Verruca Treatments

Complete Choice of Verruca Treatments

Compleet Feet offer a wide range of verruca and wart solutions from traditional acid treatments through to advanced  Nd:YAG laser and the latest Swift®  Microwave technology to successfully eradicate hard to treat verrucae and warts.

Swift

Swift® is a new technology, developed in the UK, which has been licenced for the general treatment of Verruca and skin lesions in Podiatry and Dermatology.

Find Out More

Fotona Laser Nd:YAG

Compleet Feet is a specialist laser clinic. We offer many different types of laser treatments, and are highly trained in foot and ankle analgesia techniques.

Find Out More

  • Verrucae and warts are fleshy fast growing benign skin growths
  • Verrucae are commonly found on the feet and warts on other parts of the body
  • Caused by the highly infectious human papilloma virus (HPV)
  • To date over 200 subtypes identified
  • Virus thrives on moist, warm skin
  • Verrucae can spread from feet to other parts of the body
  • Contracted from other people in communal areas e.g. changing rooms, swimming pool floors
  • Verrucae generally are not harmful, just unpleasant and uncomfortable
  • There can be a genetic predisposition to ‘catching’ verrucae
  • Verrucae or warts can spontaneously resolve, but that take years to occur, meanwhile they have spread

  • Can be shallow limited to only upper layers of skin and grouped together to form a mosaic appearance
  • Can be singular and penetrate deeper layer of skin with a cauliflower appearance
  • On soles of feet plantar viral verrucae are flattened by pressure, but can still be pronounced by build-up of thickened skin (callous)
  • There is a disruption of the skin’s striations (finger print pattern)
  • Small dark dots can be noted which are tips of innervating blood vessels
  • These blood vessels readily bleed on paring down the hard skin
  • Hard skin returns very quickly
  • Appearance is generally the differential diagnosis
  • Corns generally appear on prominent weight-bearing areas of the foot
  • Corns are painful on direct pressure
  • Verrucae are painful on pinching
  • Corns can be combined with a verrucae if on a pronounced area

If not sure consult a podiatrist

Not infected:

  • Check individuals in your home for signs of infection
  • Minimise time spent barefoot on damp floors in communal areas e.g. showers, pool side
  • Keep feet covered when buying new shoes
  • Don’t wear footwear of previously infected individuals
  • Wear flip flops, sandals in communal areas
  • Keep skin dry, use astringents is skin type is moist
  • Use products like Spirularin or Excilor antiviral, antifungal prevention products (ask podiatrist)

Infected:

  • Keep feet and verrucae covered up if walking barefoot on floors
  • Wear specialist socks when swimming
  • Don’t share your footwear, towels, socks
  • Ensure infected individuals in your home keep feet, verrucae covered up
  • Avoid touching your verrucae or warts, as can spread with  hand contact

Compleet Feet offer a broad range of treatments for the resolution of verrucae and warts. Treatment options are chosen after a thorough consultation with the podiatrist to make an informed decision. Age, health, activity and cost are all taken into account.

  • Caustics – High strength kerotalytic acid preperations are carefully applied to the skin to break down infected tissue
  • Marigold Therapy – Homeopathic treatment using a marigold formulation to initiate a healing response. Suitable for children and ‘high risk’ patients
  • Cryotherapy – Freezing verruca or wart to minus 58 degrees to destroy infected tissue. Suitable for toes or hand growths. Less effective on sole of foot and multiple lesions.
  • Electrosurgery – Verruca is sharply excised under analgesia and blood vessels cauterised with a hyfrecator electrode. Suitable for deep verruca and those with fibrous scar tissue from previously unsuccessful treatment attempts. 90% successful.
  • Laser – Using a long wave pulsed laser to cause localised tissue destruction. Reported 76 – 89% effective for really difficult to treat recalcitrant verrucae
  • Swift Microwave – Latest technology using controlled targeted microwave current to eradicate verrucae and warts. Reported 76% effective. Suitable for all verrucae presentations.

Please Note in some unfortunate cases, approximately 5 – 8%; ‘all’ attempts at treating persistent verrucae fail. We will appropriately refer patients for a biopsy or to a consultant dermatologist in these cases if deemed appropriate.

I recently came across a Blog article by Tracey Vlahovic in the American Podiatry Today, October 2015 discussing injecting Candida Albicans into verrucae and warts. This intriguing was using yeast to initiate an immune response to eradicate the Human Papilloma Virus (HPV). Tracey had previously co-written and published article on this subject which featured in the Journal of American Podiatric Medical Association (JAPMA). She undertook a study based on injecting the viral verrucae of 80 patients with the candida antigen. There was a 65% success rate. She felt that by combining this injection therapy with other treatment modalities it significantly increased resolution rates.

