Plantar warts: when to book

Plantar warts are human papillomavirus infections in the skin of the sole. They are not corns, even though they are often treated as if they were. They hurt on standing because the lesion grows inward against a surface that takes body weight. Picking them at home or applying acids without control can macerate healthy skin and delay the diagnosis of something else: a foreign body, porokeratosis or, on an at-risk foot, a lesion that is not viral.

They are common in children; in adults they sometimes coincide with a dip in immunity, shared showers or repeated microtrauma. Spread is not as automatic as changing-room folklore suggests: the skin needs a way in. Still, do not share files or cut the lesion blindly.

How they are recognised

They often look like a hyperkeratotic patch with black dots (thrombosed capillaries) and a break in the skin lines. They may be single or mosaic. Pain on side pinch is more typical than a simple overload callus, which hurts more on vertical pressure. In clinic we pare in a controlled way to see those clues; we do not “dig until it bleeds” as a rule.

Not every plantar mark or lump is a wart. Overload callus, an old foreign body, keratosis or, rarely, another skin lesion can look similar. Diagnosis is clinical and, if there is doubt or the foot is diabetic, a supermarket acid is not the plan.

What not to do

• Do not use corn plasters repeatedly, especially if you have diabetes, poor circulation or neuropathy.
• Do not cut them with blades or pierce them: bleeding and infection are a poor swap for “getting it out now”.
• Do not occlude for days without looking at what is underneath.
• Do not assume a small lesion can wait a year: if it hurts to stand, gait is already changing.

Treatment in clinic

The approach depends on number, depth, age, site (weight-bearing versus midfoot) and whether the foot is at risk. It may include controlled paring, directed topical treatment, off-loading so the lesion is not driven in at every step, and, in selected cases, other techniques we have in clinic, including laser when indicated. The aim is to clear the viral lesion without leaving a painful scar on a loading area.

Warts can resolve on their own, especially in children, but “waiting it out” while walking hurts is not always sensible. If they grow, bleed, stop school or work, or fail to improve, book at Podología Priego. If you have diabetes or notice warmth, redness or discharge around the lesion, bring the appointment forward: the urgent problem may be the surrounding skin, not the virus.

A plantar lesion is diagnosed in clinic. Do not self-treat acids on an at-risk foot.