DR. HOOK- Step on it: Plantar warts bedevil athletes

Injuries can be the kiss of death to an athlete. When Nancy Kerrigan got konked on the knee before the Olympics, her scream was the whine heard 'round the world: "Why me? Why me?" (A normal person would have just yelled, "Ow!") On the other hand, golfer Ben Hogan almost died in a 1949 accident but came back to win the 1950 US Open. 

Michele Kwan wore a foot cast before the Olympics in 1998 and got a silver medal, but in the ‘04 Olympics she pulled out due to groin pull. (Always an Olympian, never an Olympic champion.)

I'm currently "injured," just before I compete in the US National Adult Figure Skating Championships in Chicago this April. Brace yourself: I have a... plantar wart! (Okay, stop throwing the paper around and stop groaning. I was trying to be dramatic like crying judge Larry Seidlin in the Anna Nicole Smith burial case.) Can a foot wart be that painful?

Warts in general are unappealing, unless you're a witch with a really long nose– then they're dramatic. Over 150 Human Papillomaviruses (HPV) cause warts on the skin. For this article, let's focus on verruca vulgaris– warts found mostly on the hands and feet. 

Warts normally bother folks younger than I am, so I'm not sure how I got this plantar wart– though HPV can remain hidden in the body for a long time and pop up like a long-forgotten drunk relative at a family reunion. Interestingly, people more at risk for warts are meat-, fish-, and poultry-handlers. (Three cheers for vegetarians!– though personally I'm not one.)

HPV is kind of like cooties in that it's spread from skin-to-skin contact. But crossing your fingers and saying you're "cootie-proof" won't protect you. HPV can also be caught from infected floors (that's where I think I got mine– in the gym locker room) and contaminated objects. Though the virus can remain dormant for years, it tends to show up two to six months after contamination. 

Warts make the skin grow too rapidly so they look like cauliflower growths (sans salad dressing and broccoli) though they can be flat as well.

I constantly read that 2/3 of warts magically disappear within two years, but I have yet to see that. Maybe it's because almost everyone treats the ugly suckers. 

Compound W and other salicylic acid compounds are probably the most effective in treating warts— but it takes diligence, which most of my patients lack. And for good reason. The virus lives deep in the skin, so you can't just pick the warts off. You have to dig, dig, dig your way practically to China– well, my relatives would have to dig to Florida. So most people are afraid or in too much pain to dig all the way through the epidermis to pick out the deep layers of skin that contain the HPV.

You know you're deep enough when you get to the little black spots– blood clots caused by the viruses. So they have to be dug out and this takes weeks to months. Liquid nitrogen might kill the virus and is about 75 percent effective on the hands

But the feet— take a step back! The foot is harder to treat, and the purpose of liquid nitrogen is to kill the outer layers of skin fast. Then the rest is up to the patient to put on salicytic acid everyday and dig the wart out. Cantharidin is used along with salicylic acid for really tough warts. 

Duct tape is the universal cure all– against bioterrorism and possibly against warts. Covering the wart with duct tape might help kill the HPV better, and in my case, tape my mouth shut as I scream in pain when I freeze off my plantar wart and then skate. 

Nancy Kerrigan, Why Me?

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