PLANTAR WART (VERRUCA) · HPV · ALICANTE

Plantar wart (verruca): causes, symptoms and treatment

What a plantar wart is, why it appears, how to recognise it and the options for treating it.

This page answers the most common questions about plantar warts (also called verrucas or plantar papillomas): what they are, what causes them, the symptoms to watch for and the treatment options available. A plantar wart is a benign skin lesion caused by the human papillomavirus (HPV). At Clínica San Román in Alicante, our reference treatment for stubborn plantar warts is Swift® microwave technology, which activates the body’s own immune response against HPV and is backed by a randomized clinical trial (2025).

Reference treatment: Swift® technology →

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Plantar Wart or Foot Papilloma — Clínica San Román Alicante: Swift Treatment

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Clinical features of plantar warts — a lesion caused by the human papillomavirus (HPV)

What is a plantar wart?

A plantar wart —also known as a plantar papilloma or verruca plantaris—is a benign skin lesion caused by the human papillomavirus (HPV). It appears on the sole of the foot, where body weight pushes it inward, giving it its characteristic inverted and painful shape.

HPV enters the skin through micro-tears or cuts in warm, humid environments (swimming pools, locker rooms, gyms, communal showers). This is why plantar warts are particularly common in children, teenagers, and athletes, although they can appear at any age.

How to Identify a Plantar Wart

A round or oval lesion on the sole of the foot, often under the metatarsal heads, the heel, or the toes.
Black dots in the center (clotted capillaries) — a characteristic sign.
Well-defined edges with thickened skin around them.
It disrupts the skin’s normal lines (fingerprints): this is what distinguishes it from a callus.
Pain when pinching from the side (Dellaporta’s sign), rather than when pressing on top.

Wart or callus?

They are sometimes confused. A callus (heloma) is a reactive thickening of the skin caused by pressure or friction, with no viral involvement; the skin’s texture remains intact, and it hurts when pressed vertically. A wart is an HPV infection; it disrupts the skin’s surface, has black dots, and is painful when pinched from the side. When in doubt, the diagnosis is confirmed with a dermatoscope during the office visit.

Symptoms: When Should You Be Concerned?

Pain when walking, as if stepping on a sharp pebble.
Pain when pressing on the side of the area.
Warts that grow larger or new ones that appear around them (mosaic warts).
Bleeding when filing or applying pressure.
Change in color or appearance: darkening, ulceration, rapid growth.

🔴 When to seek medical attention

The wart has been there for more than 2–3 months and hasn’t gone away with over-the-counter treatments.
It hurts when you walk or limits your daily activities.
New warts appear around the original one.
If you have diabetes or are immunosuppressed, your treatment requires special care.
The lesion has an unusual appearance: differential diagnosis with other skin conditions.

Early diagnosis makes treatment much easier. Old and widespread warts are harder to remove.

Symptoms of plantar warts — pain when walking and multiple lesions

Swift®: our reference treatment for plantar warts

The most advanced option for stubborn warts. Backed by a randomized clinical trial (2025).

Swift® is a medical device that applies microwave energy to the wart for about 5 seconds per spot, activating the body’s immune response to recognise and clear the human papillomavirus (HPV). Because it leaves the skin intact, it needs no anaesthesia, no cuts and no bandages, and it is suitable for people with diabetes. It is our treatment of choice for deep and stubborn plantar warts, where cryotherapy or salicylic acid often fall short.

Swift Treatment Using Medical Microwaves for Plantar Warts — San Román Clinic

Want the full detail —how it works, the session-by-session protocol and a treatment comparison? See our dedicated Swift® page.

