Wart on the heel: what to do?

A wart on the heel is a plantar wart (verruca plantaris) of the hyperkeratotic type.

Tumor-like seals protruding above the skin surface are commonly called warts. Warts have different shapes, sizes and locations, but they are all new growths (neoplasias) that arise as a result of pathological proliferation, i.e. abnormal growth of epithelial tissue cells. The vast majority of these neoplasias are benign.

Causes of warts on the heel

Almost a century ago, it was discovered that the appearance of warts, including warts on the heel, is caused by a special non-cellular infectious agent - the human papillomavirus (HPV), which enters the skin.

A great variety of different microorganisms constantly live on the human skin, many of which, first of all, are viruses that cause a wide range of diseases. In addition to the general immunity of the body, our skin also has its own defense system - cutaneous immunity. It is provided by keratinocytes, intraepithelial macrophages and epidermal T-lymphocytes (which produce gamma interferon). With a normal level of immunity, the absence of microtraumas of the skin and any local foci of inflammation, the papilloma virus does not show activity, since (like any other virus) it can reproduce only when it enters a living cell. This virus is contagious and is easily transmitted either directly from a sick person or when using objects of a virus carrier.

The mechanisms by which HPV virions penetrate the stratum corneum and infect viable keratinocytes have not yet been sufficiently studied. And today in clinical medicine it is believed that this occurs when the body's protective function is reduced, with hyperhidrosis (increased sweating of the feet) or existing damage to the skin of the sole. In the presence of the listed circumstances, the papilloma virus easily penetrates the cells of the basal layer of the epithelium, is embedded in the DNA of the nuclei of these cells and begins active self-reproduction, which leads to pathological changes in the skin. From a morphological point of view, a wart on the heel is a proliferative focus of epithelial keratinocytes infected with HPV.

Of the more than 70 genotypes of the papilloma virus, those that are localized on the back of the feet, including the heels (as well as the inner surface of the palms), include genotypes HPV-2 and HPV-4. These most common viruses are the main cause of warts on the heel.

Symptoms of Warts on the Heel

A common (vulgar) wart on the heel is very similar to a callus and has the appearance of a keratinized rough area of skin that rises above its surface. The main symptom of warts on the heel is these dense in structure and dry in consistency growths ranging in size from a few millimeters to two to five centimeters. At the beginning of formation, a wart on the heel does not differ in color from healthy skin, does not cause discomfort or pain.

The peculiarity of the defeat of the papilloma virus of the soles of the feet and heels is that the skin here experiences maximum mechanical impact and has the most developed dense stratum corneum.

As a rule, a wart on the heel develops not outward, but deep into the epithelial tissue, protruding only slightly above the skin surface. This complicates treatment, since the process of spreading the virus and forming morphological changes in tissues affects deeper layers of the epidermis.

At the same time, on the inner part of the wart there are growths that penetrate the upper layers of the epidermis. Dermatologists note such symptoms of warts on the heel as thickening of the stratum corneum of the skin (hyperkeratosis), thickening of the epidermis (acanthosis), as well as disturbances in the processes of keratinization of the epidermis, in particular, the cessation of the synthesis of the protein keratohyalin, which accumulates in the cells of the granular layer of the epidermis and is the "building material" of the main skin protein keratin.

In some cases, a small round depression may appear in the center of the neoplasm. And the appearance of brown or black dots on the surface of the wart is a sign that blood clots have formed in the capillaries located here.

As the wart on the heel develops, it causes itching, becomes very painful and makes walking difficult. And its color becomes darker – due to various foreign particles that eat into the surface of the neoplasia.

Wart on the heel of a child

Children's skin is more delicate and is damaged more often than adults'. Therefore, through various scratches, abrasions and abrasions on the heel and foot, the papilloma virus almost freely enters the cells of the epidermis. Uncomfortable or tight shoes for children also contribute to the appearance of this pathology. Sources of this virus are literally at every step, and children often run barefoot...

So a wart on a child's heel has the same etiology and many similar symptoms. However, from the moment of infection until the symptoms appear - in the form of a small yellowish rounded nodule - quite a long time may pass.

Then the wart on the heel becomes dirty gray, and its surface is covered with a thick horny layer. The formations cause pain, especially when pressing and walking.

Diagnosis of warts on the heel

In most clinical cases, diagnosis of warts on the heel is based on visual examination of the affected area of skin with scraping of the upper keratinized layers of the epithelium.

In complicated cases, a dermatologist resorts to dermatoscopy – examination using a dermatoscope. This is a special surface microscope with 10x magnification, which makes it possible to clearly see the wart on the heel and study its structure.

In case of large warts on the heel, ultrasound may be prescribed to determine the optimal method of its removal – to accurately determine the depth of neoplasia growth into the tissue. Ultrasound is also used for differential diagnostics of warts and keratoderma – a disease in which the natural process of skin keratinization is also disrupted.

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Treatment of warts on the heel

Often warts on the heel disappear on their own, as doctors say, their spontaneous regression occurs. However, dermatologists warn: even after removing warts on the heel, a relapse of this disease occurs very often, since the chromosome of the human papilloma virus remains in the cells of the epidermis.

What to do if a wart appears on the heel? Go to a dermatologist who will prescribe treatment.

