Copy of CORN (1)

Corns Vs Plantar Warts – The Ultimate Guide

Patients will often see us because they notice a painful “lump” of skin on their feet. What this skin lesion is might not be so obvious. However, the two most common skin lesions we see are corns and plantar warts. In this article, we will go through the key differences of corns and warts and how we best treat them.

Corn is a thick, hardened layer of skin that forms when the skin tries to protect itself against repetitive pressure or friction. They often form on feet and toes but also can develop on hands.

Plantar warts are rough, hard growths that are caused by the Human Papillomavirus (HPV) and are contagious. They also often form on the feet and toes but also can develop on hands.

Given the similarities how can we tell the difference? Thankfully, we can often clinically diagnose the skin lesion without using a magnifying glass, skin scraping or referring to a dermatologist. The table below provides some key differences between Corns and Plantar Warts.

FactorCornsPlantar Warts
AppearanceTranslucent skin with “white” coreTiny black spots
Skin integritySmoothRough (cauliflower like)
Skin linesPass through normallyGo around the wart
LocationBoney prominences that press against shoes or often in contact with groundSoles of feet (not necessarily over boney prominences)
Other causative factors Tight shoes, lack of padding under balls of feet/heel. Claw toes, hammertoesYoung children swimming. Use of shared showering facilities
Pain elicitedDirect pressure over the corn siteSqueezing skin lesion

Appearance of Corns Vs Plantar Warts

The images below also show subtle differences mentioned in the table above.

Picture1  Picture2

Once we have identified the type of skin lesion we can then recommend appropriate treatment.

Treatment for Corns

For Corns, we ideally like to remove the causative factor. So if there is a shoe that is too tight we either stretch out the shoe, avoid wearing the shoes, or avoid thick shoes. If there is insufficient padding we recommend insoles or shoes that provide additional cushioning. Sometimes we recommend wide shoes with soft stretch upper for those with claw toes, and hammertoes.

As podiatrist we can cut out the corn with a scalpel and because it is dead skin this should not be painful. This will provide instant relief and stop the corn from becoming deeper and more painful over time. We can also make recommendation to prevent the causative factors.

Treatment for Plantar Warts

For Plantar Warts, there are few more options for treatment and these are summarised in the table below.

TreatmentEvidenceComment
Salicyclic acidGood scientific evidence for common plantar warts 29% cure rate over placeboUsually effective for common plantar warts. However, strength can vary from 20-80%. May be used in conjunction with another agent.
Liquid nitrogen – cryotherapyFair/inconclusive scientific evidence for common plantar wartsMay require aggressive application and can be quite painful
Silver nitrateGood scientific evidence for common plantar warts 30% higher than placeboCan stain. Ideally use distilled water.
SWIFT Good scientific evidence. Claim of 83% successTreatment involving burning the skin and can be very painful so not possible on young children.
Duct tapeInconclusive scientific evidence for common plantar wartsControversial technique. Modest improvement in some studies and other consider placebo.
SurgeryNo strong scientific studies as placebo no possible.Often only considered after other conservative treatment has failed. Risk of scarring over site is 30%

References for Evidence: Plantar warts: a persistently perplexing problem – BPJ65 December 2014 (bpac.org.nz) & RACGP – Treating common warts – options and evidence

So you might wonder what is the best treatment option for plantar warts? Well it really depends on several factors, such as the size, location, number, and type of warts, the patient’s age, health, preferences, and tolerance for pain, and the availability and cost of the treatments. There is no one-size-fits-all solution for plantar warts, and different treatments may work better for different people. Therefore, it is important to consult with a podiatrist or doctor before starting any treatment for plantar warts.

We hoped this article helps you determine what skin lesion you may have.

If you would like to have us provide a clinical assessment and treatment you can see us at Leading Edge Podiatry (Formerly Complete Podiatry Blackwood). Feel free to book online or call us on 7120 6063! We look forward to helping your feet be pain free.

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