The concept of injecting verrucae with an antigen to trigger an immune response is not new. The Journal European Academy Dermatology Venereology 2010 published: Intralesional immunotherapy of common warts: successful treatment with mumps, measles and rubella vaccine. This study evaluated the efficacy and safety of injecting recalcitrant common warts with the MMR vaccine. The study included 135 patients with single or multiple recalcitrant or non-recalcitrant common warts. They were randomly assigned to two groups; the first group (85 patients) received intralesional MMR vaccine, and the second group (50 patients) received intralesional saline as a control group. Both treatments were injected into single lesions or largest wart in case of multiple lesions at 2-week intervals until complete clearance or for a maximum of five treatments. Follow-up was made every 2 months for 6 months to detect any recurrence.

The results were impressive with complete clearance in 80% of patients, demonstrating that immune-therapy could be a safe and effective way forward for treating viral verrucae. Since the publish of that paper and this recent article injecting ‘yeast’ into verrucae there has been little to no mention of immunotherapy in the world of UK podiatry. The use of intradermal injection therapy for viral verrucae and warts is more commonly used and discussed in the dermatology world.  In a 2011 published study by Eassa BIet al entitled: Intradermal injection of PPD as a novel approach of immunotherapy in anogenital warts in pregnant women; a purified protein derivative (PPD) extract of Mycobacterium tuberculosis was injected into anogenital warts of pregnant women. It proved to be 85% successful.  Again, another example of using injectables to mediate an immune response.

What fascinates me, referring back to using Candida Albicans to treat viral warts, is that I often have patients who present with verrucae, Athlete’s Foot and nasty yeast infected nails! All co-existing and thriving nicely together. Maybe I need to agitate them all, ‘rub their heads together’ to mediate an immune response? Unfortunately, any patient who is immune- compromised in the first place immunotherapy won’t work, as nothing mediates an immune response. There is also the risk of triggering an actual Candida Albicans infection.  Candida is often passed around the body through the bloodstream. More research needs to be done. For the time being I will stick to my tried and tested verrucae eradicating methods like the Swift.

References

  1. Signore RJ. Candida albicans intralesional injection immunotherapy of warts. Cutis. 2002; 70(3):185-92.
  2. Vlahovic T, Spadone S, Dunn SP, et al. Candida albicans immunotherapy for verrucae plantaris. J Am Podiatr Med Assoc. 2015; 105(5):395-400.
  3. Clifton MM, Johnson SM, Roberson PK, et al. Immunotherapy for recalcitrant warts in children using intralesional mumps or Candida antigens. Pediatr Dermatol. 2003; 20(3):268-71.
  4. Eassa BI, Abou-Bakr AA, El-Khalawany MA. Intradermal injection of PPD as a novel approach of immunotherapy in anogenital warts in pregnant women. Dermatol Ther 2011; 24 :137-143.
  5. Mohamed El-Khalawany et al. Immunotherapy of viral warts: myth and reality Egyptian Journal of Dermatology and Venereology 2015, 35:1–13
  6. http://www.podiatrytoday.com/blogged/should-you-inject-candida-albicans-plantar-warts

Due to the huge interest the innovative Swift Microwave Verruca treatment has generated we have decided to hold the introductory price of £80 per treatment session until 19th August 2017. From 21st August the cost will be £100 per treatment.

The benefits of Swift are tremendous and have helped to revolutionise the treatment of challenging verrucae and warts for both us as podiatrists and for our patients. No bulky padding and dressings, no hinderance on bathing or showering, no discomfort  after treatment (as opposed to traditional methods), no need to stop doing what you want! The treatment of verrucae has never been easier.

SWIFT® Verruca and Wart Treatment

Swift® is a new technology, developed in the UK, which has been licenced for the general treatment of Verruca and skin lesions in Podiatry and Dermatology. Benefit of this treatment over all other afore-mentioned treatments is no requirement for padding or dressings to keep dry, which can hinder normal activities.

Learn More

Controlled, targeted microwave energy is delivered through a special probe into the infected verruca or wart
Microwaves work by generating heat in the wart/verruca, focused under the probe, to a maximum depth of 5mm.
Microwaves love water and when the electric field is applied, local water dipoles (H2O) try to align with field but lag slightly behind causing collision between molecules and therefore generating heat.

There is a little bit of initial discomfort, like stinging or a sharp scratch  but it is tolerable. Each verruca  or wart is only treated from 5-10 seconds, so it is a quick procedure. No analgesia is required, although an aneasthetic cream can be applied 1 hour before treatment for more sensitive areas or patients.

Almost anyone who has stubborn warts and verrucas can benefit from Swift.

