Did a Frog Kiss My Childs Feet?
If you’ve noticed new, small areas of growth on the sole of your child’s foot recently, there’s no need to panic! They may have been kissed by a frog, but more than likely your child has been exposed to Human Papilloma Virus (HPV); a virus that can infect the skin leading to the development of plantar warts. Plantar warts are the most common infection of the skin caused by a virus and are typically seen in patients ranging in age from 12-16.
HPV is a virus that can infect several areas of the body, including the soles of the feet, and is spread via direct contact to the skin. Most often it comes in contact with the skin when patients go barefoot in public showers where the virus has been left behind by another individuals feet. It is important to keep in mind that the strain of HPV causing plantar warts cannot be spread to other areas of the body, such as the mouth or genitals.
The incubation period for HPV on the sole of the foot ranges anywhere from 1 to 20 months, thus it can be difficult to determine when and where the virus was picked-up by the patient. Once it does present itself it may go undetected, as many patients do not experience symptoms such as pain or do not notice a change in the skin on the sole of the foot. Infection is often disregarded as a callus in the early stages, due to increased thickness of the skin, overlying the area where the virus lives. One defining feature of plantar warts is the presence of small, black circular dots just visible underneath the skin. These “dots” are areas of blood, contained in capillaries that in a healthy foot are not seen, as capillaries typically do not extended into visible areas of the skin on the foot. However, as the HPV grows and comes up towards the surface of the foot, it stimulates blood supply to come with it, helping the virus thrive.
Warts can resolve on their own, as the body’s immune system attacks the virus and rids it from the body, but not all warts will resolve without treatment. Over the counter methods that can be tried include Salicylic Acid preparations (pads, liquid, gel, or ointment) and Vitamin A, in addition to keeping feet clean and dry to eliminate moisture and decrease the viruses chance to thrive. All of the above mentioned options are likely to work on new infections, but for warts that are long-standing, professional treatment from your Podiatrist is recommended.
Depending on the severity and length of infection time, there are many treatment options that can be utilized by your Podiatrist. Selection of a method will both be based on your Podiatrists opinion and evaluation of your child’s infection as well as discussion with you, the parent, to help determine which treatment methods can be tolerated by your child. Acids and ointments, similar to those available over the counter include Canthrone, Efudex and Salicylic Acids. If such treatments fail, cryotherapy (freezing of the wart with sodium nitrate) can be utilized causing the wart to turn black, and eventually fall off. This treatment is slightly more painful than some other options and often requires several applications for success. Debridement, or trimming and cutting out of the wart can be successful, but to ensure that enough of the wart is removed to prevent recurrence local anesthetic, injected with a needle, must be used. Laser treatment is a relatively new method of treating warts and is generally clean, accurate and effective in riding your child of the infection. There is minimal to no pain associated with treatment, making it a good choice! Marigold therapy (the flower), even newer than laser treatment, has shown incredible success in treating HPV infections on the plantar surface of the foot, and is great for children as it is non-invasive and induces no pain. The only downfall with Marigold therapy is its limited availability in offices across the country.
This month we will be focusing on your child and their feet! Check back next week for information on another common Podopediatric problem: ingrown toenails. You’ll learn the best way to trim your child’s nails, and other tricks for preventing an ingrown.