Verruca's

 In most cases plantar warts cause no symptoms. Some plantar warts can be uncomfortable, particularly if they are present on a weight-bearing area. 

Diagnosis is usually based on the clinical appearance. Sometimes it can be difficult to tell a plantar wart from a corn. The Podiatrist may need to pare down the area to find the black dots that confirm the diagnosis of a viral wart. No other investigations are usually needed.  

 There is no guaranteed cure, but some treatments can help to clear warts. The best chance of cure is in young people who have not had their warts for very long. If you have an illness that affects your immunity or are taking immunosuppressant medication, treatment can be less successful. Most verrucas will clear with time and can be left untreated if not causing problems. When deciding whether to treat plantar warts or not, the following should be taken into account: 

• Warts usually resolve by themselves without leaving a blemish or scar. 
•  Successful treatment of a viral wart does not prevent further warts. 
• Some warts can be very stubborn. Treatment does not always work and may be time-consuming. 
• Treating plantar warts can be painful, especially when liquid nitrogen is used, and can occasionally cause a blister which, on the sole, can be very uncomfortable.  

• No treatment: Up to 65% of viral warts including plantar warts resolve by themselves without any treatment within two years of appearing. 
• Plantar warts that are not causing causing any adverse symptoms such as pain should be left alone. 
• Salicylic acid paints and gels: These are available in different strengths. Care should be taken not to damage surrounding normal skin, and treatment should be daily for at least 12 weeks.  If the wart becomes too sore, treatment should be stopped for a few days, then resumed. 
• Cryotherapy. Freezing the warts with liquid nitrogen. Ideally, cryotherapy should be repeated every three to four weeks. It is painful and may cause blisters and burns, and because of this is not usually recommended in children.
• Duct Tape: Although there is conflicting evidence regarding the effectiveness of duct tape in the treatment of cutaneous warts, it might still be well worth trying, especially in children. The wart should be occluded with duct tape for six days, and if the tape falls off it should be  replaced with a fresh piece. The tape should then be removed and the affected area soaked in luke-warm water and the wart pared down to remove any dead skin cells. The wart should then be left uncovered overnight and the duct tape reapplied once again in the morning. This can be continued for up to two months. • O
• Silver nitrate. The podiatrist pares down the wart and uses the caustic pencils. Contact immunotherapy with this chemical causes a  skin reaction that may boost the body’s immune reaction against the wart virus.
• Complementary and alternative treatments include hypnotherapy, homeopathy, acupuncture and herbal treatment. 

•  Wear comfortable shoes and do not share your shoes or socks with anyone else. 
• Special pads to relieve pressure on plantar warts. 
• Keep your feet clean and dry. 
• Change your shoes and socks daily. 
• Do not go barefoot in public places. Plantar warts should be covered with waterproof plasters or rubber ‘verruca socks’ if you go swimming. 
• When treating the wart, dispose of any skin filings hygienically and do not use the emery board or hard skin removal tools elsewhere as this could spread the infection. 
• Apply topical treatment regularly to get the maximum chance of cure. 
• To avoid spreading viral warts to other parts of the skin do not pick or scratch the warts. 
• Do not use same pumice stone, nail file and or nail clippers for your warts and your healthy skin and nails.