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Sting warts and plantar warts: these are the causes and these therapies can help
Thorny warts (Verrucae plantares) are also known in medicine as prickly or plantar warts and are considered to be particularly unpleasant because on the one hand they are mostly on the sole of the foot and on the other hand they grow very deep inside the foot, which can be extremely painful. To make matters worse, thorny warts are also exceptionally stubborn in treatment, which makes this form of warts one of the most unpleasant complaints.
Because of their localization on the body, thorny warts are among the so-called “soles of the feet”. The term sole warts is sometimes incorrectly used only for thorny warts, but basically also includes other common warts (verrucae vulgares) that develop on the sole of the foot and the so-called mosaic warts, which, according to the name, sprout on the sole like mosaics or beds. However, hardly any sole of the foot is as painful as the thorn. In contrast to common and mosaic warts, this type of warts does not develop superficially on the skin, but instead grows deep into the foot tissue. This sometimes makes walking and standing unbearable, because any pressure intensifies the stinging pain.
Along with most other types of warts, thorny warts are the path of their formation. Triggered by human papilloma viruses (HPV), they are the result of a viral infection, in which the skin and tissue cells degenerate as a result of the infection. In the case of thorny warts in particular, it is the papilloma viruses type 1, 2, 4, 60 and 63 that cause the cell degeneration. Since the viruses prefer to nest in corneal tissue, the soles of the feet are of course a feast for them. A small wound or injury in the cornea of the foot is enough to contract a corresponding virus infection.
The incubation period for HPV infection is relatively long and can last from several weeks to months. Only then does benign cell growth develop. With their thorn-like extensions, they work their way deep into the foot tissue. In the further course, the infected tissue turns yellowish-brown to greyish, and there is the depression in the corneal tissue that is typical for thorny warts, which from the outside looks like a dried-up insect bite. The name of the thorn or sting wart is no coincidence.
A humid climate favors infection
The way in which the thorny warts preferentially reproduce is strongly reminiscent of the pathway of athlete's foot. In both cases, a smear infection can be cited as the main cause, with warm, moist locations significantly increasing the risk of infection. It is therefore not surprising that staying in public places with the right climate favors infection. Are considered to be particularly risky here
- public baths,
- public showers,
- Saunas and
- Changing rooms.
To make matters worse, people generally walk barefoot in precisely those places, which gives the pathogens easier access to the sole of the foot.
Open wounds are a risk
Many people understand wound infections as the contamination of major injuries by germs. Thorny warts impressively prove that wounds do not always have to be large to be infected. Because the HP viruses get into the skin tissue through the slightest abrasion of the skin and therefore do not require a particularly large wound opening to spread. Again, fungal infections should be pointed out, which often precede an infection by human papillomaviruses. The athlete's foot generally causes minor skin tears and thus creates the perfect breeding ground for the viruses. Smaller lesions and skin cuts, such as stepping on broken glass or banging on fittings in the outdoor pool area, can also serve as the basis for the infection.
Thorny warts and weakened immune system
As with all infectious diseases, a weakened immune system also increases the likelihood of infection in the pathogens of the spine. This is particularly true for the sensitive immune system of children who suffer from pinch warts above average. Since their immune system is not yet fully developed, pathogens such as bacteria and viruses have an easy time of it. In addition, children stay relatively often at the number one risk location, the outdoor swimming pool.
Skin diseases such as neurodermatitis or psoriasis, which have already weakened the immune system, should also be mentioned. Of course, any other previous disease can also increase the risk of infection, but chronic skin diseases are often associated with sustained skin damage, which favors the penetration of HP viruses into the tissue.
The clearest sign of the presence of a thorny wart is, of course, the unsightly skin growth itself. The yellow to brown-gray discolored skin calluses is noticeable due to the clearly white discolored and stick-shaped callus center, which is due to the deep growth of the thorny process of the wart. If patients step onto the floor with the affected sole of the foot, this causes enormous stress pain. The deep wart outgrowths can even hit the sensitive periosteum of the foot bones, which further intensifies the pain symptoms. Even bleeding as a result of the pressure load is conceivable, which is why it is important to be warned of subsequent infections of neighboring tissue.
Overall, the following symptoms must be expected for thorny warts:
- Yellowish-brown discolored calluses with white, stitch-shaped callus center,
- sometimes extreme, sharp pressure pain,
- with tissue bleeding dark discolored spots on the calluses.
