Health Tips

Gyms are the go-to places for most people to stay fit and healthy, but they can also be one of the breeding grounds for unwanted foot conditions such as plantar warts. Plantar warts are essentially caused by the human papillomavirus (HPV) and they can be easily contracted in moist, communal areas such as locker rooms and showers. This could put gym-goers at risk for plantar warts, amongst other skin infections — unless they practice certain precautions. 

What are plantar warts?
Plantar warts or sometimes referred to as verruca, are non-cancerous growths that appear on the soles of the feet, caused by the human papillomavirus (HPV). While there are over 100 different strains of HPV, only a few causes warts on your feet, specifically types 1,2,4 and 63 whereas the others are more likely to cause warts on other areas of your skin and body (hands, face or genitals). 

Image source: volunteerpodiatry

In terms of appearance, plantar warts often have a rough, grainy appearance and can be surrounded by callused skin, making them uncomfortable to walk on. Although they are not directly related to pressure and can be found anywhere on the feet, plantar warts are often found on your heels or other weight-bearing areas.

Image source: thefeetpeople

How do I know if I have plantar warts?

A skin growth on the foot may indicate plantar wart if it has: 

1. Small, hard bumps: As mentioned, plantar warts often appear as small, grainy or rough-textured bumps on the sole of the foot. They can vary in size and may have a gray or brownish color 

2. Callused skin: The skin around plantar warts often become thicken and callused, causing the affected area to be hardened, especially around the bump

3. Pain or discomfort: Some may experience pain or discomfort when applying pressure to the affected area either by walking or standing. The discomfort can be similar to walking with a pebble in your shoe

4. Black dots: Plantar warts can sometimes have tiny black dots on their surface. These dots are actually small, clotted blood vessels and are a characteristic feature of plantar warts.

5. Changes in appearance: Plantar warts may change in appearance over time. They may grow in size or multiply, as a result, the skin around them may also become more callused.

How do you get plantar warts?

Plantar warts are highly contagious due to its viral properties and may be contracted through direct or indirect contact with the virus, particularly in warm, moist areas. Some common ways it is usually spread include: 

• Walking barefoot in public places, typically in gyms, locker rooms, shower communal areas or by the swimming pool 

• Sharing towels, socks or shoes with someone who already has plantar wart(s). 

• Scratching or picking at an existing wart and then touching other parts of your foot
   

Ways to Prevent Plantar Warts

1. Wear shower shoes or sandals in gyms, locker rooms, swimming pool or communal shower areas and avoid going barefoot

2. Never share personal belongings such as towels, socks or shoes with others in the gym as it can be spread through direct contact with contaminated items

3. Maintaining adequate foot hygiene. Make sure to wash and dry your feet thoroughly each time.

4. Change socks regularly once your feet gets sweaty

5. Choose the right footwear as ill-fitting shoes can create pressure points on your feet, making it easier for warts to develop

6. Avoid touching or scratching warts. Additionally, do be cautious when trimming your nails or using the pumice stones on your feet to avoid spreading the virus to unaffected areas

7. Wash or sanitize your hands immediately after a workout 

Treatment options

In most cases, plantar warts will go away naturally without any treatment. According to studies, about 65-78% of warts shrink or disappear eventually within 2 years. However, if they do not go away within this person, you may want to remove them either by visiting the doctor or treating them at home by yourself. Treatment include: 

1. Salicylic acid preparations
   These can be found as an over the counter medication in most pharmacies. It works by softening the affected skin and gradually causing the wart to peel away. Salicylic acid preparations come in many different forms, such as in liquid, cream, stick, or medicated pads. These products are usually applied directly on the wart after soaking it in water for a few minutes.
   
   Salicylic acid is also thought to be safe for most patients, including children EXCEPT those who are suffering from diabetic neuropathy as it might lead to other infection or damage the skin around the warts without them noticing. This method may take up to 12 weeks or more to remove the wart completely.
   
   

Image source: American Journal of Case Reports

2. Cryotherapy
   This involves freezing the wart with liquid nitrogen at a temperature of about -196 degrees, causing it to peel away over time. It tends to be painful for some and therefore may not be advisable for young children. To get the best results from cryotherapy, you may need to return every 3 weeks to your attending dermatologist to repeat treatment for a few months. Most dermatologists will however use both salicylic acid and cryotherapy concurrently to maximize the treatment outcome.

3. Duct tape occlusion
   This method is considered to be safe for children but remains an unproven approach till date. To try it, cover the wart with a silver duct tape and then change it every few days. Between applications, soak the wart in water for a few minutes and gently remove the dead tissues with a pumice stone or emery board and leave the wart open to air dry.

4. Laser treatment or Electrocautery
   For stubborn or large plantar warts, your doctor may suggest laser therapy as an alternative. This involves the use of high intensity light to destroy the warts by burning off the blood vessels that feed the wart. Though effective, it might leave a scar and hence are not really indicated unless your doctor deems necessary. Sometimes residual wart may also remain from laser therapy, and this may allow the whole wart to grow back again.
    

Conclusion
Plantar warts are common and treatable if managed right. They often go away without treatment within 2 years or you can also choose to get them treated at home or a visit to your doctor.
 

It is also worth noting that some warts may look very similar to other skin growths, so people should also consult a doctor if they’re unsure what the growth is or notice any shape/color/size changes on the feet.
 

This article is written by Janelle Leong, Bpharm(Hons) (DOC2US),
reviewed by Dr. Ng Shuk Sing, MBBS (DOC2US).

References

1. https://www.medicalnewstoday.com/articles/325813

2. https://www.healthline.com/health/skin-disorders/plantar-wart 

3. https://specialty.mims.com/warts%20-%20cutaneous/treatment 

4. https://www.aad.org/public/everyday-care/skin-care-secrets/routine/prevent-skin-infections-at-the-gym 

5. https://www.thefeetpeople.com.au/symptoms-we-treat/plantar-warts/
    

Written by

Janelle Leong, Bpharm(Hons) DOC2US