Do Plantar Warts Really Have Roots?

Well, the short answer to this question is, “no”, but I can say that it is asked often enough when a new patient presents with warts to make it worth mentioning!  The term “plantar wart”, or, “verruca plantaris” refers to a wart that is found anywhere on the bottom, or, “plantar” surface of the foot.  They are caused by a virus that can be contracted through contact with other people, often in areas or during activities where you are barefoot.  Common sites are the gym or pool, but it can also be contracted from other family members in your home, or even if you share a pair of shoes with another person.

Once you have the virus, it may become active by forming a tough lesion on the foot that can be mistaken for a callus.  The key differences in appearance are that a plantar wart tends to be more circular and focal in area, and also has tiny black or red “dots” on it.  These black dots are actually small blood vessels called “capillaries” which grow into the wart to provide nourishment.  It is the virus which signals the growth of these vessels.  One of the ways that your podiatrist can confirm that it is indeed a wart is by gently removing some of the callus tissue on the surface, and you will see pinpoint, fresh red bleeding.  This is painless.

Warts live within the top layer of skin, or epidermis, and do not extend deeper into the areas where you have fat, large blood vessels, nerves, or muscles.  It may feel as though the wart is very deep with roots due to the hardness of the skin around it, but this is not the case.

For initial treatment, it is fine to try some of the over-the-counter remedies which can be applied daily.  They are generally safe for most children and adults, but I recommend caution if you have a very young child, are pregnant, or have a general medical condition that may affect the health of your feet, such as diabetes.  In these cases, it is best to talk with your podiatrist first.

If the over-the-counter medicines do not seem to be working after 3-4 weeks, it is time to seek professional treatment.  In my practice, I generally discuss either topical treatment with a stronger chemical or having the wart excised (removed after a local anesthetic).  Both have proven to be effective and are equally good options depending on the patient’s goals and appearance of the warts.  One may be recommended over the other depending on the patient and their situation.

Once you have contracted the wart virus, you will always be a carrier, but may not always have warts.  The virus can be active or dormant, and certain situations, medical or otherwise, in your life may make the lesions reappear.  The good news is that the common plantar wart is not generally thought to be a threat to your overall health, but it can certainly be a nuisance to those who have struggled with them.