When examining your feet, you may notice small, white bumps on your heels. These bumps are normally painless and cause a mere fascination with what they are and why you have them. According to the "Journal of the American Academy of Physician's Assistants," or JAAPA, these white bumps are a condition known as piezogenic pedal papules. Labeled as harmless, piezogenic pedal papules are routinely misdiagnosed as cysts or warts.
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Piezogenic pedal papules are small white bumps that form on the outside of the human heel. According to Dermatovenereologica, these bumps are more prominent when pressure is exerted on your feet when standing. When you lie down or sit, the bumps are not visible as pressure has been removed. These papules are normally painless however in some cases, mild to moderate pain does exist with added pressure to your feet.
The reason that individual's form white heel bumps is found in the amount of pressure exerted on your feet in any given time period. According to podiatrist Dr. Marc Mitnick, DPM, the layers of subcutaneous fat become herniated through long periods of pressure exertion, thus bulging through the fascial lining of your heels. Dr. Mitnick is also quick to point out that the only way to diagnose this condition is through physical examination only.
Treatment is not usually necessary when dealing with piezogenic pedal papules, however some measures may be taken to alleviate any pain experienced. Avoiding long periods of standing and weight loss are two such measures according to JAAPA. Other treatment options include wearing heel cups inside your shoes to reduce pressure on your heels. In more severe cases surgical excision may be necessary to stop pain and correct your heel's appearance.
Although piezogenic pedal papules are diagnosed through physical examination, misdiagnosis is fairly common. In some cases, these bumps have been treated as warts, boils or cysts despite the fact that they are not filled with fluid nor are they caused by any virus. Another misconception regarding piezogenic pedal papules is that they are genetic. According to Dr. Micnick, genetics and race have nothing to do with these formations, and can strike anyone at any time. Those most likely to form piezogenic pedal papules are young, athletic individuals and women although men are also at a lower risk.
Repeated trauma and obesity to your heels increase your chance for these bumps becoming painful. According to JAAPA, another consideration in the risk of experiencing heel pain from piezogenic pedal papules, includes extended periods of standing such as with work related tasks. Consult your physician or a licensed podiatrist if you experience severe pain, leaking of fluids or signs of infection, such as inflammation accompanied by bump tenderness.