What are Verrucae?

Verrucae are benign growths on the skin that are highly vascular (lots of blood vessels) in nature. They are caused by a virus known as the human papilloma virus (HPV). Some 15 HPV types have been identified and classified according to molecular differences. These viruses are “oncogenic” this means that environment is a causative factor in the production of their growth.  Verrucae are more common in young people regularly using swimming pools and communal washing/changing areas.

Verrucae may occur as single or multiple growths affecting any aspect of the feet. There is a considerable variation in the appearance of verrucae. Those on the sole of the feet may have their appearance modified by the weight of the body, which forces the verrucae’s mass into the foot giving them a flattened look, over which can be a hyperkeratotic layer, i.e. hard callous surround. For this reason verrucae may be mistaken for corns or hard skin. Other verrucae, e.g. Mosaic verrucae, tend to be shallow and pain-free, whilst the deep plantar verrucae, depending on their location, can be extremely painful.

Verrucae are contagious but the risk of catching them is relatively low. They can often gain entry into the skin through micro-injury. This may occur during barefoot activities, especially when the skin has been wet for some time, as in swimming, or due to sweating after intense exercise, followed by showering. Other areas where verrucae contamination may occur are – trying on shoes in shoe shops without wearing hosiery, hotel rooms, saunas, gymnasiums or health farms. It is also known that a stress factor may be involved in verrucae infection, (they have been seen to be more prevalent at school examination times).  Certain illnesses can make a person more susceptible to infection by verrucae. A lowering of the body’s immune system may cause this.

Unfortunately, if you are unlucky and do catch one, there is no proven effective treatment that works in every case. Some treatments work for some people whilst for others it will have no effect.  The good news is that most verrucae will just disappear of their own accord with no treatment – although this may take up to 2 years, which is the verrucae’s usual life-span.

Why is there no proven treatment?

Verrucae are clever! They are a virus and need to be killed by your own immune system. The body is generally good at this – if it knows what it needs to kill! Unfortunately Verrucae operate in such a way as to make themselves ‘unknown’ to your body.  Verrucae are living organisms and need nutrition. They do this by creating their own blood vessels within themselves which connect to your blood supply and they are able to draw your blood up into themselves. These blood vessels are the dark spots you see on the verrucae.

Unfortunately the blood supply is one way only. The verrucae lie in the top layer of the skin (the epidermis), but draws from your blood vessels in the dermis layer of the skin. However, nothing from the verrucae enters your blood system. Hence the body’s immune system is unable to identify the virus and so deal with it.

How To Treat

My advice is to leave the verrucae alone to clear up itself. However if it is painful and/or is limiting what you can do then you may wish to try to treat. There are various treatments available. This includes self-help, over the counter products, dry needling, laser, or surgical removal. They are generally based on occlusion, destruction, freezing and inducing an immune reaction. Some of the treatments contain salicylic acid – and strength of less than 26% w/w is unlikely to be effective.

Over the Counter – There are two main types – salicylic acid and freezing.  Salicylic acid, at no lower than 26% strength, is most effective

Bazuka Extra Strength Gel 5g  – This contains 26% w/w salicylic acid and involves applying the gel and filing (file included). This is a good starting point – but if not successful you could then try Bazuka Sub Zero.

Bazuka Sub Zero – this is based on cryotherapy – i.e. freezing of the verrucae.  Sometimes only one treatment is needed – if successful the verrucae will fall off after around 10 days. Please note this treatment is not pain-free!  Additionally there are other brands that offer this treatment, but Bazuka use a special safety cap to help to ensure accuracy, so only the verrucae is frozen.

If you do purchase any treatments, always read the information sheet to ensure it is suitable for you to use.  If you have any concerns, always seek medical help.

Diabetics – You should never try to treat a verrucae yourself ALWAYS seek the advice of your GP, Diabetic Nurse or a qualified Foot Health Practitioner or Podiatrist.

Home Remedies – There are many but here are a few examples

Duct tape – You soak your foot in warm water and then file the verrucae with an emery board, apply silver heavy-duty duct tape, leave on for 1 week, remove the tape, soak and file again. Leave open overnight, soak and file again as before, re-apply duct tape, leave on again for 1 week. Repeat this until it has gone.

Banana skins – Tape the white side of a banana skin to your foot and leave overnight, in the morning file it with an emery board. Repeat until disappeared.

Apple Cider Vinegar – some of my patients have also had success with apple cider vinegar – applying daily and covering the area until the verrucae have disappeared.

The above and other home remedies are all medically unproven – they may work for you but they may not. 

If you have any concerns always consult a Medical Professional, qualified Foot Health Practitioner or Podiatrist

Surgical Treatments – Some examples

Dry Needling– this is performed under local anaesthetic by a Doctor or Podiatrist – the aim is to promote an immune response. Quite a new treatment, and as yet no research as to its proven effectiveness.

Cryotherapy with Liquid Nitrogen – this can be undertaken by a Podiatrist, Foot Health Practitioner or Nurse qualified in this technique.

Surgery –Verrucae can be removed surgically by a Doctor – but they can return.

Low Intensity Laser Therapy (LILT) –  usually undertaken by a Podiatrist or Practitioner qualified in the use of laser therapy. Often used in conjunction with chemicals, treatments can be prolonged. In fact, if treatment is successful, it is still unsure if this is a result of the Laser therapy, or the chemicals used with it. Further investigations are required.