Verrucae and Warts are one of life’s frustrations; they can oft be stubborn and non-responsive to treatment.
Warts and Verrucae come from the Human Papilloma Virus (HPV)
About 1 in 10 people in the UK has a wart or verrucae at any one time
Verruca and Warts are contagious; they are spread from direct skin contact, or from damp places such as swimming pools and communal changing rooms.
People whose immune system are suppressed or reduced are more susceptible to getting a verruca.
The virus can only survive in the top layer of the skin (epidermis), so does not infect tissue beneath, and does not have roots.
Verrucae can present in many different ways from single 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.
They are benign, and often spontaneously resolving.
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 than in adults to treatment.
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.
Leave alone – with up to 9 out of 10 disappearing without treatment within two years in children, may longer in adults. If the area is not painful, it’s worth considering.
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.
Salicylic acid is one of the most common forms of treatment, many of the over the counter Verruca and wart preparations contain Salicylic acid in low dosages. It is an effective treatment, with evidence reporting around and 80% success rate, again with repeated applications.
Over the counter, preparations are a good starting place to treatment. Within the clinic, Salicylic acid is used at a higher strength from what can be purchased from over the counter.
The number of treatments depends upon the size and location of the lesion. It is a relatively pain-free treatment option, however, involves keeping the foot dry for 3 to 4 days, and often more treatment applications are required.
Other acids such a Silver Nitrate are used.
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.
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
Referral to Dermatologist
To find a Podiatrist in your area, here is a link for the College of Podiatry