Swimming Pools and Plantar Warts

Summer is nearly upon us, and everyone will be looking forward to diving into a nice refreshing swimming pool on a scorching hot summer day. However, what you may not realize is that swimming pools could place you at risk for developing a painful and unsightly lesion on your foot. These lesions can be very resilient, recur, and are challenging to treat. What is this lesion I speak of?

Plantar warts or verrucae plantaris are skin lesions that develop on the plantar (bottom) aspect of the foot. They are caused by the infection of keratinocytes (skin cells) with the human papillomavirus (HPV), which is ubiquitous. Most people are asymptomatic carriers of HPV, however, 2% of the general population will seek medical care for warts annually due to pain, embarrassment, and, in rare cases, cancer. Plantar warts demonstrate an annual incidence of approximately 14%. The majority of cases occur in children and adolescents. However, other populations, such as immunocompromised patients, are at increased risk for acquiring plantar warts.

HPV can survive for months to years on surfaces. Infection often requires direct contact with the viral particles. This can ensue through either direct contact via a plantar wart or indirect contact via fomites (such as socks, shoes, towels and sports equipment). As the virus tends to thrive in warm and moist environments, places like shower floors, locker rooms and public swimming areas are ideal places for transmission. The virus enters the skin through small cuts or abrasions on the bottom of your feet, infecting the basal skin cells and finally resulting in plantar warts a few weeks later. You will observe what appears to be corns/calluses with small black hemorrhages or black dots under the skin that are very painful when compressed or squeezed. In addition, you will note that normal skin lines will diverge around the lesion and will not go through the wart.

You can reduce your risk of plantar warts (verruca plantaris) this summer by simply following a few precautions listed below:

  • Wear footwear in/around swimming pools, communal showers and locker rooms
  • Sanitize communal sports equipment with isopropyl alcohol, ethyl alcohol, or bleach
  • Do not share towels, shoes, socks, equipment, or other personal items
  • Avoid trauma and maceration of the skin
  • Do not share nail files and pumice stones with others
  • Avoid walking barefoot
  • Keep feet clean and dry
  • Check children’s feet periodically
  • Avoid direct contact with warts on self or others

So, if you have any type of skin lesion on your foot, especially one that is painful or new, let the experts at the Foot and Ankle Specialists of the MidAtlantic diagnose your condition and treat it quickly and appropriately. Treatment options include topical medications, freezing, laser, excision, or a combination of modalities.

Finally, here’s a link below to the Centers for Disease Control and Prevention (CDC) for considerations for public pools, hot tubs, and water playgrounds during COVID-19.

https://www.cdc.gov/coronavirus/2019-ncov/community/parks-rec/aquatic-Venues.html

Reference:

Witchey DJ, Witchey NB, Roth-kauffman MM, Kauffman MK. Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management. J Am Osteopath

Assoc. 2018;118(2):92-105.

 

Dr. Emmanuella EastmanDr. Emmanuella Eastman works in our Rockville, MD (Shady Grove) and Wheaton, MD offices for your convenience.

 

 

 

 

 

 

 

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