Your assessment appointment will last approximately 30 minutes and treatment options will be discussed. If you opt for cryosurgery, your first treatment will be at this assessment appointment.
What are Verruca and how do I know if I have one?
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 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.
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 verrucas as the skin cab be come 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.
What is cryosurgery?
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.
How does it work?
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.
What happens during a cryosurgery appointment?
Firstly the podiatrist will debride the overlying callus. Depending on the size of the lesion, the podiatrist will apply the cryopen for approx 10-15 seconds. During this time the area freeze and turns white. After this white thaws out a flushing occurs which causes the area to turn red. This may cause a pinching sensation. In most cases a blister will form between 1-24 hours after the treatment. This will begin to scab after 2-3 days and the scab will fall off after 1-2 weeks. A dressing will be applied to the area for the first few days.
Will there be scaring?
No but it can take up to a year from the last treatment for the skin to appear normal again.
Will it hurt?
There may be some tingling with the initial freezing but most patients get an anaesthetic effect from the extreme temperatures. You may feel a pinching sensation as the area thaws out. Depending on the location of the Verruca, you may feel pain or pressure on walking, The podiatrist can apply some padding to offload the area if you wish.
What are the side effects/contraindications?
De-pigmentation of coloured and dark skin is possible. Young treated areas can develop hyperpigmented borders when exposed to the skin. In some rare cases, continuous pain is possible after nerve damage.
Is it permanent?
For some lesions the cryosurgery process may need to be repeated several times at a 2 week intervals. For most people this process is a permanent removal although it does not guarantee that you will not suffer from Verruca again in the future. Some lesions are harder to remove than others.