“What’s the best treatment for a Verruca?” the unwanted truth

How to get rid of a Verruca: assessing the risks versus the benefits.

Verrucae viewed through a dermascope“What is the best treatment for a Verruca?” and How to get rid of a verruca are questions I get asked a lot, sadly the truth is most people don’t want to hear the difficult answer . Why? Because it’s like asking how do I cure my common cold, preferably, right now?

Naturally, as a health professional, I want to give you a quick, finite and guaranteed answer for How to get rid of a verruca? A treatment that I know will work today, 100% of the time. But I can’t.

You will understand then, how hearing that question makes my stomach churn slightly because I know you are not going to like what I’m about to tell you. Why? Because it’s the truth and that’s the way I operate, even if it means I lose business initially.

This story of a recent inquiry I had about a verruca will help you start to understand why it’s important for me to hold this value.

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I got an email recently from a parent seeking my help, wanting to know: “How to get rid of a verruca” for a child around 12 years old, very sporty and very active with a 2 year history of a painful verruca underneath the big toe joint. As you can imagine, being on a weight bearing area of the foot, getting friction and pressure, it was sore to run about on.  I hadnt yet seen the child (who was busy playing sport). The parent and I became email penpals though so I could get the context of where we were at. I needed to know the history and what had happened so far. 

It’s a frequent story, familiar to many Podiatrists like me :(names and gender removed to protect confidentiality)

  • The Verruca had been treated at home with the various over the counter preparations including acid gels and freeze sprays for a period of about 2 years or so without success.
  • Both parent and tween-ager were understandably getting fed up with this Verruca and wanted it gone, so they reached out to me to find out how I could help to “get rid of it” once and for all. (If only it were that simple)

I really wish I had a simple yes or no answer at this point to say do this, or that, and for it to work, I really do.

For an active tweenager like this, there’s only two options left in my book. One is Cryotherapy, the other is Swift, both of which involve some degree of discomfort and inconvenience, so that’s where I had to go next.

Here are some of the verruca related questions I asked by email:

  • On a scale of 1-10 with ten being the worst pain ever, how painful is it? (Answer) Its an 8 at its worst (my tween-ager has been very lucky in this short life and not really had any illnesses or pain). It is especially painful when the foot is dangling!
  • Did you use each of the over the counter treatments for 6 weeks continuously? (A) Yes
  • How good is your tween-agers pain threshold? (again let’s use a scale of 1-10, with 10 being highest tolerance of pain imaginable) (A) Reasonably good with pain but, not been ill much. I’d probably say 7

It can be tough asking these questions as I know I’m opening doors in people’s minds that they perhaps haven’t thought of before. It’s starting to indicate where I am going with it though. Just for the record, I’m no fan of pain and would put my threshold around a 5-6 before you see me yelping like a whimp.

How to get rid of a verruca. Going beyond home treatment

Swift Verruca TreatmentThese answers gave me an understanding of my potential client and as such, a direction to go with my suggestions. It can be tricky, as a podiatrist I am balancing the options I can offer, versus how well I think the individual I’m working with might handle it.

Why is that?  Because when the over-the-counter remedies have failed, I am looking at four remaining potential treatments. All of which have got a risks along with potential benefit, the main one being pain or discomfort.

Questions, if I asked you on a scale of 1-10:
  • How much pain can you tolerate if 10 is the most intense pain that you can imagine. What do you think your answer would be?
  • Further, how much pain do you think your child/teenager should tolerate in order to get rid of their Verruca? What would your answer be to that one?

The fact is, the remaining choices for cases like this boil down to either Cryotherapy or Swift both of which are fast, clean and convenient.  Further they don’t require:

  • padding or dressings,
  • a wound covering,
  • to be kept dry,  
  • a local anaesthetic,
  • plus, activities can remain normal.

However, the risk is:

  1. at best Cryo/Swift are uncomfortable when carried out.
  2. At worst they are downright painful.

Whilst they are fast treatments, the visible resolution ‘cure’ can take months to see. (The immune system works at its own pace. Let me ask you, how long did that last cold take you to recover from?)

How to get rid of a verruca

For this case study, I have ruled out the other two options of Caustic therapy or Faulknor’s needling. Post treatment dressings would need to stay dry and in place afterwards. This would impede sports and activities, which wasn’t a viable option.

What happened next in How to get rid of a verruca story

I sent this parent links to my blogs, website information on Verruca and an email about the two treatment choices I would suggest (if they came to see me), quite rightly, they chose to have a think about it.   

Let’s face it, what Mum or Dad realistically wants their son or daughter to endure any potentially painful treatment for a non life threatening problem at all if they don’t absolutely have to?

Embarking on a course of treatment for a Verruca is not a decision to be taken lightly. So many factors have to be considered for each individual case. As a Podiatrist of some 27 years now and by working with my clients, I try hard to figure out the best treatment plan for them.  Realistic, practical expectations are key to that goal.

So, How to get rid of a verruca ?

I hope this story helps you make the right choice for you and your family members.

If this blog has helped you, please share or write in the comments, till next time..

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