Swift is a great verruca treatment for patients who do not want to have any pads or dressings applied to foot which may inhibit daily activities e.g. swimming, showering. A Swift treatment does not involve any breakdown of the skin which can occur with other treatments although treatment times maybe a little longer to achieve a resolution when compared to laser, which is quicker, but healing takes longer.

There are contra-indications to Swift, but outside these anyone who has warts/verrucas on their hands or feet can benefit.

If any of the following apply to you, speak to your Podiatrist before treatment –

  • Metal pins, plates or replacement joints in the foot or ankle
  • Pacemaker
  • Neuropathy or poor peripheral circulation
  • Poor or limited healing capacity
  • Immune suppression
  • Pregnancy or breast feeding. It is known that verrucas and warts can increase in size during this period
  • Low pain threshold
  • Young children

We do not treat children under 10 with Swift, but this is decided during a thorough consultation

Verrucae and warts come in many shapes and sizes, and appear on different parts of the foot which will have an impact on how many treatments are required, but we generally advise a course of 3. Treatments are spaced apart at 1-2 week intervals.

The number of treatments required also depends on an individual’s immune response. The Swift mediates an immune response, some people respond faster than others in producing antibodies. Research demonstrates the heat generated by the microwaves stimulates heat stress protein production which is known to prompt a strong healing response.

Patients who are immune-suppressed are at risk of developing multiple, resistant lesions, which are difficult to treat, but at Compleet Feet we will employ all the verruca treatments we have to get an effective result. We may need to combine the Swift with other treatment modalities.

Immediately after the treatment there will be no change to the appearance of the wart/verruca. You will feel no pain, maybe slight discomfort.

A change should start to show after a few days.
The immune system is starting to ‘kick-in’
As regression is established the verruca will shrink in from the edges at the same time as reducing in thickness – or ‘debulking’.
The dermal striations or ‘fingerprint’ of the skin will gradually re-establish
Skin will be clear

We recommend a course of 3 treatments                          £240

Thermal Nd:YAG Verruca Laser Treatment

Compleet Feet is a specialist laser clinic. We offer many different types of laser treatments, and are highly trained in foot and ankle analgesia techniques. Researchers have reported success rates of 76 – 89 % with the use of thermal lasers for treatment of recalcitrant verrucae or warts. Anectdotally laser application for difficult to treat verrucae is by far our most effective treatment. It is a powerful treatment modality. We will always undertake a consultation first to ascertain suitability.

We use a  Fotona  XP Spectro long wave Nd:YAG 1064 nm laser. This is a vascular laser with a wavelength that is specific for deeper lying targets with a vascular component e.g. blood vessels. We can carefully and precisely target into verrucae or warts to destroy infected tissue only with reduced marginal skin damage.

The infrared beam needs colour/ pigment for the light energy to be absorbed into to create heat. This is termed a chromophore. The chromophore in a verruca is the capillary blood vessels which are drawn up into the infected verrucerous tissue. The infected tissues are heated up to cause localised tissue destruction. Laser heat energy is attracted to haemoglobin in verruca/ wart blood vessels causing the vessels to thrombose.

  • Quick and very effective
  • Direct precise tissue destruction to reduce potential risk of verruca getting bigger as can occur with acid treatments.
  • Reduces risk of collateral skin damage
  • Generally, only 1 treatment required
  • Will treat deep seated recalcitrant verrucae/ warts which have not responded to other treatments
  • Not suitable for very young patients
  • There will be localised deep tissue ablation which will require dressings
  • Some disruption to normal sporting activities
  • Pain during treatment

The laser causes a build-up of concentrated localised thermal heat so it is a sharp stinging sensation. Everybody has a different pain threshold. Some individuals tolerate the discomfort much better than others and no problem with the lasering requiring no analgesia. It is a quick treatment only lasting seconds, but if an individual cannot tolerate the discomfort that could mean we may not be able to deliver an effective treatment so we do recommend analgesia. This will be discussed during a consultation.

A cooler can be used during lasering to keep the skin’s thermal temperature down, or analgesia can be administered for a pain free and effective treatment. We are specialists in ankle block analgesia techniques. Ankle blocks are very safe and are comfortable.

A post laser blister will form whether clear or blood filled (haematoma) over 24 -72 hours. If the blister is on the sole of the foot it will flatten out slightly whereas on a toe or hand it will be raised. We will issue deflective padding and dressing if required to make treated area comfortable. You will be required to return to clinic after 1 week to have the blisters drained and dressed. Several dressing appointments may be required. Depending on the size and location of the lasered verruca/ wart healing can take 2-6 weeks. Verrucae can be 2-3 mm thick in depth.

A consultation is required first prior to any laser treatment to check suitability. Only available at Compleet Alton.

From £60