Verruca treatments: your options explained

We understand verrucas can be frustrating to deal with and cause havoc with your daily life, perhaps causing discomfort, embarrassment and stopping you getting on with the activities you love. In this article we explore the different methods to treat your verruca and the options our team of podiatrists choose to offer here at Epsom Footcare

What to do if you have a verruca

If you have a verruca try not to touch or scratch at it as it could potentially spread into a cluster. If the skin has broken down or split, keep it covered to help prevent it spreading to others. Constantly covering with plasters can make the skin moist and can lead to breakdown of the skin.

If your verruca isn’t really causing you any issues you choose not to pursue treatment. Often verrucas will disappear on their own within two years without any treatment. However if your verruca is causing you pain, discomfort or affecting your self esteem then it’s time to take action and book a consultation with your podiatrist.

What treatments are available?

There are various treatments available for verrucas, all with varying success rates. Many people try over the counter solutions and at home remedies however these have lower success rates and can often make things worse if not used correctly! Our team can fully assess your verruca, explain and answer any questions about the treatments available and advise which would be most suitable for your condition.

Some of the options our team of podiatrists use in clinic are as follows:

REGULAR DEBRIDEMENT

The verruca virus can stimulate rapid production of skin cells which do not mature properly and can cause the formation of a painful mass which you may feel when weight-bearing. Although this option is unlikely to remove your verruca it should be able to make you a lot more comfortable. Regular sharp debridement with a scalpel by clinically trained podiatrists such as ourselves is the best way to debride as we are well trained and highly skilled in this technique, plus we use only sterilised equipment to ensure nothing is spread.

SWIFT MICROWAVE TREATMENT

The latest way to treat verrucas – Swift – uses microwave energy. The microwaves are applied to your verrucas using a probe that heats the infected tissues and triggers the production of proteins that alert the immune system to the presence of the verruca virus. Clinical trials report a success rate of over 80% and we are currently seeing this rate in practice. The treatment sensation can vary depending on the individual’s pain tolerance and the site of the verruca. Usually the treatment will cause a very short hot discomfort but it can occasionally be quite painful. This quickly subsides and rarely lasts for more than a few minutes. Inflammation can occur which can last for a few days but again this will vary between individuals. The treatment generally requires no injections or dressings, meaning you can go back to your daily life straight after treatment. In most people a minimum of three treatments spaced four weeks apart are required to successfully treat the verrucae. Sometimes more treatments are required, especially in older patients or where verrucas have been present for many years. If you are interested in Swift to treat your verrucas please contact our Patient Care Team. You can also find more information here.

FAULKNOR’S NEEDLING PROCEDURE

This is a procedure designed to provoke an immune response, in a similar way to the Swift treatment except with Faulkner’s needling, damage is done to the tissues to alert the immune system to the presence of the verruca virus. This procedure requires local anaesthesia either directly under the verruca or by a regional block (usually done around the ankle) to anaesthetise the entire area affected. Your podiatrist will then use a needle to break down the infected tissue causing damage to the verruca. This treatment pushes particles of the virus into the dermis (the deeper layer of skin) where there are more immune cells present. Faulkner’s needling tends to have a success rate of approximately 50-60% and the treatment can cause some pain or discomfort after the procedure which can last several days. You will also have a thick dressing placed over the verruca for 24 hours before you can resume normal showering etc. Just one procedure is usually needed and success, if achieved, tends to happen after 12 weeks. Follow up appointments are sometimes necessary to keep the thick skin under control during this time.

What about Caustic (acid) and Cryotherapy (freezing) treatment for verrucas?

These are more traditional treatments with a much lower success rate and a possibility of damage to the surrounding areas which can lead to a spread of the virus. We no longer offer these at our clinic, however there may be other clinics locally who are still using these methods if you would prefer to explore these options.

CAUSTIC (ACID) TREATMENT

Acids are used in various forms and strengths – some as liquid and some in ointment or crystal form. The object of the treatment is to destroy the skin cells containing the virus and the virus itself. Some acids are much more reactive than others. Caustics available from the pharmacist are mild and can be used at home. The stronger acids are more reactive and can be unpredictable and difficult to control. The acid reaction can lead to tissue breakdown with blistering and/or ulceration. This can lead to infection which can be dangerous even in healthy patients. Generally, they have a success rate of around 30% and it can take many treatments to resolve the verrucas. This means that it may be necessary to spend a lot of money on a potentially dangerous treatment that has less chance of success. This type of treatment is available at some podiatry practices but we have chosen not to offer them for the reasons outlined above.

CRYOTHERAPY (FREEZING TREATMENT)

This is the use of extreme cold on the verruca, the object being to freeze the cells containing the virus. This causes the water within the cells to expand, splitting the cell wall and destroying the cell. The treatment is unpredictable and difficult to control. It causes actual tissue damage and the immune response that this provokes does not provide long lasting immunity and is less likely to cause resolution of the verrucae (30% to 40%). Freezing can cause pigmentation changes in darker skins – this often resolves but can be permanent. In view of this we no longer offer this treatment.

Can we guarantee success in banishing your verruca?

Unfortunately no verruca treatment guarantees complete eradication of the virus and even if your verruca does go with treatment you can pick up the virus again in the future. As with many medical treatments there is a possibility of adverse/allergic reactions to medications and treatments although these are rare. There is also the chance of scarring of tissues, especially with caustic and cryotherapy treatments. The risks and benefits can be further discussed with your podiatrist as necessary.

Contact our patient care team on 01372 723000 to book in an initial consultation for a full assessment and discussion of your options. Alternatively you can book your new patient consultation via our booking page. Depending on the condition we may be able to start treatment right away.