A mandrel wart can be easily identified by eye diagnosis. If there are doubts about the type of wart or if there are any ambiguities regarding the individual pathogen strain, additional skin biopsies are taken to identify the pathogen through laboratory tests.
Treatment of thorny warts
Thorny warts are one of the particularly persistent types of warts that can plague patients from several months to two years. One of the reasons for this is their extreme deep growth, which complicates complete therapy. The wart often heals superficially, while its outgrowths remain in the foot tissue beneath the cornea.
Interestingly, thorny warts often heal on their own, especially in childhood. It is important to leave the warts alone and not to cause bleeding due to excessive pressure. You should therefore only run if it is really necessary. With a view to targeted treatment steps, the following measures can also be successful:
There are various active ingredients that promise a good effect on thorny warts. Above all, it is tinctures made from monochloroacetic or salicylic acid that reliably kill thorny warts again and again. Formic acid has also worked well so far. These can be purchased, for example, in the form of end-of-the-line Guttaplast plasters. It is best to put the acids on a patch and stick it on the affected area on the sole of the foot. The active ingredients of the acid then gradually dissolve the horny calluses of the wart, which means that this layer can be removed layer by layer. However, it should be noted that such a treatment can take up to 3 months, since the complete healing of the mandrel warts with acids does not take place overnight.
As an alternative to the active substances mentioned, there are also cell-active substances such as fluoracil and imiquimod. After application to the wart, they either directly attack the degenerated cell tissue or stimulate the immune system to produce the appropriate antibodies. Treatment should only be carried out here by the responsible dermatologist.
Cryotherapy is better known to many as cold therapy or icing. There are two different variants. For private icing, patients in the pharmacy have over-the-counter icing agents available that cool the degenerated cell tissue down to -57 ° C and thus let it die. In addition, liquid nitrogen for icing can also be used for cryotherapy, which, with temperatures of -196 ° C, enables even more reliable icing. Due to the extreme minus degrees, such a cold treatment may only be carried out by a specialist dermatologist.
It is not always possible to say whether cryotherapy is successful. Because mandible warts reach very deep under the skin, often only the upper layers of calluses can be removed. However, the success of treatment can be increased if the therapy is repeated every two weeks and the cornea is removed with a coarse file before treatment. This allows the cold to penetrate deeper into the degenerated tissue and thus also reach deep tissue layers.
Naturopathic remedies for wart treatment are external thuja tincture or external chelidonium solution, both of which are applied undiluted twice a day. Internally, Thuja C30 is three globules twice a week, but often Sulfur or Causticum is the method of choice.
Lasering away or scraping out the mandrel warts is relatively painful and therefore especially not recommended for young patients. Both measures are performed under local anesthesia, but the pain after the procedure is still very great. With laser therapy, the wart is cauterized with great heat. A special, sharp-edged stencil is used to scrape out the degenerated tissue. With local anesthesia, warts can also be removed from the sole of the foot using a laser or a surgical stencil. It should be mentioned that these two treatment methods are particularly painful and therefore not necessarily recommended for children.
Trimming the wart should be the last option, as warts can be a sign of constitutional weakness. By cutting away only the sign is treated, but not the actual weakness. In the best case, the warts come back, in the worst case, another illness appears, which is usually more serious. (ma)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Editor Heilpraxis.de, Barbara Schindewolf-Lensch
- Prof. Dr. med. Peter Altmeyer: Verrucae plantares (accessed: July 17, 2019), enzyklopaedie-dermatologie.de
- Institute for Quality and Efficiency in Health Care (IQWiG): Warzen (accessed: 07/17/2019), gesundheitsinformation.de
- Walter de Gruyter GmbH: Verrucae plantares (access: July 17, 2019), pschyrembel.de
- Merck & Co., Inc .: Warts (Verrucae vulgaris) (access: July 17, 2019), msdmanuals.com
- Mayo Clinic: Plantar warts (accessed: 07/17/2019), mayoclinic.org
- American Academy of Dermatology: Warts (accessed: July 17, 2019), aad.org
- Ruck, Hellmut: Handbook for medical foot care: basics and practice of podiatry, Karl F. Haug, 2nd edition, 2012
ICD codes for this disease: B07ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.