Warts in general are more commonly associated on the bottom of the feet (also known as plantar warts), but can present on the hands as well (palmar warts). Warts occur as a result of a viral infection, where the virus feeds off a more superficial network of small blood vessels. Often times, it gives the wart a raised appearance with a darkened center, but may also appear as raised crusty skin. They are usually well contained, though more severe cases may present in an 'Mosiac' form (a large cluster of warts). Symptoms typically include some form of pain or discomfort, as well as the presence of a skin lesion as mentioned above. Warts are highly contagious, meaning they spread very easily. If you or a loved one suspects they may have warts, it is recommended to begin immediate treatment to reduce the possibility of spreading the virus.
Plantar warts are warts that appear on the feet, usually on the bottom. They may present anywhere from the heel to the toes (and anywhere in between). If the warts are large enough, they usually cause some degree of pressure or pain. Often times, they are described as a squeezing or pinching sensation in the area. Due to the inherent thickness of the skin on the bottom of the feet, there are a wide array of treatment options. We start off by physically removing the superficial layers of the wart, going to the level of their food source (at which point we see a small area of a pinpoint bleed). While this may sound scary, there is typically minimal pain or discomfort during this step because the warts are more superficial than nerves of the skin (so in most cases no nerves will be touched). We typically like to start a bit more aggressively with an acid treatment (as opposed to freeze treatment). However, there is a fine balance between being aggressive to the wart and using an acid that is potentially hard on the good surrounding skin. We begin with a milder acid to ensure that your skin can properly tolerate the treatment. If the warts persist after several treatments, then we advance the strength of the acid while monitoring the health of the surrounding skin. In rare circumstances if all conservative options are exhausted, there is an in-office surgical procedure available as well.
Palmar warts are warts that present on the hands. They are usually smaller compared to feet counterparts. However, a similar raised crusty/dark lesion is often observed. They tend to show themselves around knuckles around the nails. Discomfort tends to be milder compared to warts on the feet (usually not nearly as much pressure applied to the area). The skin in the hands are inherently thinner, so more consideration is given towards safety. As a result, after scraping down the wart (almost always painless because the wart is above all the normal skin/nerves), we opt to apply a freeze treatment. While the freeze therapy is generally milder to the wart, it is also less destructive to nearby skin. If you tolerate the freeze treatments well, then we may advance to a milder acid treatment and observe the skin closely. Surgery is quite rare, and usually not done for warts on the hands.
In general treatment for both types of warts, it is highly important that treatments are done on a consistent basis, and for several treatments to take place after the wart appears to subside. Remember, all it takes is for one cell to survive and the wart can return! For more information, please feel free to get in touch with us.