Plantar wart treatment with Swift® technology →

Other treatment options (when Swift isn’t the best choice)

Although Swift is our treatment of choice for stubborn plantar warts, not all cases are the same. Depending on the size, number, location, and patient profile, we may recommend:

Cryotherapy with liquid nitrogen for small, superficial, and recent warts.
Bleomycin injection in selected cases of multiple or recalcitrant warts.
High-concentration salicylic acid under the supervision of a podiatrist.
Curettage with electrocoagulation under local anesthesia in cases involving a large volume of tissue.
Monitoring of young children with recent warts (up to 65% heal spontaneously within 2 years if they are caused by HPV type 1).

⚠️ Personalized treatment. There is no one-size-fits-all solution. The podiatrist assesses the type of wart, how long it has been present, previous treatments, and the patient’s profile to recommend the treatment with the best balance of effectiveness and comfort.

First podiatry consultation at Clínica San Román in Alicante

Your first appointment with us

Free initial consultation with no obligation. During a visit, we do the following:

Differential diagnosis using a dermatoscope to confirm that it is a wart and not a callus, a foreign object, or another condition.
Assessment of the size, depth, and number of lesions.
Review of medical history: duration of illness, previous treatments, comorbidities.
Personalized treatment plan and fixed-price quote.
Preventive measures to avoid reinfection and transmission to family members.

We provide service in Spanish, English, German, French, and Dutch.

Frequently Asked Questions About Plantar Warts

📋 About warts

Are plantar warts contagious?

Yes. HPV is spread through direct contact with contaminated surfaces, especially in damp environments (swimming pools, locker rooms, communal showers). That is why it is common among families and athletes. Tips: Do not share towels or shoes, wear flip-flops in common areas, keep your feet dry, and cover the wart when using sports facilities.

Why did this happen to me?

Infection requires two conditions: exposure to HPV and a small break in the skin (crack, cut, or callus). Some people are more susceptible due to genetics, their immune system, or walking barefoot in contaminated environments. Children and adolescents are at higher risk because their immune systems are still developing.

Do they heal on their own?

In children and adolescents, up to 65% of plantar warts caused by HPV type 1 may clear up on their own within 2 years. In adults, this rate is much lower (under 7% within 2 years for HPV types 2, 27, and 57). If the wart is painful, bothers you when walking, grows, or new ones appear, it is recommended to seek treatment without delay.

Can I exercise if I have a plantar wart?

Yes, but take precautions: wear flip-flops in locker rooms and communal showers, cover the wart with a waterproof bandage at the pool, and avoid sharing shoes. After a Swift session, you can resume normal activities the same day.

🌊 About the Swift® treatment

How long does a Swift session last, and does it hurt?

The session itself lasts between 5 and 15 minutes (including preparation). The microwave application lasts only about 5 seconds per point. The sensation during those seconds is described as a sharp, bee-sting-like prick. Once the application stops, the pain goes away and you can walk normally.

How many sessions will I need?

The standard treatment plan consists of 3–4 sessions spaced 4 weeks apart. Some small warts respond after just 2 sessions; larger or more stubborn ones may require more. During your first visit, we will provide a personalized estimate after examining the lesion.

Can I get wet or exercise after a Swift session?

Yes, right away. There are no open wounds, no bandages, and no restrictions. You can shower, go to the pool (wearing flip-flops), exercise, and go about your normal life starting the very day of the session.

Does Swift always work?

No wart treatment is effective in 100% of cases. The 2025 randomized clinical trial (Haase et al.) showed a 27.3% complete remission rate compared to 0% with placebo. Previous longer-term follow-up studies have reported even higher rates. For stubborn warts that did not respond to other treatments, Swift plays a prominent role.

Is it suitable for children?

Yes, Swift is suitable for children of a certain age, provided the child can tolerate the brief discomfort (similar to a tooth extraction in older children). For very young or very fearful children, we usually start with gentler treatments and reserve Swift for more challenging cases.

What if I have diabetes or am immunosuppressed?

Swift is one of the few techniques that is safe for people with diabetes and those who are immunosuppressed, because it does not cause open wounds or pose a risk of secondary infection. If you have any underlying medical conditions, we will assess them on a case-by-case basis during your first consultation.

