We’ve had a few requests for information about verrucas and how to treat them so lets start by talking about what a verruca actually is.
Verruca Pedis- a human papilloma viral infection of your own skill cells affecting the foot. They can be raised lesions or if on weight bearing surfaces, they will appear flat. They have a life span of 2-5 years and will go of their own accord. Much the same as a common cold (also a viral infection) there is no cure and you just have to wait it out BUT if it is painful and you are really keen to move things on there are a number of things we can do to encourage it along.
The problem with verrucas is that they infect the superficial layers of the skin so your body’s immune system doesn’t actually know there is a problem (low immunogenicity), thereby leaving it to sit there happily undisturbed. There are a number of treatments available over the counter, which all work on the premise that they cause damage to the skin, which the body will recognise as an injury and hopefully in doing so will ‘discover’ the virus and kick it out. These treatments might be acid based, crythotherapy (cold burn) and some herbal things as well. In actual fact, the action of a Podiatrist debriding the callus (hard skin) that forms over the verruca, causing it to bleed, has the same affect as these treatments in that it causes an injury, which the body will then address. These treatments don’t often work because its a bit hit and miss as to whether you will be fortunate enough for the body to find the virus and kick start its immune system to get rid of it…. but on occasion you get lucky.
The gold standard management for verrucae is actually occlusion therapy, as recommended by Dermatologists. Its 70% effective in eradicating the viral infection but hold tight because its super complicated…
Step one: Podiatrist debrides callus to expose infected tissue.
Step two: Person afflicted with said virus, sticks duct tape to verruca
I know what you’re thinking, “how am I going to manage this… panic!”
So, the theory behind this isn’t really understood, but it seems to work. The rules are you keep the duct tape on the whole time for a period of maximum 6-8 weeks changing it when it starts to peel off or on a weekly basis for a fresh piece. Cut it to slightly larger than the verruca and visit your Podiatrist during this time if you notice that the hard skin is building up again as this will prevent the therapy from working as effectively. You can pumice the skin yourself but its never quite as effective as sharp debridement (please do not use a scalpel on your own foot, it takes Podiatrists 3 years to train in using a blade safely and you will only do more harm, trust me on this!).
If this doesn’t work, we can try something a little more invasive but equally uncomplicated- its always the simple things that work the best.
A technique called Needling is something that Mark specialises in. It involves having a local anaesthetic and then a needle is pushed in to the verruca to force the virus in to the deeper layer of skin beneath (lots and lots of times hence the anaesthetic!) so that the virus is then in a layer of skin that your immune system will respond to. The mechanical trauma of this treatment also helps to trigger a immune response to the viral infection- a theory that all the other treatments also work on, as above.
There are many considerations your Podiatrist must make to determine whether needling is appropriate for you and we ALWAYS offer the more conservative treatment first. Why use a bazooka when a nerf gun will do?!
Hope that clears things up,
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Photo credit: Commando trailer