Alex Kor, DPM, MS
Camp Springs Medical Center
“Ribbit! Ribbit”! Common folklore suggests that kissing a frog will result in a wart.
Well, this is obviously NOT true. Acquiring a wart has nothing to do with your kissing habits. Actually, a wart is typically caused by the foot coming into direct contact with a virus that causes a wart. Usually, the foot has some type of opening (e.g. scratch, abrasion, scrape, etc) that will allow for the virus to proliferate. Over a period of time (e.g. 60 – 90 days), a “bump” will form on the skin. This is the first sign that a tennis player has a wart.
A tennis player that has a wart on the foot will commonly complain of pain when the wart becomes larger or if the lesion is on a weight bearing area of the foot. Typically, if this condition goes untreated, multiple warts can result. Usually, when a wart is shaved by the athlete (or treating physician), bleeding occurs very easily. This should NOT be a cause for concern. Rather, seeing this pin-point bleeding suggests that the wart may NOT be easily treated. In other words, the virus that causes the wart has been on the foot for a prolonged period of time. The most common location on the foot is on the bottom of the foot, and typically near the “ball of the foot”. But, a wart can actually occur anywhere on the human foot.
Although the cause of the wart is easily identifiable, there is NOT one treatment that cures all warts. Thus, the lack of a viable “quick fix” can, at times, be very frustrating for many tennis players. Initially, I explain that the easiest and least painful treatment is any number of topical medications. Over the counter remedies include Duo-film, Occlusal HP, or Duo-plant. Prescription medications such as Efudex or Carac Cream are also successful in resolving warts on the foot. However, it must be remembered that any of these topical medications usually require, at least, 6 – 8 weeks of daily use. In addition, I urge the tennis player to perform weekly scrapings of the wart (with a pumice stone) or to see a health care provider every 3 weeks for trimming of the wart. If, after a 6 – 8 week period of time, no improvement is seen, other options may be considered. If the athlete is less than 20 years of age, an oral medication (e.g. Tagamet) has shown excellent results. Although this medication is indicated for stomach ulcers (e.g. GI upset), a skin doctor found that this medication could be taken by our younger patients, and the warts on the feet resolved in a relatively short period of time. Other treatments tend to be more invasive and thus the tennis player may miss time on the court. That is, a variety of lasers exist that cab “burn” the wart. Usually, this procedure is done in a surgical setting (e.g. operating room) and can result in a scar. The last option is to surgical “cut out” the wart(s). Obviously, I reserve this as the VERY LAST OPTION, and is rarely necessary.
When a tennis player with a wart presents to my office, I will also make use of other adjunct treatments. Besides thoroughly shaving the wart, I will also make use of some type of “cryo-therapy” (e.g. cold). There are numerous products that have the ability to “freeze” some of the viral cells and may decrease the “life” of the virus. Rarely will the use of Liquid Nitrogen be helpful for warts on the foot, but products like “Histo-Freeze” have been useful in my hands. In addition, many tennis players will “spread” their warts because of the excessive sweating that they experience on the court. Thus, I will prescribe a topical antiperspirant (e.g. drysol) for the foot. It is used twice per week.
There are other conditions that mimic warts. Primarily, adult tennis players tend to experience painful, hardened lesions that are frequently confused with warts. More times than not, in the adult tennis player, these lesions are NOT warts, and are actually “plugged up” sweat glands. The treatment is virtually identical to the above treatment for a wart, but “plugged up” sweat glands are NOT contagious. Second of all, I have seen a few tennis players who thought that their “bump” on the bottom of their foot was a wart; only to find that they had stepped on a foreign body (e.g. splinter, wire).
“Ribbit ! Ribbit !” There are many myths regarding kissing a frog. First of all, I have heard that ,”Kiss a frog and he will turn into a prince” . Second of all, from my single female friends, I hear that “You have to kiss a lot of frogs before you find your prince”. Well, I cannot confirm or deny these myths. But, after reading this column, you now realize that kissing a frog does NOT cause warts!