What is a Verruca?
Verrucae are harmless lesions caused by the Human Papilloma Virus (HPV), most of the time they will resolve in 2-5 years, however, some people find they have their Verrucae for longer.
There are currently more than 100 known types of HPV with the most common being on hands and feet.
The virus is contagious and the host is infected when the virus enters the skin, commonly a foot can be infected in wet areas such as swimming pools, changing rooms and bathrooms. An infected bare foot will release virally infected cells onto the floor, if another foot walks over the same area and picks up the virus, through the now vulnerable wet skin, a new host can now be infected, this process can also occur from towels and footwear.
The virus can have an incubation period of a number of months before it becomes visible to the naked eye.
Verruca Treatment Options
The most common treatment for Verrucae is using over the counter caustics, these are effective and generally painless although they involve consistent use and take time.
Cryosurgery Freezing of Verruca
Cryosurgery, or put simply, the freezing of a verruca with the use of either Carbon Dioxide or Liquid Nitrogen, is a procedure which aims to remove the verruca with single treatment episodes administered by the Podiatrist.
What will the procedure involve?
Cryosurgery Freezing of Verruca. The procedure will involve applying either Carbon Dioxide or Liquid Nitrogen at -196 degrees to the area of skin affected by the verruca. This will either be done with a metal probe or a spray, depending on the size and location of the lesion. The application of the cryotherapy is either done as a single 30 – 45 second application or as 3 X 15 second applications, depending again on the type of lesion. This can be quite a painful procedure performed at 3-4 week intervals and usually involves a minimum of 3-4 treatments.
Cryosurgery Freezing of Verruca is not an invasive procedure and only affects the upper most part of the skin. Immediately following the procedure, patients can drive as long as they feel able. In the immediate couple of days following the procedure the patient can experience some discomfort and may need to elevate the limb if pain occurs until this subsides and this may result in a reduction in patient activity.
What are the specific risks of this procedure?
There may be pain in the immediate days following the procedure, there may be no improvement in verruca size or in more rare cases the affected area may blister.
Verruca needling is a technique where, under local anesthetic, a Verruca lesion is punctured by a needle multiple times to create a localised inflammatory response in an effort to initiate the body’s own immune system to destroy the HPV. This is a similar process to the principles of immunisation used to prevent disease.
It was first described in 1969 by G.W. Faulkner, but to date, only a handful of scientific studies have been conducted to support its efficiency, and even fewer RCT’s (Randomised Control Trials) have been explored. Your Podiatrist may have given you this leaflet as another treatment option if all other Verruca treatments have failed. You should carefully read all the information contained and if you have any questions, consult your Podiatrist.
The needling procedure will only be carried out after an initial assessment determining your suitability based on; your age, the number and location of Verruca, general health, medical history, duration and previous Verruca treatments etc.
If you are over 18, have had a Verruca for over 5 years and have exhausted all other treatment options, then this procedure may be suitable for you.
Your Podiatrist will be able to confirm diagnosis and recommend the most appropriate treatment option for you, including management only of the Verruca, especially in young children.