Verruca: What is it?

Officially, its a viral skin infection of the outer (epidermal) layer of skin caused by the human papilloma virus.

In normal terms – a verruca is a foot wart, caused by a virus. Much like the common cold, there’s many different types of the virus.

Luckily, like the common cold, you don’t need to know which virus you’ve got as the treatment for all of them is the same.

Will it go on its own?

Yes, eventually! In some people (especially young children) verrucas will self resolve in 6-24 months. In adults they can last a lot longer, sometimes years to decades. But why? Because the sneaky verruca virus puts out chemicals called ‘cytokines’ that cloak or hide it from the body’s ‘detective’ immune cells (langerhans) whose job it is to send the memo to the killer T cells to destroy the virus. (This is called Cell Mediated immunity).

How to treat a verruca:

1. Time; yes time is one of the best tinctures when it comes to verrucas. Leaving them alone if they are not bothersome is allowed! Verrucas are common harmless skin viruses which can clear without treatment, especially in children as their evolving immune system is designed to create new antibodies to stand up to microbial baddies.
2. Taping: keeps the moisture in the skin by covering the verruca. Make sure you use a hypoallergenic tape, not Duct tape, which is industrial and NOT designed or tested for skin use. Keeping the moisture in keeps the overgrown verruca tissue soft and more comfortable to walk on.
3. Swift, the new microwave technology for creating a ‘heat shock’ in the skin to ‘de-cloak’ the viral defence chemicals and enable the immune system to attack on the viral particles. It gets it’s name from it’s super speedy treatment just taking 10 seconds! (Available here at Lane Ends Podiatry) Want to read more detail about it? Click here:- Swift

One month after Swift treatment

12 weeks after initial Swift treatment

4 months after final Swift treatment

What else can you do?

Treat at home

1. with a salycylic acid based gel eg Bazooka, you can find out more about how to do that by combining with the taping method here:- home treatment for verruca.
2. with a cryospray device eg Wartner. Although, my personal view of these is they don’t get the skin cold enough to have a therapeutic effect, but some parents have told me they had success with it. I’d recommend using some of the other methods first.

Other clinic based treatments

1. Attend clinic for cryotherapy treatment, usually using liquid nitrogen – super cold!  NICE guidelines mean that the NHS no longer offers this treatment as the data does not show it to be sufficiently effective (under 45-50%)
2. Attend clinic for higher concentrations of salicylic acid ointments. This requires repeated weekly appointments and keeping the felt pad on the foot in place and dry in-between treatments. Whilst effective, it can be difficult for showering, quite inconvenient, as well as costly over time.
3. Needling, this is an inoculation technique which involves a local anaesthetic to numb the verruca area and pushing the viral particles into the deeper fat layer of tissue. This is where the T cells of the immune system are more active and more likely to ‘de-cloak’ the viral defence chemicals, thus enabling the immune response to activate and ‘fight off’ the verruca. You can see Dr Kevin Kirby demonstrate it here:-
   
4. Surgical excision, this is usually done by a Podiatric surgeon or Dermatologist, here is a video link to one of my colleagues, Ian Reilly doing this treatment (warning surgical procedure, not for the squeamish):-

So if you or a loved one are currently bothered by a pesky verruca, those are your current choices for treatment. If you want to know more, drop me an email or fill out the contact form and I will do my best to help.

Till next time

Hugz