Currently due to Covid-19 Evolution Podiatry at the Portobello Clinic are not seeing patients face to face unless in an emergency.
We thought it might be helpful to create a series of posts for simple home treatments and do’s and don’t for common conditions seen in clinic.
Verrucae & warts are a common viral skin infection most frequently affecting the hands and feet. Most people experience warts in one form or another at some point in their lives
They caused by the human papilloma virus. While not harmful and usually go away in time without any treatment.
They can be unsightly and painful. Warts on the soles of the feet are also called ‘plantar warts’ or ‘verrucas’.
Mixed levels of prevalence are reported with 3.9% to 4.7% reported in 11 to 16 year‐olds in the UK and 33% in 3 to 12 year‐olds in the Netherlands.
The appearance of warts is variable depending on the type of the virus strain and site that is infected.
This also affects the the number of lesions as there can be single lesion or a cluster of verrucae or warts.
Not all verrucae or warts have black dots.
They can appear on any part of the foot or hands.
Corns are pressure lesions, that are plugs of dense skin that typically occur over sites of pressure. Such as shoes that are to tight.
Wash your hands after touching a wart or verruca
Change your socks daily if you have a verruca
Cover warts and verrucas with a plaster when swimming or bathing if you share a bathroom.
Do not share towels, flannels, socks or shoes if you have a wart or verruca
Do not bite your nails or suck fingers with warts on
Do not walk barefoot in public places if you have a verruca
Do not pick or cut with scissors
Most topical treatments for verrucae and warts are thought to work by causing damage to cells infected with the virus. Completely‐destroyed infected cells are eradicated, but it is likely that partially‐damaged cells expose the virus to the immune system encouraging natural immune‐mediated eradication of the infection.
Children tend to respond a lot quicker to treatments.
Unfortunately, there is no quick fix to treating verrucae and warts
It is always a good idea to monitor the sites and theses days most of us have a camera readily available on our telephones. Using a point of reference such as a ruler or a coin. This can be repeated every 2-4weeks.
No treatment is an option as most do resolve spontaneously at some point.
If you share a bathroom you might want to cover the sites when in the bath or shower.
However, the longer until intervention, treamtment takes longer
This is often a good starting treatment for children,
The first step is to cut a piece of duct tape roughly the same size as your wart. Then stick it on top and keep it on for six days. If it falls off, cut and stick on a new piece.
On the morning of the 7th day, take off the duct tape, soak the wart in warm water and file off the dead skin with a pumice stone or emery board. Then leave the duct tape off for the rest of the day and night and reapply it the following morning. If you have trouble keeping the tape on, try sticking a plaster over the top of the duct tape.
Keep doing this for four weeks. The key is to keep the tape on your wart for six days at a time, followed by a break of one day. And every time the tape is taken off, remember to file away the dead skin from the surface.
Early studies of its use for two months showed complete clearance rates in 60 to 85% of patients treated. However, later placebo-controlled studies found poor response rates.
Home topical therapy is a good treatment option for all ages, there is typically minimal pain and discomfort associated with treatment
There are various products available on the market and and we would recommend a product that contains salicylic acid and lactic acid.
Apply the product and then covered with tape and leave overnight. Remove in morning and with a file or pumice stone gently rubbing the area. Repeated the process each night up to 4 -6 weeks or following the instructions.
Do monitor the area if the surrounding skin becomes inflamed do stop for 48-72hours.
Home ‘Cryotherapy’ freezing is available, no data or research on success of this type of treatment was found. The freeze time needs to be long enough to cause a blister, hence in our experience this is why the home freezing kits fail.
Banana skin! You can cut a piece of banana skin and place it over the wart securing it with a plaster do this every night for 2 weeks. This can be a bit messy but, beware of banana juice getting on your sheets it will stain them dark brown.
No evidence could be found in the literature on success rates or outcomes!.
Swift works by applying microwave energy to the verruca or wart increasing the tissue temperature to create precise localised cell destruction.
As the microwaves travel into the infected tissue, water molecules begin colliding and creating heat energy. This leads to destruction of the infected tissue within a predetermined depth.
for further information here is a link to our Swift page
Needling is the use of a needle to pierce the verrucae lesions to create a cellular response at the site of the verrucae.
For more information here is a link to needling
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.
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.