What are verrucae (warts)?

Verrucae, or warts, are a common skin infection caused by the Human Papilloma Virus (HPV). It is a harmless but very contagious skin growth, which usually occurs in the hands and feet.

Why do verrucae appear?

The warts are caused by the Human Papilloma Virus (HPV). This virus causes rapid proliferation of skin cells, and as a result benign lumps are formed, which are annoying rather than dangerous but also highly contagious.

How contagious are warts?

The virus is transmitted by direct skin contact or by touching wet surfaces, such as floors in swimming pools and changing rooms. The virus can also be transmitted through contaminated towels or shoes. Verrucae typically occur when there is a crack on the skin at the moment when the individual comes in contact with the HPV or on areas where the skin is exposed to excessive moisture, as in sweaty feet.

How do I recognize a wart on my feet?

Warts on the feet resemble a cauliflower look and have a bumpy, rough and thick surface because of pressure forced on the foot. Warts on the feet are often more painful because of the increased pressure the warts are receiving during walking and standing.

They can be brown or gray with a dark centre and small, black spots. Black spots are caused by blood vessels that bleed because of the pressure on the wart when one stands or walks.

What is the treatment for verrucae?

Warts on the feet can be very painful and persistent if not treated at an early stage. The greater the delay in seeking treatment, the more times it will take for the treatment to work.

Warts are frequently presented covered with callus and are often treated wrong by non-specialists or from the patients themselves. This might lead not only to failure to resolve the problem, but to further spreading of the virus, too.

What can a podiatrist do for verrucae?

At first, your podiatrist will ask you about your history and inform you on the choices you have regarding treatment. It is usual practice to initially remove callus covering the warts to reduce the pain.

No specific treatment is shown to be more effective than the other, and no treatment is as effective to all people. Some patients benefit from one treatment, and some of a different one.

You need to be aware that in addition to any treatment, you should follow the rules basic foot hygiene and avoid conditions where continuous re-infection can occur (common pools etc.).

Some of the available treatments are:

  • Local treatment with salicylic acid. This treatment can be done either by you at home with low concentration salicylic acid preparations available from pharmacies, or from a specialist (podiatrist) with high concentration salicylic acid preparations on a weekly basis and until verrucae are eliminated.
  • Treatments with Silver Nitrate sticks. This substance is of the class of caustics and the use by a specialist is recommended to avoid unwanted side effects. The treatment is done on a weekly basis and is less painful, so it is a recommended treatment for minors. Your podiatrist will inform you about the course of treatment depending on the results.
  • Cryotherapy. This treatment comprises of frosting the verrucae with liquid nitrogen and is carried out by a specialist. It is quite painful and therefore not recommended as a treatment for minors. This treatment is repeated until the warts disappear. There are cryotherapy preparations available in pharmacies for home use which are less painful, but also less effective.
  • Laser therapy. This therapy aims to burn and destroy the verrucae tissue and is usually done under anaesthesia. This treatment is done when the warts are large and dispersed. A wound is created where the wart was, which can cause pain or get infected. Laser treatment is done only by specialists with the appropriate training to carry out laser therapy.
  • Surgical removal of verrucae. This method is typically the last choice if no other treatment is effective. It is done by a dermatologist or general surgeon. It is a painful treatment because of the wound created, which can get infected.

Your podiatrist will discuss with you the most appropriate treatment options based on the verrucae severity of infection and will agree with you the most appropriate treatment plan.

Very often, several treatment sessions are required to eliminate the problem. Treatment depends on the size and number of warts and sometimes you may have to try more than one treatment option until you see some results. No treatment guarantees killing the virus or that no re-infection will happen in the future. You always need to follow the instructions given by your podiatrist or your physician.

If conservative treatments are not effective and your podiatrist deems it necessary, you will be referred to a dermatologist or a general surgeon to discuss and explore surgical choices and exclude any potential problems with your immune system.


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