Laser wart removal

What warts are and where they come from

A wart is a skin infection caused by the human papillomavirus — a large family of viruses, of which only certain types affect the skin of the hands and feet. The virus enters through tiny breaks in the skin, often ones you would never notice, and sets up in the outer layers where it makes the skin grow abnormally.

On the sole of the foot your body weight presses the wart inwards rather than letting it stand proud, so it grows down into the skin. That is why a plantar wart, or verruca, so often feels like standing on a small stone or a splinter, and why it hurts more when pinched from the sides than when pressed straight down.

Warts are contagious. They pass on through direct skin contact and through damp shared surfaces — pool decks, change rooms, showers, gym floors and the family bathroom. They are especially common in children and teenagers, because immunity to HPV builds up gradually with exposure over the years, and younger feet simply have not had time to build it yet.

The types we see most often are:

• Plantar warts (verrucae). On the sole, flattened by weight-bearing, usually with a grainy surface and tiny black dots, which are small clotted blood vessels.
• Common warts. Raised, rough and firm, usually on hands, fingers and knees.
• Periungual warts. Around and underneath the nails. These are the most awkward to treat and can distort nail growth if left alone.
• Facial warts. Typically flatter and smoother, and often present in larger numbers.
• Filiform warts. Thin, finger-like projections, most often around the face and neck.

Why warts persist and spread

Warts survive because of where they live. The virus sits in the upper layers of the skin, where immune surveillance is limited, so the body can take a very long time to recognise it is there at all. Some warts do clear on their own, but plenty last months or years, and on the sole of the foot they tend to thicken and become more painful the longer they stay.

The second problem is spread. Every wart is a live reservoir of virus, which means it can seed new warts elsewhere on the same foot, on the other foot, and on the hands. Picking, scratching, filing or cutting a wart at home is the fastest way to make that happen, and it is the usual reason a single wart turns into a cluster or a mosaic patch that is far harder to clear.

How the GenesisPlus laser works

We use the GenesisPlus Nd:YAG 1064nm laser, an FDA-cleared device also used in our fungal nail treatment — we have been using laser for wart removal since 2012. A wart keeps itself alive by recruiting its own blood supply from the surrounding skin. The laser is drawn to the pigment in that blood supply and delivers energy precisely into it, shutting down the vessels feeding the wart and killing the HPV in the tissue, while the healthy skin around it is left intact.

In practice the appointment is straightforward. We confirm the diagnosis, pare away any overlying hard skin so the energy reaches the wart rather than the callus above it, then treat. The laser itself takes only a few minutes, and we will be honest about how it feels: each pulse is a short, sharp sting — patients often describe it as a pin-prick or a small electric shock. There is no needle, no local anaesthetic, no acid and no cutting. As the wart’s blood supply shuts down, a blood blister commonly forms beneath it — that is the treatment working, though the area can be tender for a few days and sometimes needs a dressing. Most people go back to work, school or training the same day.

Most patients see results in two to four sessions, depending on how large the wart is, how long it has been there and where it sits on the foot. Warts under the heel or around a nail generally take longer than a single small wart on the ball of the foot. We review between sessions so you can see what is actually changing rather than guessing.

Laser works well for adults, teenagers and older children. For younger children the honest caveat is that the treatment does hurt, and not every child tolerates it — so we assess each child first, and where laser is not the right fit we will say so and recommend a gentler approach. See children’s podiatry for how we work with younger patients.

Laser compared with acids and freezing

There is no single treatment that clears every wart, so it is worth understanding the trade-offs honestly.

• Over-the-counter acids. Salicylic acid paints and plasters work by destroying skin layer by layer. They can succeed, but they need faithful daily application for weeks or months, they damage healthy skin around the wart if applied carelessly, and most people give up long before the course is finished. On the thick skin of the sole, progress is slow.
• Cryotherapy (freezing). Effective for some warts, but usually needs repeated visits, is sharply uncomfortable at the time, and often blisters afterwards. A blister on a weight-bearing sole can make walking genuinely difficult for a few days, which matters if you are on your feet for work or sport.
• Needling or surgical removal. Carried out under local anaesthetic, with a wound to care for afterwards and a real risk of scar tissue on a surface you have to stand on every day.
• Laser. No needle, no cutting and no time off your feet, though each pulse stings and a blood blister often forms under the treated wart, occasionally needing a dressing. The other trade-off is that it is a short course of treatments rather than a single procedure, and health fund cover varies.

At your assessment we will tell you which approach we think suits your wart, your age and your circumstances — including when leaving a small, symptom-free wart under observation is the sensible choice.

Aftercare and stopping the spread

Aftercare is simple, and it matters as much as the treatment itself, because reinfection is common in households where warts are already circulating.

• Keep the area clean and dry. Normal shoes and normal activity on the same day are fine.
• Tenderness for a few days afterwards is normal and settles by itself. A blood blister under the treated wart is common and part of the process — leave it intact, and if it sits somewhere that rubs we may cover it with a dressing.
• Do not pick, file or cut warts at home. This is the single most reliable way to spread them to your hands and to the rest of the foot.
• Use your own towel and do not share it, and wear thongs or sandals in shared showers, change rooms and around pools.
• Cover the wart with a waterproof dressing before swimming or gym sessions.
• Wash your hands after touching your feet, and change socks daily.
• Alternate your shoes so they dry fully between wears, and dry between the toes properly after showering.
• Tell us if new warts appear between sessions so we can adjust the plan rather than chase them one at a time.

If you have diabetes, reduced circulation or reduced sensation in your feet, do not treat a wart yourself with anything from the pharmacy. Have it assessed first — see diabetic foot care.

Common questions

This page is general information, not personal medical advice. Reviewed by Gideon Poratt, Principal Podiatrist (B.App.Sc (Pod), M.A.Pod.A), a member of the Australian Podiatry Association. Please book an assessment for advice specific to your feet.