Therapeutic pedicure in Coimbra
Plantar wart in Coimbra
Plantar wart (HPV)
A plantar wart looks like a corn, but it is a viral infection — so the treatment is different. Confirming what it is first saves weeks of treating the wrong thing.
What it is
A plantar wart is a skin lesion on the sole of the foot caused by the human papillomavirus (HPV). The virus enters through tiny cracks in the skin and makes the cells multiply, forming a rough, hardened lesion. Because it sits on a weight-bearing area, body weight pushes it inwards — hence the pain, which feels like a stone in the shoe.
It can be single or appear in clusters (mosaic warts). It is contagious, by direct contact or via wet surfaces — the floor of pools and changing rooms is the classic place — and may take weeks to months to appear after exposure. In children and young people it often disappears on its own within 1 to 2 years; in adults it tends to persist and grow.
Signs and symptoms
- A rough, rounded lesion on the sole or toes, often covered by a layer of thick skin.
- Small black or brown dots inside: these are thrombosed capillaries, not “roots”.
- The skin lines bend around the lesion instead of crossing it, unlike a corn.
- Pain when the lesion is squeezed from the side, more than when pressed from above.
- Several lesions close together merging into a plaque (mosaic).
Most common causes
- Contact with HPV in pools, changing rooms, gyms and shared showers, walking barefoot.
- Damp, macerated skin or skin with small wounds, which lets the virus in.
- Sharing towels, socks or shoes.
- Self-inoculation: touching or scratching the wart and then another area of skin.
- A weaker immune system, which lets the virus establish itself more easily.
How it is treated
The first step is to confirm it really is a wart. Then treatment at the clinic combines debridement of the layer of thick skin covering it — which relieves the pain immediately and exposes the lesion — with PDT laser therapy (photodynamic therapy), in which a photosensitising agent applied to the wart is activated by the laser light to destroy the infected cells.
Warts rarely disappear in a single session: the initial protocol is 5 sessions, usually one to two weeks apart, priced per session or as a package paid upfront. Old, large or mosaic lesions may need more. Between sessions a keratolytic (salicylic acid) may be recommended at home to keep the lesion thin.
It is worth knowing that no wart treatment — laser, liquid-nitrogen cryotherapy, acids or others — is 100% successful, and that recurrences happen because the virus can remain in the surrounding skin. The advantage of the debridement-plus-PDT approach is that it is well tolerated, leaves no open wound that stops you walking, and suits people who cannot or do not want more aggressive treatments.
What happens at the appointment
- 1Assessment of the lesion to tell it apart from a corn, and of the surrounding skin.
- 2Debridement of the hyperkeratosis covering the wart, to expose the lesion and relieve pain.
- 3Application of the photosensitiser and PDT laser session.
- 4Protection of the area and instructions for the following days.
- 5Further sessions every 1 to 2 weeks, reassessed each time; referral to dermatology if the lesion does not respond.
What you can do at home
- Do not cut, pick or scratch the wart: it spreads the virus and can get infected.
- Wear flip-flops in pools, changing rooms and public showers, and avoid walking barefoot at home if you live with others.
- Your own towel, socks and shoes while you have the wart; wash socks at a high temperature.
- Keep feet dry; if using a keratolytic recommended at the appointment, apply it only to the wart and protect the surrounding skin.
- Cover the wart with a plaster when going to the pool and do not share files or pumice stones.
When not to wait
Book without delay — or see a doctor — if you notice any of these signs:
- The lesion bleeds spontaneously, changes colour irregularly or grows quickly: it should be seen by a doctor to rule out other lesions.
- Signs of infection: redness, warmth, pus or intense pain.
- You have diabetes, poor circulation or reduced immunity: do not use acids at home and book an appointment.
- Many warts appearing, or warts that do not respond to several treatment cycles.
Frequently asked questions
How do I tell a wart from a corn?+
A wart has black dots, interrupts the skin lines and hurts more when squeezed from the side; a corn has a central core, keeps the lines and hurts on direct pressure. When in doubt, the assessment at the appointment settles it — and the treatment is different in each case.
How many sessions are needed?+
The initial protocol is 5 sessions, 1 to 2 weeks apart. Many warts clear within that number; older, larger or mosaic ones may need more. Progress is reassessed at every session.
Does the treatment hurt? Can I walk afterwards?+
Debridement relieves pain rather than causing it, and the PDT session is well tolerated — you feel warmth or tingling. There is no open wound, so you leave walking normally and can carry on with your routine.
Can the wart come back?+
It can, because the virus may remain in the surrounding skin. That is why treatment continues until the lesion has completely gone and why prevention matters: flip-flops in wet places, dry feet, nothing shared.
This information is general and meant to help you understand the problem. It does not replace an individual assessment or medical follow-up. If in doubt, book an appointment. Content reviewed by Priscila Arantes, registered nurse (Ordem dos Enfermeiros no. 117508).
Other problems we treat
Corns and calluses
Debridement takes the pain away the same day. What stops the corn coming back is understanding where the pressure comes from — and that is what the appointment assesses.
Learn more →Nail fungus
Yellow, thick, brittle nails are not just cosmetic: they are an infection that, untreated, spreads to the other nails. Debridement and laser treat the nail; patience does the rest — a new nail takes months to grow.
Learn more →Cracked heels and fissures
Cracks start as dry skin and end up as splits that hurt and bleed. The skin is treated and, more importantly, whatever is drying it out and splitting it is corrected.
Learn more →Ingrown toenail · Thick or deformed nails · Podiatric risk · Wounds and dressings