Worry Warts- Verrucae
Are you concerned that you or one of your family members has a verruca? Are you unsure what a verruca actually looks like and if it IS one, you're not sure what the best treatment is? Let me help you out.
What Is A Verruca?
Verrucae are warts, usually found on the sole of the foot, which are caused by a virus (the Human Papillomavirus or HPV). They can be single, round warts or can be spread over a larger areas depending on which type of verruca a person has (there are 3 different common presentations on the foot, each caused by a different subtype of the HPV). A key method of identifying a verruca is to look at the skin striations, these are the lines which run through your skin, similar to your fingerprint. If you have a verruca, these lines will stop at the edge of the verruca. Verrucae also sometimes have small black dots in them.
Will It Go Away If You Don't Treat It?
Most often, yes. In children, verrucae generally resolve themselves within 6-24 months. This can take longer in adults. Verrucae are sneaky and send out chemicals called ‘cytokines’ to 'camouflage' themselves from the immune cells (langerhans) who in turn let the killer T cells know that they have to destroy the virus. So put simply, it's not always easy for your immune system to find the virus to be able to kill it. However, if you don't want to treat it, you don't have to! But if this is the case, I recommended to cover the area up when using communal areas such as swimming pools, showers etc to reduce the spread of the infection to others.
How Do I Treat A Verruca?
There are many different ways to treat a verruca. I will outline the main methods we recommend:
Podiatrists describe the option of leaving a verruca to resolve as "the tincture of time". The best resolution is one which involves an immune mediated response (eg your immune system kicks in and gets rid of it) which will leave you will immunity against that type of the virus. If the verruca is not troublesome, this is a great option.
2. Occlusion Therapy
This is when you cover the verruca with a non-breathable dressing/plaster such as a non-breathable zin oxide tape or a blister plaster for a prolonged period of time with the aim of preventing the skin from losing water (trans epidermal water loss or 'TEWLS'). The prevention of TEWLS causes the cells to fill with the water they've not been able to lose by evaporation. This can soften the verruca and make it more comfortable while you wait for the immune system to kick in. This has been shown to be as effective as acid based treatments.
Depending on the location of the verruca, we may be able to 'needle' it. We give you a local anaesthetic to numb the area and use a sharp needle to break down the verruca. The aim of this is to push the virus deeper into the body and 'awaken the immune system' to it's presence so it can kill it off.
4. Home Treatments
Unfortunately many home treatments are just not that effective. You may want to try Bazooka which is a salycilic acid based treatment. If you do, I recommend using tape or a felt pad with a hole cut in it to keep the acid solution on the skin you wish to treat and not the healthy skin around it.
Things You Should NOT Do To Your Verruca
Please don't do any of the following:
- Use emery boards or pumice stones on it. This can spread the virus to surrounding tissue and repeated use of the board/stone can cause reinfection.
- Use medicated corn plasters as the acid in these is very strong and difficult to keep in the right area.
- Use sharp instruments such as blades or razors to cut your verruca.
Verruca are generally tricky to treat. We can help you out in the clinic by removing some of the hard skin from the top of the verruca which can make it much more comfortable for you while you carry on with the treatment of your choice.
If you need help diagnosing or dealing with a verruca please get in touch.