What is the Best Verruca Treatment?

Verruca are a very common complaint that we would see in the clinic almost every day.  Normally, when a patient books an appointment for a verruca treatment, they have tried treating the lesion themselves by using over the counter products they have bought in their local pharmacy, a mild acid prescribed by their GP or even a treatment from a supermarket.  These treatments can work for some people with a bit of persistence, perseverance and using the product religiously. Most people give up after a few weeks because they don’t see any difference in the verruca and feel the treatment is not working and that’s when they come to see me.  I generally recommend treating a verruca because they can become bigger causing pain, they can multiply and they are contagious to other members of a household.

Verruca are a viral skin infection, the same virus that causes warts on the hand.  Most people pick the virus up in areas around swimming pools and communal changing rooms where people are walking around barefoot. All it takes is a cell containing the virus to penetrate a microscopic tear in the skin, the rough anti-slip tiles around a swimming pool can easily cause micro traumas to damp skin and the virus can lie dormant in the skin for weeks, even up to a year. 

Verruca come from strains of the Human Papillomavirus (HPV) and can present as hard, raised lumps with a rough surface and usually have black dots caused by broken capillaries.  They tend to be painful if squeezed from each side unlike corns that are painful when there’s direct pressure applied. They can appear anywhere on the foot, sometimes as clusters called mosaic verruca, they are more common in children but can present at any age and tend to be more difficult to eradicate in adulthood. 

Verruca infect the basal cell layer of the epidermis, this is under the dead skin cells but just above the dermis where there are capillaries so the patient’s own immune system does not always pick up on the infection. Treatments for verruca cause injury to the skin which initiates an immune response and antibodies are made to kill the virus.

There is no 100% guarantee with any treatment that they will work to get rid of the verruca.  We recommend patients to try a treatment for around 3 months and if there is no improvement in this time to try and another treatment option.  Sometimes even keeping the verruca covered 24/7 with zinc oxide tape or black duct tape for 3 months is enough to resolve the verruca.

In Active Health we provide 3 Verruca Treatments:

  • Silver nitrate which is a mild caustic and needs to be applied at home every 3 – 4 days
  • Two different acid treatments; salicylic acid and Verrutop containing nitric acid, both need to be applied in the clinic every 1 – 2 weeks
  • A minor surgical procedure called Verruca or Faulknors Needling.

Verruca Needling

Verruca Needling has the highest success rate at around 75% patients having complete eradication within 3 months and it tends to be a one-off treatment.  It involves anaesthetising the area then once numb using a sterile needle to puncture the verruca, pushing the virus into the blood stream and an initiating an immune response.  This does not sound very pleasant but once the anesthetic wears off the majority of patients have very little post-operative pain and go about their normal activities after 24 hours.  This procedure is becoming more popular because of the high success rate and there is no commitment involved for regular attendance compared with the other treatment options.