(music) What’s up my toes? It is Jonathan, a.k.a The Toe Bro, and day number 10! We are still going strong. I’m still alive! I was getting a little scruffy, which is why it was helpful for me to do a surgery video yesterday. Cleaned up a little bit feeling much better. It’s wearing me down but I’m still going, still putting out the videos, still trying to give you guys the best information I can just so you guys get to learn a little bit more about your own feet, the feet around you, and see if you guys can help each other out. Today’s topic, as you guys have seen from yesterday’s video, is about plantar warts. It’s a very very very common issue that everyone probably will experience once in their life. As of now, I was just looking at a stat around 7 to 10 percent of all adults will experience a wart so it’s a pretty high number. Very very common issue you might have experienced them yourself. You might have them right now, you might be trying to treat them, and need a little bit more help. It’s a very common issue that’s very difficult to treat so I’m going to try to give you guys as much information as I can to help you guys out on what you can do with plantar warts. So number one what are plantar warts? Plantar warts are lesions on the bottom of your foot caused by the human papilloma virus or the HPV virus. There’s over a hundred and twenty different strands of the human papilloma virus.
There’s a certain specific strain of the HPV virus that causes plantar warts. Different strains cause different types of warts, whether it’s oral warts or genital warts and those two especially the oral and genital warts can lead to the development of cervical cancer. So in terms of plantar warts, they’re caused by the HPV virus but a different strand than those other types of warts. I’ve been asked as many times but there is no vaccination or the HPV vaccination that can help keep you immune from plantar warts because it’s a different strand. That vaccine is not going to help you with trying to stop getting plantar warts. Plantar warts means that the wart is on the plantar surface or the bottom surface of the foot. Warts don’t only occur on the bottom of the foot; they can happen on the tops of the toes, in between the toes, can happen anywhere else on the body, but when we say plantar warts we’re specifically talking about warts on the foot. What happens is the HPV virus is sitting on the floor and somehow it becomes in contact with your foot and transfers into the skin. The virus then infects the superficial layers of the skin and then the replication cycle starts and then we get the growth of a wart. There’s a few ways the virus actually gets into your body. It usually starts by trauma or by a portal of entry so cracked dry skin, sensitive thin skin, or it can happen due to having a decreased immune system or certain medications that suppress your immune system. Warts are most commonly picked up in places where many other people might be barefoot and might have plantar warts on their feet. So the most common areas you always hear about swimming pools, community showers, the gym, yoga studio, anywhere where people are barefoot, touching the ground and there might be a little bit of moisture. There’s this chance that there might be warts on the ground. Somehow the moisture allows the virus to stick onto your foot and then infect the skin. The crazy thing to think about is that warts only live on the top layer of the skin; they don’t go deeper than that. But what happens as the wart grows and multiplies, it actually pulls blood vessels and sometimes nerves from the deeper tissue into the top layer skin and that’s why sometimes warts can be so painful or uncomfortable to walk on. Most people don’t realize they have a wart until it really starts to bother them because there’s a basically a foreign object on the bottom of their foot and it’s under a lot of pressure, when we’re standing, the body builds hard skin to cover the wart and as the hard skin builds, it starts to apply too much pressure and then we get pain. Then someone looks at their foot and says hey what the heck is going on and then they realized they have something on their foot that shouldn’t be there. So, you know what warts are, you know where you can commonly pick them up, and you know that they’re just living on the top layer of skin; nothing deeper than that. So how do we treat them? Right now the majority of treatment involves doing one thing- damaging the top layer skin, where the wart lives. If you damage that top layer of skin, there’ll be no more tissue for the wart to live on and everything comes off. There’s two main treatments available in the wart section- that’s salicylic acid or some sort of liquid nitrogen spray or freezing. These are two options you’ll find four salicylic acid. You’ll have either liquid format or you’ll have medicated pads. Both of these will be applied to the wart multiple times causing the skin to be very wet, white looking, we scrape it down, and then we apply the liquid or the pad over and over and over until the thickness of the wart has gone. The other type of treatment we have here for warts it’s the liquid nitrogen or freezing aspect of wart treatment. So here we have a cotton tip that you apply into some sort of liquid nitrogen container which creates a very cool tip that