Verrucae and Warts
What is a verrucua or wart?
Verrucae and warts are areas of thickened skin, that often can be unsightly and painful that commonly affect the skin on the feet.
What do they look like?
Verrucae and warts can present in many different ways from singular deep lesions to mosaic patterns and clusters. They are typically found on the sole of the foot and toes.
There are different strains of HPV, and depending on the strain this determines the appearance.
About 1 in 10 people in the UK have a verrucae or wart at anyone time.
Children often respond to better to treatment compared to adults.
Single warts of a short duration have been shown to resolve more readily to treatment comapared to long standing multiple lesions.
What causes them and how did I catch one?
Verrucae and warts are caused from a viral infection in known as the Human Papiloma Virus or HPV.
This affects the top or outer layer (epidermis) of the skin, by causing the skin to produce an excess amount of keratin, which produces a thick area of skin.
Verrucae and warts are transmitted and caught from infected skin scales, typically from areas swimming pools and communal changing rooms.
The virus enters the skin through tiny breaks in the skin surface, and it has been found moistness and sweaty feet creates an easier environment for the virus to enter.
Are they contagious?
Yes, however, they are not considered to be very contagious, they can be passed on by skin-to-skin contact.
Those whose immune system is reduced or suppressed are more susceptible to getting a verruca.
Verrucae and Warts are one of life’s frustrations; they can often be stubborn and non-responsive to treatment. Unfortunately, no single treatment is entirely effective in all patients.
Verrucae and warts can be unpredictable. They may fail to resolve with treatment, and they can recur.
Factors that influence the response of verruca and warts to treatment:
1. Verrucae and Warts in children respond more readily to treatment than when compared to adults.
2. A mosaic wart pattern often responds less well than singular warts.
3. Single warts and those of short duration disappear more readily than multiple and long lasting ones, so treatment in the early stages is beneficial.
There are a variety of treatment options; we can suggest the best treatment for you, based on size location and activity.
Evolution Podiatry's Treatment options.
1. No Treatment
Verrucae and warts can be harmless and go away by themselves without treatment.
In children, about half go away within a year, and about two-thirds disappear within two years.
It may take longer for warts and verrucas to clear up for adults – in some people it can take five to 10 years.
So if your verrucae are not causing you any pain, one option is to leave it alone.
2. Swift (Microwave Therapy)
Swift is the newest treatment against the battle for verrucae and warts and producing very good results and outcomes.
Swift uses microwaves to cause localised and targeted tissue destruction.
For further details on Swift please see our page on Swift.
3. Acid Therapy:
Salicylic acid is one of the most common forms of treatment, with many of the over the counter verruca and war preparations contain Salicylic acid in low doses.
Within clinic Salicylic acid is used a higher strength than what can be purchased over the counter. The amount of treatments can depend upon the size and duration of the verrucae, patients experience minimal pain and discomfort following this treatment. However, it does involve leaving the acid on the foot for 3-5 days. Often repeated treatments are required. Evidence shows in the region of an 80% success rate with this treatment.
Other acids used include Silver Nitrate.
4. Cryotherapy or Freezing
Freezing with liquid nitrogen does not kill the virus. It destroys the tissue in which the virus lives and possibly enhances the host’s immune response. Evidence reports around a 75% success rate, this is with repeated treatments, from 4-6.
This form of treatment can be uncomfortable during the procedure, combining the use of local anaesthesia is an option. Repeated freezing avoids the need to freeze deeply thus minimising scarring.
5. Needling (Falknor's technique)
This treatment is a relatively new addition and with good outcomes reported. This involves piercing the verruca multiple times under a local anaesthetic to create an immune system response. Minimal pain is generally reported after, but taking a painkiller is recommended.
After the treatment, it can take around four weeks to notice any significant change. This technique has an approximate 70% success rate.
For further information please see our post on Needling
This is a good treatment for children, as involves sticking duct or zinc oxide tape over the site. This method occludes and starves the verrucae of oxygen; the tape is kept on all the time and changed following bathing.