Verrucae are warts found on or around the toes and the soles of the feet. Podiatrists have treatments forthis common viral skin infection, which are otherwise unavailable.

A verruca is the result of an infection from certain strains of the human papillomavirus (HPV). It appears likea small, dark, puncture mark later turning grey or brown. It may become rough and bumpy with a cauliflower-like appearance. It can also develop a black spot in the middle, as the result of bleeding. A verruca can growin diameter and may spread into a cluster.

Verrucae are harmless and will spontaneously heal over time without treatment, but may also persist foryears. However, if they are bothering you or causing pain, there are things that can be done.

Verrucae are typically painless, but the disruption they cause to the skin if one develops on a weight-bearingarea such as the ball or the heel of the foot, can cause a sharp, burning pain. The pressure of weight bearingcan cause the resulting hard skin to protrude painfully into the skin.

Many treatments, such as creams, gels, paints and medicated plasters, are available over-the-counter from pharmacies. These are not as strong as the products made available to Podiatrists and from our experience don’t have avery high success rate.

What is successful in treating verrucae?


It has been shown that acid is effective at treating verrucae. However, acids are not selective and alsodestroy the surrounding healthy skin, so it is important to have the treatment professionally applied,particularly if you are vulnerable or high risk.

Before applying the treatment, excess skin around the affected area should be reduced in order toimprove its efficacy. Patients should follow the instructions given by the practitioner or those given inan over the counter product, which is to keep the area dry and not remove the dressing for 48 hours. Ifthe dressing comes off the acid could burn soft furnishings or your fingers, should you touch it.

This treatment can be uncomfortable, cause mild pain, blistering and skin irritation around the verruca. Applications are usually necessary every fortnight for an average of 12 weeks.

When using any acid product you should stop the treatment if your skin becomes sore and seek advice from a professional. You should also seek advice before using a product like this if you have poor circulation – for example,if you have a condition such as diabetes or peripheral vascular disease as there is an increased risk ofdamage to your skin, nerves and tendons.


This involves using nitrous oxide to freeze the verruca, causing the cells to die. Again, this can take a number of applications before resulting in success. This treatment can be uncomfortable, cause mild pain, blistering and skin irritation around the verruca.

Success Rates of Treatments (Statistics taken from The College of Podiatry 2017).
Acid: 30%
Cryotherapy: 30%
Microwave Therapy: 80%

The most effective treatment is Microwave therapy.

This is available here at The Nantwich Clinic and has an 80% plus success rate with 3-4 applications. After an application of Microwave Therapy, in some cases the area may feel sore but generally a patient can continue life as normal, head off for a swim or jump in the shower as the therapy works internally and does not normally affect the surface of the skin.

Like other treatments for verrucae, some minor discomfort may be experienced with MicrowaveTherapy. Before treatment the podiatrist may decide to reduce the verruca with a blade.

Microwave energy is delivered directly to the site of the verruca using a hand-held probe. It sendsmicrowaves to a precise and predetermined depth leaving surrounding tissue undamaged. It targetswater molecules within the skin, creating heat. This activates an immune response, which destroys theinfected cells.

Pain levels vary from person to person but most people undergoing Microwave Therapy liken it to a pain similar to an injection or a scratch, lasting 2 – 3 seconds then quickly subsiding.

No single treatment for Verrucae is 100% effective, and sometimes the verrucae may return.


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