Everything you wanted to know about verrucas

I sometimes have patients asking why we don't treat verrucas. While we used to treat it successfully in the past, we found it was taking more and time away from patients with more urgent concerns. In almost all cases they'll eventually go on their own. To understand why we removed verrucas from our list of priority treatments, it's helpful to talk about what they are.

I want them gone NOW!!

We call them plantar warts...

...and they're usually found on sole of the foot or sometimes the toes. They are benign, localised thickenings of the skin often mistaken for corns. You may have one or a more, or a small cluster of them. If you see one with tiny black dots please don't pinch it. The dots are blood vessels, and you'd find it extremely painful.

They're caused by a virus...

...found in the outer layer of your skin. The virus is a strain of 'Human Papilloma Virus' caught through contact with infected skin scales found on damp floors (gyms, swimming pools and showers) or contaminated personal items such as socks, towels & bedsheets. HPV enters through tiny abrasions on the skin and replicates itself as your skin cells are formed.

It can take 1-3 years to resolve...

...but they eventually go away by themselves. Your health can affect your recovery times,

which means if you're immunosuppressed (for example you have uncontrolled diabetes) or suffering from anxiety or high levels of stress, it can take longer for the virus to clear.

There's no high quality evidence for almost all treatments

...which leaves it to the clinical judgement of the practitioner. Needling and cryotherapy can sometimes work for patients but it does so by destroying localised areas of the skin, rather than directly targeting the virus. Unless you've washed all your socks, towels and bedding at high temperature on the same day, as well as giving all your floors a serious clean, you may find it coming back.

What we found over the years is that no single treatment is completely effective in every patient. Given the advances in modern medicine, it's become an anachronism where something benign can take so long to be treated.

This was the dilemma we faced at the clinic. Warts are ugly, and they may cause problems with self-esteem, but they're rarely life-altering or threatening. Left alone, they eventually go. The same can't be said for an ingrown toenail, a damaged plantar fascia or a bunion. We would give as much time and care to a patient with a single wart as we would one of our high-risk patients who may have a far more complex medical history. Covid-19 has made us us re-prioritise our energies, and with the limited hours we now operate under, we'd do the most good treating those who have issues that require direct intervention and management.

In the extremely rare cases where it starts bleeding, increases in size or causes continual pain you should contact your GP directly. Otherwise, clean your floors and wash your bedding at the highest temperature you can, and pop your feet up. The verrucas will go; you go and own the parts of your life you can control!