Plantar Wart or just a callus?

Many people come to my office with what has previously been diagnosed as a wart.

It ends up being something called an intractable plantar keratosis. That's a very complicated term for a "seed corn" which basically means you're putting too much pressure on an isolated area of the foot.  This is obviously treated differently than a wart, so it's important to get the distinction. 

3 things to consider when deciding whether that lesion you have is truely a wart:   1.) Are you btw the ages of 15 and 30? Warts occur most often in this age group.   2.) If you pare down the lesion, do you get multiple areas of pinpoint bleeding? Warts do.   3.) If it hurts more when you press directly on the lesion you most likely have an IPK (intractable plantar keratosis). If it hurts more with side to side pressure, the lesion is likely a wart.

The photo attached is a wart.

A wart is caused by a virus, specifically the human papilloma virus.  It is estimated that almost 90% of them will go away on their own in two years if left untreated.

Problem is, in the meantime, if the wart is under a weight bearing area, the pain can be excruciating.

For painful warts, or to prevent them from spreading and becoming "mosiac warts", one should pursue treatment.  Over the counter acids work well, if you want to spend months fussing around with acid patches and a slow cure. 

Otherwise, you're looking at surgical removal, where a podiatrist or other specialist removes the warty tissue and either "freezes" or applies some sort of chemical to kill the remaining wart cells.

Warts have a high re-growth rate.   The downside is that the above procedure may need to be done more than once.