A wart typically presents as a small rough surfaced skin growth and can appear anywhere on the body.  On the feet, they are commonly found on the plantar (bottom) surface and thus referred to as plantar warts.  Warts are caused by the human papillomavirus (HPV) and can look like a solid blister or a small cauliflower.  The appearance of a wart depends on its location on the body and the thickness of the skin. 


A wart is a viral infection that invades the skin through small cuts or breaks.  They can persist for years and have a high reucrrence rate.  If left untreated, warts can spread.  Unlike a callus, a wart will usually hurt when squeezed from side-to-side and will bleed when trimmed.  

Treatment lessens the symptoms of pain, decrases the duration of growth and the spread of the lesions.  Many of the over the coutner (OTC) treatments as well as cryotherapy (freezing) only treat the surface without addressing any infection that may be deeper set.  The key thing is to get down to the root where the virus has settled and is stemming from.  Treatment is directed in debridement of the callused skin and restricting viral replication.


Surgical intervention may also be warranted if the wart is not responding to conservative treatment or if should change in appearance during the course of treatment.  In some cases, a wart can convert into a recalcitrant (stubborn) verruca vulgaris condition, and in rare cases, warts can convert to verruca carcinoma which is a type of squamous cell cancer.  When surgical excision is recommended, this can be performed in office or in outpatient settings.  


Laser treatment is especially effective on large warts that have grown internally, or spread to form a pattern of numerous warts.  For some patients, a local anesthetic is applied to the treatmetn area to numb it.  The laser then targets the blood vessels within the wart, which keeps nearby tissue from being harmed.  The laser uses intense light energy delivered in rapid pulses to heat the capillaries that provide the wart's blood supply.  This causes the blood vessels to seal, destroyign the tissue within the wart.  The number of treatments necessary varies depedning upon several factors, including the size of the warts and how many there are.  Patients are able to return to all normal activities immediately following treatment.  For several days after the laser procedure, the treatment site may be somewhat uncomfortable.  It may also remain slightly discolored for a number of weeks.  Frequently, the warts are eliminated within one to five laser sessions.