Warts are due to a potentially painful infection of the skin that afflicts both young and old. Sometimes mistaken for a simple calluses, warts can be a persistent problem that will rarely resolve on its own. We often find that treatment is delayed for years, and in that time the wart may spread and become much more resistant to treatment.

Warts are caused by a skin virus that infects the body through any break in the skin. Warts on the bottom of the foot are particularly painful as they form a thick callus that receives constant pressure with walking. The virus may lie dormant in the skin surrounding the wart, hidden from view, leading many to think the infection is only a small problem. Warts may potentially spread easily to other people, as the most common areas of infection are locker rooms, shower stalls, bathrooms, and other public places barefoot individuals are present. The body does not generally react to the presence of the virus on its own as the infection is limited to the top layers of the skin and the immune system does not get excited about the infection. Treatment is usually necessary to eradicate it due to this very reason.

Currently there is no true medical cure for foot warts. There is no anti-viral medication available to kill the virus, and the infection may be extremely resistive to treatment overall. Fortunately, the body has an excellent mechanism for destroying the virus once it is stimulated to do so. The most effective and consistent therapy involves removing the calloused skin and applying acids or other chemicals that either dissolve the warty material or increase skin peeling. This process causes a generally painless local skin inflammation that activates the body's immune system. Eventually, the body's immune system recognizes the virus and eradicates it by creating circulating antibodies that will seek out the virus and destroy it where ever it is in the body. Freezing the foot skin can also be beneficial, although this technique is generally less effective than similar treatment for hand warts. It requires a direct, potentially painful application of pure liquid nitrogen delivered via a cotton swab to freeze the thicker foot skin. Other less commonly used treatment can include the use of immune system modifying creme medications, the use of high dose Tagamet (an anti-acid medication) in children and young adults for several months, as well as anti-tumor injection therapies. Surgical removal with electrical cauterization or laser therapy may also be considered, but a potentially high reinfection rate can seen afterwards. This is due to the presence of untreated dormant virus in the skin surrounding the treated wart, as an immune response is not generally created by surgical excision.

With an effective immune response, most patients are permanently cured of the viral infection, and will be immune to exposure to the same strand of virus for possibly a lifetime.