The goal of treating heel warts is to remove the proliferative focus of epithelial keratinocytes infected with the papilloma virus from the patient's heel. As already noted, the appearance of warts is facilitated by a low level of skin and general immunity. For this reason, doctors include the use of immunomodulatory drugs in the drug treatment of the human papilloma virus.

Removing a wart on the heel using non-surgical methods

There are several methods for removing a wart on the heel. The most common method is chemical coagulation, i.e. the destruction of pathologically overgrown tissue by cauterizing it with chemicals. Silver nitrate (in the form of a lapis pencil), 10-20% salicylic acid or salicylic plaster, concentrated nitric acid, retinoic acid, and special preparations are widely used here.

The lapis pencil is used as follows: the tip of the pencil is moistened in cold water and the surface of the wart on the heel is lubricated - twice a day. The duration of treatment depends on the size of the lesion.

A salicylic plaster - salipod - also helps remove plantar warts. The heel should be steamed in moderately hot water and wiped dry. A circle corresponding to the size of the wart is cut out of the plaster and glued to it. It is recommended to secure it with a regular adhesive plaster on top. After 2-3 days, the salipod should be removed, and the exfoliated skin should be carefully removed (do not tear off everything, but remove only what comes off easily). Then, for a week, lubricate the wart with oxolinic ointment three times a day. If necessary, the salicylic plaster can be applied several times, and the entire treatment can last a month or longer.

The liquid preparation Ferezol, which contains phenol and tricresol (therefore, it is not recommended for use by children), also cauterizes warts on the heel. It is necessary to lubricate only the surface of the formation, preventing the liquid from getting on healthy skin. Lubrication is carried out continuously: for 60 minutes, after steaming the skin on the heel. If the wart does not disappear the first time (the scab must not be torn off), lubrication is repeated 3-4 times with an interval of 10 days.

Treatment of warts on the heel is carried out using retinoic acid, which is part of 0.05% Trethionine cream. The cream is applied to the wart in a thin layer - once a day and kept for 6 hours, after which it is washed off. In the process, the wart ingrown into the skin of the heel softens and can be carefully removed.

Aldara ointment (imiquimod) is also used to treat papillomavirus infection, including warts on the heel. This medicine stimulates the immune system of the skin. The cream should be applied in a thin layer to the wart at night (for 6-8 hours) three times a week - every other day. In the morning, the cream is washed off with warm water and soap. This drug is most often recommended by specialists for the treatment of warts on the heel of a child.

Removal of warts on the heel by surgical methods

Removal of warts on the heels is done by excision with a scalpel - under local anesthesia. Laser or ultrasound can be used.

Very often, a wart on the heel is removed by cryodestruction, that is, destruction by freezing with liquid nitrogen. When frozen with liquid nitrogen, the wart turns pale and becomes dense, and after 1-2 minutes it turns red and swells. A few hours after the operation, a blister filled with serous or bloody fluid appears at the site of the wart. The blister lasts for about a week, and then the fluid in it disappears. The freezing site is covered with a scab, which completely disappears in about two weeks, leaving a pink spot.

The next method of removing a wart on the heel is electrocoagulation under local anesthesia, which is considered by dermatologists to be the most effective. Electric current coagulates the pathological tissues of the wart, but does not cause bleeding. The dry crust that forms after the procedure falls off after an average of 10 days. And a small spot on the site of the former wart will disappear after some time.

How to remove a wart on the heel: folk methods

The arsenal of proven folk remedies for getting rid of warts on the heel includes garlic, celandine herb and vinegar essence.

Before using garlic, you need to steam the wart in hot water, slightly cut the skin fold surrounding it and place a plate of garlic on the wart with the cut side facing the skin, securing it with adhesive tape. The procedure is performed before going to bed. The next morning, you need to replace the "used" garlic with fresh garlic. For at least 15-18 days, the garlic on the wart will have to be changed daily. The wart will disappear within a month, and not even a trace of it will remain.

How to remove a wart on the heel with celandine? To do this, you will need the bright orange, burning juice of fresh grass. It is enough to smear the wart with it 3-4 times a day, and in a month, as herbalists assure, there will be no trace of it left.

Removing a wart on the heel with vinegar essence is done as follows.

Mix 1 part of the essence with 2 parts of wheat flour. Cut a hole in the adhesive plaster - exactly the size of the wart (to protect the surrounding skin from a chemical burn), stick it on the heel and smear the wart with the prepared mixture. Seal it with a piece of plaster on top. The procedure should be carried out twice a day for at least a week.

Prevention of warts on the heel

Today, it is impossible for a person to completely get rid of the papilloma virus. It remains to observe preventive measures for warts on the heel. This means: leading a healthy lifestyle, maintaining your immunity with proper nutrition and physical activity, and taking well-balanced multivitamin complexes.

To avoid catching HPV, do not wear other people's slippers when visiting; bring your own flip-flops when visiting a sauna or swimming pool. You should follow the rules of personal hygiene, and if your feet sweat excessively, do not wear tight shoes and use special products or medicinal herbs (chamomile, calendula, oak bark, St. John's wort - in the form of night baths).

A wart on the heel will have fewer chances if you do not allow the skin to be injured, and if the slightest damage appears, treat it with antiseptics.