you press against the skin and this one we have an applicator that you apply right to the foot. You push down and it applies that liquid nitrogen spray. The goal of these two treatments is to basically think of it as frostbite to the skin; it basically freezes the skin at such a temperature that damages the tissue, causes the dead tissue to come off, and hopefully the wart that’s in the top layer skin pulls off with it. So here again, we can see all the cryotherapy; this is all freezing the wart. We’re basically freezing the skin damaging the skin, think of it as frostbite, and the dead skin will peel off, dry off, come off, and hopefully the wart goes with it. This is all freezing. Down here, we have all the salicylic acid contained in either a pad or some sort of liquid stick or gel that you apply directly to the wart. Here, this one is 40 percent, this one seventeen percent. I would always go with the stronger salicylic acid because you’re gonna have more damage to the tissue and that’s effectively what we want to do, damage the tissue. So here we have one that’s twenty-seven percent, forty percent, Seventeen percent, so I definitely would go with this. If we go back to our corn treatment, we can look and it’s exactly the same; it is salicylic acid. It’s hard to see but this one is also 40 percent salicylic acid. So like I told you guys before, corns, calluses, and warts are pretty much treated the same way over-the-counter. You use the salicylic acid to damage and soften the skin so it can be easily removed. So what’s the best treatment for you guys to choose? It’s really tough. Really over-the-counter, you only have the two options: liquid nitrogen and salicylic acid. To me, salicylic acid might be a little bit safer than the liquid nitrogen. If you put too much of this freezing, if you press too hard or apply too much to the area, we can get a serious blister that can form and a lot of damage to the tissue. In terms with the salicylic acid, if you put the liquid on once, in a greater area than needed, yes the skin will turn white but if you stop after that, you have no more further reaction. If I had a choice between a liquid and the pad, I’d take the liquid or gel. The reason, if we look at the medicated pad, it’s only that size. So if you have a larger wart and that pad is not touching the medicated pad is not touching all of the wart, we’re not gonna get a good reaction. If we use a liquid we can tape around the wart isolating the bad warts, leaving the healthy skin untouched, and we can apply the liquid to the damaged area. So if we have a very irregular shaped wart or very large wart, this would be a better bet than this one. Same thing goes for the tip or the freezing with the like liquid nitrogen. We can touch exactly the wart that’s present and try to reduce the amount of damage to the normal skin. With both of these treatments, a lot of damage to the normal skin can happen so it’s very important we try to reduce the amount of damage to the normal skin by protecting the skin around using tape or something and then we isolate the tip or the liquid right over the warty tissue. With both of these treatments, whether it’s a salicylic acid or the liquid nitrogen, multiple applications are important. We damage the tissue and the most important thing is to scrape down that damaged tissue. The more that we’re able to scrape off, the thinner the skin, the thinner and less deep the wart is and the better the penetration of a salicylic acid or the liquid nitrogen. So the big difference, when you go to a foot specialist, they are able to scrape the wart very very thin, accurately, precisely without creating too much damage to you. But if you’re able to treat your own feet or if you’re able to reach your own feet, scraping down the wort is very very important. You would apply the liquid nitrogen or the salicylic acid. After you have the reaction of the skin or the damage of the skin, you scrape it down as much as you can, and apply it again. This is something that you repeat on a daily or every other day process. The more you scrape down, the better damage you’re going to get with the salicylic acid or the liquid nitrogen and hopefully the further the damage will get down in the top layer of skin to remove the wart that’s living there. The issue that I see a lot is people are doing a scraping but they’re using the same tool over and over. So you can use a corn or callus shaver but if you’re using the same blade or a file over and over over, you could be possibly reinfecting the area with the wart virus. So it’s important that if you’re scraping down the area, you’re using a disposable tool. When is it time to give up on over-the-counter treatments? After trying these over-the-counter treatments for roughly around two to three weeks and you’ve been going relatively consistent, plus scraping down the dead skin, if they’re still not resolving the problem, if the warts are still present, it’s still causing a lot of pain, that’s pretty much a sign that you should go see a foot specialist, your medical doctor, or dermatologist, to get more advanced care. At my clinic, I do offer laser treatment. Laser treatment is something that I offer in my clinic and what the laser that I use does, it targets the little black dots red dots of the wart. That’s the body’s blood supply