Verrucas

What causes a verruca?

Verruca’s, also known as plantar warts are caused by a common virus (the Human Papillomvirus), of which there are many types. and are frustratingly difficult to get rid of.

How to identify a verruca:

Sometimes verruca’s can be mistaken as a corn because they are often painful to walk on. They can be distinguished from a corn by the presence of tiny little black dots in the skin which are capillaries (haemorrhage) and circular skin striations around the verruca.

How do you get a verruca?

Plantar warts are most common in children and young adults. Risk factors include the use of communal showers, a history of previous infection and poor immune function. The virus enters the body through a break in the outermost layer of the skin. Due to pressure on the bottom of the feet, the wart is pushed inwards and a layer of hard skin often forms over the top. Sometimes verruca’s spread and form clusters of warts on the foot. This then inevitably leads to a build-up of callus around the Verruca, which then becomes painful to walk on.

To treat or not to treat?

In allot of cases verruca’s tend to clear up spontaneously after about 2 to 4 years and Doctors often advice to leave them be and to let nature take its course .  However, this is not the case for everyone and there are some people for whom they seem to persist for much longer. There are a number of reasons why one might consider treatment for verruca’s but very often it is because they can be painful to walk on. If this is the case then it is important to see a podiatrist to have the hard skin paired down over the site of the wart to remove the pressure and friction under the foot. Also because they are fairly contagious and therefore can spread over the feet, often forming clusters, which can then result in them becoming more prominent, leading to increased pressure and pain under the foot.

Treatments for plantar warts:

There are many treatments for verruca’s, many of which have zero evidence to support their use as an effective treatment. The key to achieving successful resolution is in triggering an immune response in the body. The human papillomavirus is adept at hiding from the bodies immune cells, however once the immune system recognises the virus as a foreign invader, it will mount a defence and ‘kick it out.’  Cryotherapy and salicylic acid are commonly used, however they often require months of regular treatment.

Which treatment is the most effective?

There is limited research to show a consistently high success rate for the successful resolution of plantar warts. However there are a number of methods used by podiatrists for the treatment of verruca’s, that are advocated and rated as the most effective in clinical practice. One of these procedures is known as verruca needling and is the method that I tend to use in my practice. The rationale for this treatment is to produce a physical trauma at the sight of the wart.  This involves puncturing the tissue with a needle multiple times, after giving a local anaesthetic to block pain receptors over the area of the verruca. The result of needling the wart creates a small wound, causing an inflammatory reaction, pushing the virus into the circulation. The immune cells then have a greater chance of recognising the virus and killing it. It is a bit like ‘waving a flag and saying over here!’

Once the treatment has been done the wound is cleaned and dressed. It is then advisable to take it fairly easy for a couple of days but it is still possible to remain weight bearing but to avoid vigorous activity. If the treatment is successful it is expected that the immune system will destroy the virus but this can take up to six months to occur and in many cases it does require another treatment to see successful resolution of the problem.

Pricing

1 hour (initial consultation and treatment session) – £ 150.00
45 min (follow-up treatment) – £100.00

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