and viruses; it breaks up strands of the DNA molecule. The human papilloma virus (HPV) that infects the skin and causes the wart to form dies as its DNA is chopped up by the bleomycin. Bleomycin may also target the blood vessels that feed the wart. Dr. Ravaei may use cantharidin -- a substance extracted from the blister beetle -- on your warts. Typically, the extract is mixed with other chemicals, painted onto the skin and covered with a bandage. The application is painless, but the resulting skin blister can be uncomfortable and may cause swelling. However, the blister has an important purpose. It lifts the wart off your skin, so your doctor can remove the dead part of the wart.

Laser surgery: Laser surgery uses an intense beam of light, or laser, to burn and destroy the wart tissue. Dr. Ravaei offers two procedures for laser wart removal; one type of laser cuts away the growth, while another cauterizes the blood vessels that feed it so that the wart dies and falls away on its own. Laser surgery is considered by many as the last treatment for warts. Usually when all other treatments fail, this treatment is used to once and for all get rid of the condition. The patient usually needs to come back for a few treatments to get rid of the condition. Sometime the insurance does not cover the laser treatment and the patient might need to pay out of pocket for part or all of the treatment.

Surgical procedures: Dr. Ravaei may choose to use a technique that involves cutting away the wart via a process called electrodesiccation and curettage, which uses an electric needle. The lesion could also be removed with a blade. This will require the patient to undergo local anesthesia and or sedation and it may mean the patient might be required to take few days off from work should this lesion be on a weight-bearing part of the body. The procedure may feel cumbersome for some patients; however, it is an effective form of treatment and results in long- term wart removal.