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My Verruca Won’t Go by Miss Jane Olver

What is a Verruca?

Verrucas are benign warts found on adults and children’s faces, hands, legs, and commonly on the feet. A verruca on your foot is known as a plantar wart and appears on the soles or toes. Teenagers and children are more prone to plantar warts.

Verrucas emerges as white patches on the skin, frequently with multiple black dots. The tiny black dots in the centre of the wart result from blood clotting in small blood vessels in the outer layers of your skin. Hard skin builds up containing the viral plantar wart. Plantar warts may cause pain when weight is placed on the foot, as the hard skin build-up gets pressed inwards with weight-bearing.

If you or your child has a persistent verruca (plantar wart) on your foot you may need to see one of our Dermatologists for treatment.

Do I have a corn or Verruca?

A verruca is a viral infection from HPV which has got into the skin via a small cut or break. A corn is merely layers of dead skin built up from friction wear.

Distinguishable plantar wart characteristics include:

  • Verruca (plantar wart) is painful to pinch or press. Corns are painful when physically examined.
  • Black tiny dots are regularly seen in the plantar wart lesion due to the blood supply; corns don’t have black dots.
  • The pigment of the skin changes with patterns broken in a verruca, compared to no pigment changes in corn.
  • Verruca has a cauliflower appearance with multiple verrucas, often referred to as satellite and cluster verruca. Corns are cone-shaped hard tissue.

Symptoms of Verruca’s

Aside from their unattractive appearance, verruca’s don’t always cause symptoms. However, they may be uncomfortable or painful if they’re on your feet or near your nail beds. They can interfere with activities, affect your gait, and are troublesome when they persist, multiply or recur.

What causes verrucas to develop?

Verruca is a common skin infection caused by the Human Papillomavirus (HPV). HPV is contagious and can be found on many surfaces we have contact with daily. Because of this, it isn’t easy to entirely eliminate it from our environment.

The virus needs a portal of entry, which can be dry cracked skin on your feet or a cut undetectable by the naked eye. Walking on tiles in the house or around a wet swimming pool or locker room is sufficient to cause minor abrasions to the skin, permitting the virus to enter. The virus thrives in a  warm moist environment. It can be unknowingly inactive in the skin for weeks before presenting as a physical verruca or plantar wart.

Verrucas are worse in people who are diabetic, who have diminished sensation on their feet from peripheral neuropathy and those with immune deficiency or on immune suppressant drugs.

How can I treat my Verruca?

Home treatment:

Salicylic acid liquid

Salicylic acid is a topical treatment put on the affected area in the form of a liquid painted daily onto the lesion. The purpose of the ointment is to gradually lift the layers of the concerned skin area. Salicylic acid in weak strengths is an over the counter (non-prescription) medicine.  It is repeated regularly for several weeks until the verruca is gone. Many verrucas will disappear with time and with weak salicylic acid.

Treatment by Dermatology Consultant at Clinica London:

You should attend Clinica London if the verruca persists, recurs, or spreads despite home treatment. The Dermatologist will examine the verruca with a dermatoscope which illuminates and magnifies the microstructure and helps them to see the extent and confirm the diagnosis of verruca from the vascular pattern. Our dermatologists treat both children and adults with verrucas.

At Clinica London, the Dermatologists have several approaches to treatment:

  • Stronger acids
  • Cryotherapy
  • Surgery
  • HPV vaccine

Stronger Salicylic Acid Gel / Ointment

Prescription grade salicylic acid ointment and patches under regular clinic supervision.

Cryosurgery – Freezing Treatment

The Dermatologist uses liquid nitrogen which is sprayed focally onto your verruca. This freezes the viral cells within the Verruca, destroying the virus-cell structure. Once this takes place, the body detects its presence and begins the healing process, first with a blister, which then sloughs off and healing occurs. Cryotherapy also stimulates your body´s own immune system to fight the verruca. The number of cryotherapy sessions required will vary. You will have to return every three to four weeks until it has disappeared. The time taken to rid your verruca depends on the size of the verruca/e and the body’s ability to heal it effectively.

Surgery

Occasionally your verruca needs to be cut out surgically under local anaesthetic because it is either too big or resistant to other treatments. An electrical needle and curetting may be used. Fortunately, surgery is rare.

HPV vaccine

There is increasing evidence that the HPV vaccine helps although it is not specifically created to target plantar warts.

How long does treatment take to see results?

The timeframe to clear your verruca varies from person to person. Treatment can be an extensive process depending on the length of time the Verruca has been present, its size, and its depth.
If you or your child has a verruca that just won´t go away, you should seek the advice of one of our Dermatologists, Dr Jennifer Crawley, who can assess, advise and treat.

My Verruca Won’t Go 1

Miss Jane Olver

Consultant Ophthalmic Surgeon
Oculoplastic (Eyelid) & Lacrimal Specialist
Medical Director
President International Society Dacryology and Dry Eye 2024-2026

Dr Jennifer Crawley

Consultant Dermatologist
Children & Adults

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