Verruca Needling (Falknor’s Technique)
As previously posted verrucae can be one of life’s frustrations; they can oft be stubborn and non-responsive to treatment. They are caused by the Human papillomavirus (HPV) which invades and infects the top layer of the skin (epidermis). The HPV infection gets into the skin cells following an abrasion or breaks in the skin surface. The virus can then remain here for up to 8months.
In our previous post on verrucae and warts we looked at the cause and treatments options available.
We have based this post on verrucae needling, this was initially described by Gordon Falknor an American Podiatrist in 1969. He used the needling technique on 126 patients with recurrence in 2 patients.
Recent studies in 2013 by Longhurst and Bristow have shown a 69% completed resolution (39 of 46).
So what is Needling?
Needling is the use of a needle to pierce the verrucae lesions to create a cellular response at the site of the verrucae.
When there are multiple lesions the primary and largest are targeted.
The procedure is completed under a local anaesthetic, this may involve various injections. The area will stay numb for 3-4 hours.
Once the area is numb, any overlying hard skin is reduced. The area is cleansed, a needle is used to pierce the verrucae, this is repeated over an over to the lesion. Once completed a light dressing is applied with a deflective pad which needs to remain in place and dry for 24hours.
After the procedure, if painkiller is needed paracetamol can be taken.
It is advisable to avoid taking NSAIDs (Ibuprofen) or other anti-inflammatory medications for 48 hours to increase the likelihood of a successful controlled inflammatory response.
It is recommended to take it easy on the day of the procedure and not drive as parts of the foot will be numb.
The procedure takes around 5-10minutes, allow 1hour to include time for anaesthesia to take effect and for monitoring after.
Are there any Risks I should be aware of:
Every effect is considered to reduce complications, and achieve the best outcomes, however:
Unsuccessful and non-resolution of the verruca.– Current research does show good outcomes, unfortunately, treatment is not 100% successful, with studies showing outcomes success rates of 69% +.
Recurrance-. Currently, there is no data to provide statistics for recurrence rates.
Infection. Infection rates have not been reported or seen clinically, advice will be provided on how to look after the area.
Scarring or thickened skin Again this has not been reported, but if you have experienced thickened, hypertrophic or keloid scarring let us know.
To find a Podiatrist in your area, here is a link for the College of Podiatry