A plantar wart is a common skin lesion on the soles of the feet, caused by the human papillomavirus (HPV). The viral infection penetrates the skin through tiny cuts and creates a growth often driven inward by walking pressure. Because of their location and the constant weight they bear, plantar warts can cause significant discomfort. Monitoring the visual progression from an active lesion to a fully healed site helps determine treatment success.
What Untreated Plantar Warts Look Like
An active plantar wart has a distinctive appearance that differentiates it from a common callus. The lesion is typically rough and grainy, often resembling a small head of cauliflower covered by hardened skin. The constant downward pressure from standing and walking causes the wart to grow inward.
Tiny black specks, often called “seed dots,” are characteristic signs of the infection. These are actually small, clotted blood vessels (thrombosed capillaries) pushed toward the skin’s surface. A definitive visual marker is the complete disruption of the normal skin lines (dermatoglyphics), which abruptly stop at the wart’s border, unlike a callus where the lines continue over the surface.
Visual Changes During the Healing Process
The first visual sign of successful treatment is a change in the tissue’s color and texture. Following procedures like cryotherapy or chemical treatments, the affected area may first turn white or gray and form a blister. This initial reaction indicates that the treatment has damaged the viral cells and surrounding tissue.
As the wart tissue begins to die, its color will darken significantly, often turning black, deep purple, or dark brown. This color change is a positive sign, indicating the lesion is becoming necrotic, or dead, and the immune system is responding. The thrombosed capillaries may become more pronounced during this phase before they disappear entirely.
The dead tissue shrinks, dries out, and eventually separates from the healthy skin underneath. This sloughing process can take several weeks, with the dead portion peeling or flaking off naturally. The goal is for the entire viral core to detach, leaving a small depression that will fill in with new, healthy tissue.
Recognizing Complete Wart Removal
Successful plantar wart removal is confirmed by the complete restoration of the skin’s normal ridge pattern. Once the dead tissue has fully shed, the area should be smooth, with the natural dermatoglyphics flowing continuously across the site. The return of these skin lines confirms that the virus is no longer actively multiplying, allowing the skin to normalize.
The skin should no longer have any rough, grainy texture or residual black dots. The area should also no longer elicit pain or tenderness when direct pressure is applied, such as when walking or standing. A fully healed site will visually integrate with the surrounding skin, with any initial redness fading over a few weeks.
Signs That Treatment Was Unsuccessful
Monitoring the site for signs of persistence or recurrence is necessary because the human papillomavirus can remain dormant in surrounding tissue. If the wart remains the same size or begins to grow larger in the weeks following treatment, the therapy was likely ineffective. The continued presence of the rough, grainy texture and disrupted skin lines indicate that the viral tissue has not been fully eliminated.
Another sign of treatment failure is the reappearance or persistence of the small black dots after the initial sloughing. This indicates that the blood vessels feeding the active viral core remain intact beneath the surface. In some cases, the original wart may be surrounded by a cluster of new, smaller lesions, known as mosaic warts, suggesting the virus has spread locally and requires further intervention.