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A Guide to Verrucae and Treatment Options
Verrucae are very common foot problems which can affect us at any age. They are caused by a viral infection of the skin and can be difficult to resolve. Though many don’t cause any harm and are without symptoms, they can last for many years and some people find them unsightly and embarrassing and in some cases people start limiting their activities due to becoming self- conscious of their verrucae.
Verrucae are notoriously difficult to treat and many people find themselves using over the counter products or home remedies that have little or no evidence to support their use. These can lead to scarring or damage to healthy skin around the verrucae which can cause the verrucae to spread. In time many verrucae will resolve without treatment. Treatment is indicated if the verruca is painful, shows signs of spreading, does not resolve over time or if the patient wishes to speed resolution. Whilst verrucae can take a number of years to disappear naturally there is increasing evidence that the longer a person lives with an infection the rate of natural resolution is reduced. (Reference: Dry Needling and Microwave Therapy – The Journal of Clinical Medicine)
What treatment options are available?
There are many options available all are an attempt to stimulate the body’s own immune system in recognising and fighting the verruca but no treatment can be guaranteed 100% successful. To date, clinical trials have shown that the most effective treatments available are Falknor’s needling.
Options available at Cheshire Foot Clinic include:
No treatment: This would usually be the case for young children under the age of 6. This is because the body’s immune system recognises the presence of the virus and fights the infection naturally. If your child is under the age of 6 and has a verrucae which is painful our Podiatrists can advise you and help relieve the pain
Cryotherapy: This involves freezing the verrucae with liquid nitrogen. The rapid freezing of the skin followed by the thawing effect is thought to induce and inflammatory reaction which will then trigger the immune system to fight the virus. A large clinical trial reported 14% resolution of verruca using cryotherapy or 50% salicylic acid. Cockayne et al 2011: BMJ 2011;342:d3271
Verrutop- This is a topical solution, that requires application by a Podiatrist every 1-2 weeks for up to 6 applications. The solution contains a nitric-zinc complex, which triggers a weakening of the virus’ DNA and dehydrates the tissue. Between treatments the client is required to apply surgical spirit twice daily to the verrucae tissue to further help this reaction. This treatment is suitable for adults and children over the age of 6. Trials done on warts on various parts of the body by the manufacturers report between 22-88% resolution using this method of treatment.
Falknor’s Needling technique This is a minor surgical procedure carried out under a local anaesthetic. Once the area is anaesthetised a fine needle is used to push verrucae tissue into the deeper layers of the skin. The action stimulates the bodies immune system to fight the virus. Verrucae needling involves 1 or sometimes 2 needling treatments, each with a dressing check 24-48hours later and a review 8 weeks post operatively. On the day of the procedure, the client must not drive due to the administration of a local anaesthetic. This treatment is not suitable for children under 16 years of age. (Longhurst and Bristow reported 69% resolution of verrucae following this method in adult patients whose verrucae had been present for an average of 5.7 years in J Clin Med. 2013 Jun; 2(2): 13–21)
Verruca Microwave Therapy This uses a probe to send a microwave pulse through the verrucae tissue. The heating of the tissue stimulates the bodies immune system into fighting the virus. This treatment method is non invasive and can be carried out without the use of an anaesthetic. This usually requires 3 treatments, 4 weeks apart. A follow up appointment after the last treatment is then needed 12 weeks later. Trials indicate 79% resolution in verrucae which have been present for greater than 12 months. The average duration of the verrucae treated in the trial was 5 years.
If you have painful or unsightly verrucae or would like more information about our verrucae treatments please complete the form to book an appointment or contact us to speak to one of our team:
Cheshire Foot Clinic: 01565 655840/ email@example.com