❌ Myths

Should you burn the wart until it bleeds?

False. Modern treatments—especially Swift—remove warts without causing open wounds, bleeding, or scarring. Aggressive methods that burn all the way through are outdated and have a higher rate of complications.

Are over-the-counter patches enough?

For superficial and recent warts, salicylic acid may be effective, but it requires several weeks of daily application with close monitoring. For deep, old, or stubborn warts, it is not effective enough. If you have been using patches for more than 2 months without results, please consult a doctor.

If I remove the wart, will the virus go away?

False. HPV can remain in the area even after the visible lesion has disappeared. That is why modern treatments (such as Swift) aim to activate the body’s own immune response to eliminate the virus, rather than simply removing the lesion. This reduces the risk of recurrence.

Are warts cancer?

No. Plantar warts are benign lesions caused primarily by HPV types 1, 2, 4, 27, and 57. They differ from oncogenic HPV types (16 and 18) associated with cervical cancer. When faced with an atypical-looking plantar lesion, the dermatologist or podiatrist confirms the diagnosis to rule out other conditions.

Scientific bibliography and references

Swift® Technology (microwave) for plantar warts:
– Haase O, Barkawi A, Mrowka P, Krengel S. Microwave therapy for the treatment of resistant plantar warts: a randomized, placebo-controlled clinical trial. Arch Dermatol Res. 2025;317(1):208. [PubMed — RCT 2025]
– Gupta AK, Wang T, Cooper EA, Conenello RM, Bristow IR. The treatment of plantar warts using microwave—A review of 85 consecutive cases in the United States. J Cosmet Dermatol. 2023;22(10):2729-2736. [PubMed]
– Hagon W, Hagon J, Noble G, Brenton-Rule A, Stewart S, Bristow I. Microwave therapy for the treatment of plantar warts. J Foot Ankle Res. 2023;16(1):37. [PubMed]
– Bristow IR, Webb C, Ardern-Jones MR. The Successful Use of a Novel Microwave Device in the Treatment of a Plantar Wart. Case Rep Dermatol. 2017;9(2):102-107. [PubMed]

Other treatments (cryotherapy, antimitotics, comparative studies):
– García-Oreja S, Álvaro-Afonso FJ, Tardáguila-García A, et al. Efficacy of cryotherapy for plantar warts: A systematic review and meta-analysis. Dermatol Ther. 2022;35(6):e15480. [PubMed]
– Alrashidi AR, Shaheen E, Abualola A, et al. The efficacy of cryotherapy compared to other modalities in the management of palmoplantar warts: a systematic review and network meta-analysis. Dermatol Rep. 2025;17(2):10121. [PubMed — Network meta-analysis]
– Xu Y, Wang Y, Huang K, Huang W, Zhao S, Jiang Z. Topical antimitotic treatments for plantar warts are more beneficial: A Bayesian network meta-analysis of RCTs. J Evid Based Med. 2024;17(1):37-53. [PubMed]

HPV pathogenesis and clinical guidelines:
– Bruggink SC, Gussekloo J, de Koning MNC, et al. HPV type in plantar warts influences natural course and treatment response. J Clin Virol. 2013;57(3):227-232. [PubMed]
– Zhu P, Qi RQ, Yang Y, et al. Clinical guideline for the diagnosis and treatment of cutaneous warts (2022). J Evid Based Med. 2022;15(3):284-301. [PubMed]
– Sterling JC, Gibbs S, Haque Hussain SS, et al. British Association of Dermatologists’ guidelines for the management of cutaneous warts 2014. Br J Dermatol. 2014;171(4):696-712. [PubMed]

Request your free consultation at Clínica San Román Alicante

Say goodbye to plantar warts. Say goodbye to pain.

We have the technology, the experience, and the procedures. The initial consultation is free and requires no obligation. In just one visit, we’ll let you know which treatment is best for you and how long it will take.

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