Read our post on how we are staying safe during Covid

I often get asked……what is a verruca and how can they be treated

Verruca’s

About a third of my patients come to me asking about verrucae and how we can treat them. So I thought it right to share some information about them with you.

Verrucae are caused by a virus called human papillomavirus (HPV). This virus affects the skin causing hyperkeratotic lesions. They can be found anywhere on the body but can be particularly prevalent over weight bearing areas on the feet. They are often known as warts but are given the name verruca when they appear on the feet. They often appear as a cauliflower appearance which sometimes contain black dots which are caused by small blood vessels leaking into the lesion. These areas can become painful on walking or in certain shoes.  It is generally believed that approx half of all Verruca will disappear within a year. Of those that are still present after a year, 2/3 will disappear after 2 years and the remaining 1/3 can be persistent.  They are more likely to naturally and quickly disappear in children than in adults.

How do we catch them?

They can be caught by direct cross infection and are more likely where there is a portal for infection i.e. macerated soggy skin, blisters or a cut in the skin. Sweaty feet may predispose you to verrucae as the skin can become soggy and the pH level of the skin becomes altered. Current research doesn’t identify the reasons for why some people are more likely to get them. It is believed we may carry the virus on our skin in harmony with other bacteria and that something happens that lowers the immune system (e.g. stress, poor diet) which allows the virus to take hold. This explains why they can be present for years and suddenly resolve almost overnight.

Are they contagious and do they spread?

Yes they are contagious but the risk of infection is quite low. As a precaution you should try and avoid sharing towels and avoiding contact with verruca with other area of your body (i.e. refrain from picking and If you do touch it wash your hands straight away.

Treatments include:

Salicylic acid

These come in various lotions, paints and special plasters. They are widely available in chemists and supermarkets. An example is Bazuka. Usually they need to be applied on a daily basis for 3 months. The acid burns the top layer of skin. Every couple of days you will need to file the dead tissue away. They work best if you soak the verruca in water for 10 minutes before applying. Studies report that about 7/10 verrucae are cleared within 3 months using this method.

Cryotherapy

At 21st Century clinic we use cryopen technology. The benefit of this is that the freezing process occurs only to the affected tissue rather than damaging surrounding skin. The cryopen method is used to freeze the tissue without the use of cryogenic liquid or gases. Cryosurgery requires no anaesthesia and results in less scarring than other techniques of skin removal meaning minimal post operative care.

The application of the cryopen to the area freezes the affected tissue bringing the temperature of the affected cells down to a very low temperature, very quickly. In a 12 second application the temperature reaches -40 degrees. This process causes ice crystals to form, destroying the affected cells. Water then rushes into the surrounding area which can result in a blister forming. The principle is that this blister formation will lead to the body’s own inflammation and healing to clear this virus and Verruca. It is also believed that this process helps the immune system to recognise the virus so that the patient may be less likely to get a Verruca again.

Resent research suggests that freezing treatment is more likely to be successful at clearing warts and verrucae compared with acid treatment. Also, freezing treatment tends to be quicker to get results.

Obscure treatment methods…..

Duct tape

One research study found that covering a wart with duct tape seemed to give a good chance of clearing warts within a month or two.  In this study, about 7 in 10 warts had cleared within 2 months with using duct tape. However 2 subsequent studies failed to demonstrate the same findings as the original study. If you do fancy giving it a go then this is the best way to do it:

Cover the verruca with a small piece of duct tape for 6 days. If it falls off replace it. After the 6 days remove the tape and soak the foot in warm water for 5 minutes. After drying, file the area with a foot file or pumice stone to remove the dead skin. Leave the area uncovered that night and then start a new block of 6 day treatment. Continue this process for up to 2 months.