Warts and All!Warts or verrucae pedis,(meaning of the foot), to give them their medical name seem to be on the increase in our practice.
Verrucae are caused by the human papilloma virus (HPV), which commonly infects the skin. It affects the lower layers of the skin and causes a change in the growth pattern of the skin which results in a small tumour. However, this tumour is BENIGN!
Traditionally, podiatrists were taught that verrucae affect the younger patient, but it is quite clear that they can affect any age group. I have recently treated a 70 yearold lady!
Warts occur on any part of your foot and even under the toe-nails. They also appear differently as they develop. Often starting as a small puncture mark they can develop to look like a cauliflower growing in the skin.
Plantar warts are the most common – that is on the sole of your foot – growing anywhere, including on weight-bearing areas, where they are really painful.
Diagnosis is a big problem, podiatrists believe that many hard corns are misdiagnosed as plantar warts – with resulting surgical excision – which is wrong and leaves painful scar tissue in many cases.
Recognising clinical appearance is very important and difficult. Although it starts as a small spot, later the skin striations are usually pushed aside in a wart. The growth looks like a cauliflower, with black dots in the middle. Often there is a group of them, not just a single growth. They can grow on any skin surface including the knees and hands. Pain like a pin- prick is common on pressing and also throbbing when the foot is lifted off the ground.
Treatment is variable! Some of us will freeze with Liquid Nitrogen. We also use Acids in pastes or solutions. Excision is the last resort (in my opinion), but electro-dessication under local anaesthetic does work. Although you have to get used to the smell of a bad braai whilst doing this treatment! The dead tissue always needs cutting off. This is not usually too painful.
Plantar warts are my worst nightmare and I tell my patients that I call them “reputation ruiners”, because they can take weeks to clear and often new ones grow during treatment. They also spread quickly in boarding school and some families – and sometimes they don’t!
That’s traditional treatment. If you don’t like the sound of it try some ‘home remedies’. Rubbing it with liver. Kissing a toad. Rubbing with various medicinal herbs (this works). Shouting at the moon, or finally, hoping that the Golden Lions rugby side wins one game in next years Super 14 competition!
So what to do