that’s kind of mixed in with the warty tissue. What the laser does, it focuses on this tissue and damages it. We essentially create a very localized bruise to the area. What will happen over the next month month and a half, that bruise turns into a scab and the scab just pops off. The laser is able to penetrate much deeper and that’s why I do offer in this clinic because we’re able to penetrate deeper. The option that you saw yesterday, the surgical removal option, is something that I save for you know one, a really bad wart. A wart that’s really painful. A person can’t stand on it or they’ve had this wart for many many years that’s been treated many times and there’s a lot of maybe scar tissue or or callus, hard dead skin on top that’s really blocking the wart. Surgery is a great option, but it’s a lot more aggressive. We have to numb the area, we have to actually scoop out the top layer of skin, where the warts living. So we’re creating an open wound. The wound is going to fill up quite fast, but for the first couple days, it can be quite uncomfortable to be standing on depending on where it is on the foot and the size of it and then we have to be taking enough care that we don’t allow an infection to happen. But what normally happens is within the week to two weeks, the area fills up to the surface, we get a scab that forms and after a month, we’re able to see if there’s any more tissue still present. A really cool concept that has been put out there and a lot of foot specialists are starting to use, it is something called dry needling. So the reason why warts are so tricky to treat is that the body actually doesn’t know they’re there. The warts are sitting in that top superficial layer of the skin and they’re replicating in that area and because it’s kind of hiding on top the body, it actually doesn’t know anything is there. So the concept of this treatment is that we numb a wart and we push the wart using a needle into the body. What we’re trying to do is create some sort of immune response. So there’s been studies showing that by us treating one wart and pushing the wart right into the body, in within three to six months, sometimes we get this immune response by the body and the warts on even other parts of the foot areas, that never been treated, have been eliminated. I’ve done this quite a few times in my office and I’m around 60% successful with this treatment. It’s really something that I use when people have both feet covered with a lot of warts or very large warts and instead of treating it with surgery or laser, which can have a lot of complications, because it’s the large wart and the amount of pain or discomfort after the healing that sometimes this needling technique where we treat just one spot can get rid of everything. So we have liquid nitrogen, salicylic acid, we can go something stronger like laser treatment, we can do even surgical removal. All these treatments really just do one thing- damage the layer where the wart is living to hopefully get rid of the virus particles that are living there. We get rid of that those virus particles and we can have new healthy skin fill in. I know there’s a lot of home remedies out there. You hear about apple cider vinegar, crushing up aspirin pills. What’s really interesting about that, when you think about it, apple cider vinegar is an acid and what the acid does is damage the top layer of skin. All the treatments have the same principle: we damage the top layer skin, where the wart lives. If we can get rid of the top layer of skin, the warts gonna go with it. But because the wart is so much thicker or deeper because the skins thicker on the bottom of the foot and because we’re stepping on the wart, that’s what makes warp treatments so painful and that’s why treating it with routine scraping of the area is very important. So again, using apple cider vinegar, using salicylic acid, all these things can work because as long as we damage the top layer of skin and get rid of it, the wart will be gone with it. I’m really sorry for the late video, guys! It’s been a very very long day at the office and unfortunately, I wasn’t able to get to this sooner. Tomorrow I have 26 people booked 9 to 6. It’s gonna be crazy! I’m definitely gonna try my best to put something out during the evening tomorrow to get you guys those daily videos. It’s been a lot of fun but a lot of work to get these done. I’m quite happy with you know, the response and you guys following along. So continue to share these videos, comment, subscribe, if you haven’t. I’ve just finalized my location for my seminar, so I’m gonna put some info on that soon on the website. But again, June 9th, I’m having my first educational seminar. It’s basically themed “Step up Your Foot Care 101” and my goal is to improve your foot health, your foot knowledge, and your treatment of the feet for foot care nurses, for pedicurists, for nail technicians, anyone who deals with feet; I would love to improve your services so you guys can provide an even better experience for your clients. So that’s what I’m really hoping to do. If you ever want any more info, please go to the website www.thetoebro.com and you can get some more info there. So, sorry for the late video, guys. Check in, watch it, I hope you like it tonight, sleep in tomorrow. I’ll be at the office. Toe Bro, out.