What is a Verruca?

A verruca is simply a wart that is usually found on the soles of your feet, though they can also appear around the toes. In the early stages, a verruca looks like a small, dark, puncture mark but later turns grey or brown. It may become rough and bumpy with a cauliflower-like appearance and may develop a black spot in the middle, which is caused by bleeding. A verruca can grow to half an inch in diameter and may spread into a cluster of small warts.

Verrucae are caused by the human papiloma virus (HPV). This virus is very contagious, but can only be caught by direct contact. It thrives in warm, moist environments such as swimming pools, changing room floors and bathrooms. So if an infected bare foot walks across the poolside, it may release virus-infected cells onto the floor. If you then walk on the same floor, you can pick the virus up, especially if you have any small or invisible cuts and abrasions that make it even easier for the virus to penetrate. You could also catch the virus from an infected towel.

They are harmless. However, they can cause a sharp, burning pain if you get one on a weight-bearing area such as the ball or the heel of the foot. Because you are constantly pressing on the area when walking, they can protrude into the skin and become more painful.

When you have verrucae on a non-weight-bearing surface (such as on the top of the foot or on the toes), they protrude above skin level, tend to be fleshier and cause less pain.

Who gets a Verruca?

Tend to be common in children, especially teenagers. However, for unknown reasons, some people seem to be more susceptible to the virus, whereas others are immune.

What’s the difference between a corn and a verruca?

• A verruca is a viral infection, whereas a corn or callus are simply layers of dead skin. Verrucae tend to be painful to pinch, but if you’re unsure, your podiatrist will know.
• When you squeeze a wart, there is pain. Squeezing a corn does not cause pain.
• When you press a wart there is no pain. If you press a callus, there is often pain as bone is underneath the area
• When a verrucae is removed, there is pinpoint bleeding due to the small vessels underneath, the black dots commonly seen. Removing a corn does not cause bleeding unless deeper layers of healthy skin are affected.

What can I do?

Minimise your chances of catching a verruca by keeping your feet clean and dry, and covering up any cuts or scratches. Avoid walking barefoot in communal showers or changing rooms (wear flip-flops) and don’t share towels. Though you should wear verruca socks when swimming to avoid passing on the virus, they can also be worn as a preventive measure.

If a verruca does appear, avoid touching or scratching it as it may spread into a cluster of several warts. Instead, cover it up with plaster. In some cases, this may cure it.

Do not self-treat if you have diabetes or circulation problems.

What can a podiatrist do?

If yours is causing pain, there are a number of treatment options available – though no one particular treatment can guarantee a cure.

Dry Needling – Our immune system is far more active in the deeper layers of our skin (dermis), which explains why some verrucae lesions are so resilient. Between these two layers is the dermo-epidermal junction and it is this that is traumatised during dry needling. Dry needling is a minor surgical procedure, which involves the use of a fine needle to puncture the verruca lesion and dermo epidermal junction multiple times under local anaesthesia. The goal is to implant infected cells into the dermis thus stimulating an immune response and, therefore; destruction of the virus. One huge advantage over other treatments such as cryosurgery and caustic (chemical acid) is that only one session of treatment is usually needed. If you have multiple lesions then still only the “mother lesion” needs to be treated as a systemic immune response is initiated. There is no evidence that suggests using this technique can spread the virus further. Recent studies have shown Verruca Dry Needling has a success rate of approximately 80%.

Chemical (Acid) – A recent review of treatments in the British Medical Journal (August 2002) concluded that the safest and most effective treatments were those containing salicylic acid. This acid is applied to the wart to disintegrate the viral cells and has a cure rate of 75%. It will need to be applied at weekly intervals over a period of time, and the foot needs to be kept dry.

Cryotherapy – This involves freezing warts off with liquid nitrogen or nitrous oxide gas. This needs to be done every 2 or 3 weeks for a few months before the verruca is fully removed. However, it can lead to soreness and blistering in some people. You can still swim after this treatment, but it’s not advised for sensitive or anxious children.

Electrosurgery – After a local anaesthetic, the verruca is pared down. An electric needle is then placed in the middle of the wart for a few seconds until the wart boils – the verruca is then scooped out.

Homeopathy – taking tablets that will heighten your immune system to fight off the virus. However, this method is very slow and can take several months; but is a pain free method.

Leyton Foot Clinic offers a number of treatments, that will be discussed with yourself and then a mutual decision will be made as to what treatment will be best for you. At present there is no treatment that is 100% effective.