By Carly Kriedberg, DPM, Heartland Foot and Ankle Associates
I often see patients that have a painful lesion on the bottom of their foot. They’ve typically been trying to treat this spot themselves, without success, causing them to finally see a podiatrist to get rid of it once and for all. It can sometimes be difficult to determine if this painful spot is a wart or a callous. The two conditions have similar symptoms, but have very different causes and treatment options. So, is it a callous or a wart?
Let’s talk warts
Warts are caused by the HPV virus embedding itself in the tissues of the body through small cuts or abrasions in your skin. This often happens from walking barefoot in warm, moist environments, like a swimming pool. Warts come in various shapes and forms. For our foot and ankle educational purposes, the strain of virus that most affects the feet are caused by HPV types 1,2,4, and 63. It should be mentioned that there are over 200 known strains of HPV! Warts often appear on the soles of the feet, usually along prominent pressure points where the foot contacts the ground. Because of their location, the skin is pushed inward towards the body. They tend to enlarge and may spread. They often look like hard bumps that may have tiny black dots at the center that bleed when trimmed. They are often painful when squeezed side to side. You will not be able to notice a continuation of skin lines through the wart. Since they are a virus, warts can be contagious so you shouldn’t wait for it to resolve by itself.
Let’s talk calluses
A callus is a patch of thick, tough skin tissue that is caused by repetitive friction or rubbing against another object, often times the shoes. The body is attempting to accommodate for a structural or functional deformity by creating a “thick padding” to help protect the skin from break down in high impact areas. This thickened area of skin tissue is painful to direct pressure, not the side to side pressure of warts. Unlike warts, callouses are not contagious, and they will not spontaneously re-appear on a different part of the foot.
Let’s talk prevention
Callouses can be prevented by simply wearing better fitting shoes and discussing foot structure and mechanical stability with your podiatrist. Your podiatrist may suggest custom casted or medical-grade orthotic inserts to remove excessive strain on your feet. If left unchecked, calluses can develop into ulcerations and lead to infections that can cause more serious complications. Since warts are contagious, they can be a little trickier to prevent. The most important thing is to avoid coming in contact with someone else’s wart, especially if you have cuts on your hands or feet. HPV may be spread from one individual to another simply by coming into contact with the virus. Small abrasions, cuts or other openings in the skin may leave the skin susceptible to HPV. Avoid sharing personal items such as towels and socks with others, and avoid walking barefoot across locker room floors or other warm, damp public areas.
Let’s talk treatment
Sometimes, warts go away without any sort of treatment, but they tend to be persistent and may often reemerge later on. In fact, a wart can come back months or even years later! There are several effective treatment options. One of the most common treatments is an active ingredient found in over-the-counter topical products called salicylic acid. This may be prescribed by your podiatrist to work in conjunction with other treatment options such as cryotherapy (freezing), and infrared laser treatment to burn away the virus.
Callouses can be effectively treated with over-the-counter padding, creams, and soaking. It should be warned that pads that are impregnated with medication often contain acids that can cause burns to surrounding skin tissue which can lead to infection with out proper usage. If you have diabetes or poor circulation, it’s important that you do not try and treat any foot problem yourself. Always check with a podiatrist for the best course of action.
Dr. Jarod Spencer and Dr. Carly Kriedberg have joined Dr. Lockwood and the team at Heartland Foot and Ankle Associates, located at 10 Heartland Dr. in Bloomington. If you have any foot problems, please contact them at 309-661-9975, or visit them online at www.HeartlandFootandAnkle.com.