• 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

Nearly all verruca treatments are about mediating an immune response, but unfortunately for some individuals this can be hard or seemingly impossible to initiate. Patients have what we term immune ignorance, whereby the infecting HPV lives under the body’s immune radar. It does not necessarily mean that a person has a poor immune system, but just one that which appears disinterested in challenging the virus which resides in the skin’s top layer. Podiatrists cannot determine whether a patient will resp0nd to treatment or not until they start treating them.

https://www.compleetfeet.co.uk/treatment-resistant-hpv-verrucae-discovery-of-verruca-pseudo-biofilms-part-1-2025/

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

Yes, we cannot lie and state like other clinics that Swift treatment is painless. In our experience people have vastly different pain thresholds, so we ensure we have various methods to make the treatment acceptable for our patients. The microwave energy creates very short spikes of generated heat which can be sharp in intensity. Using a Zimmer Cooler or ice we can help to modulate the spikes of heat to make the treatment comfortable. We can also administer local analgesia for complete pain relief which is great for toes or fingers.

The heat generated in the tissues is extremely short lived, it dissipates very quickly so unlike other conventional verruca treatments you will be able to comfortably walk away without painful side effects. This is a very important point to note. Swift does not hinder normal activities. It does truly represent a break through in the treatment of verrucae.

Effectively eradicating any verruca requires initiating tissue damage. Verrucae can be quite deep, and if you have tried to treat it over a long period of time there will be a certain amount of scar tissue to break down.

Almost anyone who has stubborn warts and verrucas can benefit from Swift. We do not treat children under 11 with verrucae and carefully consider whether those 11+ are suitable.

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. It is a great treatment solution for patients with multiple verrucae/warts, especially those on toes. Acid treatments can break down good skin to result in further spread of infection, especially on toes.

A Swift treatment does not involve significant 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.

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, although older verrucae may require more applications. Older treatment resistant verrucae may have an element of scar tissue which is harder to break down. The new Swift protocol (November 2017) for time between treatments is 4 weeks.

As well as scar tissue present, the number of treatments required 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. These stress proteins are active for several weeks so at least 4 weeks between treatments is necessary for an optimal immune response. Think of 1 Swift treatment being akin to taking a ‘therapeutic dose’ of a drug; 1 dose lasts 1 month, 1 month to deliver desired outcome.

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. We find combination treatments work well.

Key to a Swift treatment is patience.

Generally after a treatment there will be no change to the appearance of the wart/verruca, but occasionally there may be  signs of early blistering. The treated verrucae may throb or sting for a short period of time, but generally it does not cause you to limp. The discomfort dissipates quickly. We can offer deflective padding if the verruca is over a pronounced weight-bearing area to off-load any discomfort caused by pressure.

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’. There may be blistering or darkening of the verruca tissue as capillaries have thrombosed.

Desired outcome is dermal striations or ‘fingerprint’ of the skin  gradually re-establishing. Skin will be clear.

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

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 for laser treatment

Low Level Laser therapy is a great adjunctive therapy to bio-stimulate a deep cellular responses within infected skin and mediate a healing response and resolution of the visible verruca infection. It can be used in conjunction with needling to expediate an immune response. Great for immuno- challenged patients.

Local analgesia is required whether it is a toe or ankle block. Once the area of concern is nice and numb the selected verruca is punctured multiple times into the deeper dermal layers of the skin to penetrate the subcutaneous layer. It is a very targeted treatment. Once the verruca is treated it is appropriately dressed with antiseptic dressings and deflective padding. The patient is advised to get a lift home and not drive.

The treated verruca will be sore for several days after treatment, but will quickly settle down if patient has rested the area and kept wound clean and dressed. The wound will soon start to scab over. It is advised to have a follow-up appointment with the podiatrist a week later.

Cost varies for verruca needling depending on location of verruca and analgesia required:

Toe                                               from £150

Foot                                             from  £200

The treated area will require careful woundcare. A follow-up appointment is booked 1 week after treatment. The wound will heal by secondary intention, and will take 2-4 weeks to heal depending on size and location of treated verruca. The treated area maybe sore for awhile so it is advisable to rest the foot for 2 -3 weeks.

Yes, electrosurgery is safe in the hands of a skilled practitioner. A very low electrical current is used and it is focused only to the area treated. There is no risk of burns or electrocution. A thorough consultation will be performed before assessing a patients suitability. It is not suitable for all patients.

Cost is dependent on size and location of verruca. Discussed during consultation.