What are verrucae?
Verrucae are plantar warts that commonly occur on the soles of the feet or around the toe area. They are caused by the Human Papilloma Virus (HPV), which is contagious through direct person-to-person contact. There are various forms of HPV, which all relate to various parts of the human body.
What causes verrucae?
The HPV virus is thought to thrive in moist, damp environments such as swimming pools, changing room floors and communal shower areas. It is possible to contract verrucae simply by walking across the same floor area as someone with a verruca, especially if you have any small or invisible cuts or abrasions that make it easier for the virus to penetrate.
Who gets them?
Verrucae are most commonly seen in children, teenagers and young adults, largely those who use communal changing rooms. It is possible to develop an immunity against the virus over time but most people remain susceptible, although some more than others.
How do I know I have them?
The most common appearance is that of a small cauliflower-type growth on the soles of your feet with tiny black dots. If it is painful when you pinch the area (like when you squeeze a spot), you are likely to have a verruca. They can grow to 1cm in diameter and may spread into a cluster of small warts. If you are unsure, seek advice from a podiatrist.
Are they serious?
Verrucae are harmless but can be uncomfortable and painful if they develop on a weight bearing part of the foot. In addition, hard skin (callus) can form over the top of the verruca, increasing the discomfort in this area. There are also some strains of the virus that spread very quickly and can look unsightly.
What are the treatments?
In the first instance, avoid touching or scratching a verruca as it may spread into a cluster of warts. Instead, cover it up with a plaster. In many cases, evidence suggests that verrucae will disappear of their own accord within six months for children but longer for adults (up to two years). This is because the body’s immune system recognises the presence of the virus and fights the infection naturally but it can take many months for this to happen. If it is painless, no treatment may be required as some treatments can be painful especially for children and can cause side-effects.
For painful and/or unsightly verrucae or ones that are spreading, you can self-treat using ointments and gels from your local pharmacist following the instructions carefully. Sometimes, merely by rubbing away the dry skin over a verruca and applying a plaster helps to stimulate the body’s immune system to fight the infection. However, if your verruca becomes unusually painful or the surrounding skin area goes red, stop treatment immediately and see a podiatrist. This is because if the healthy tissue around a verruca is damaged, you could hamper further treatment.
Treatments provided by a podiatrist involve an assessment of your general well-being and foot health before deciding on a treatment plan. This may include:
Acid-based treatments, which are stronger than regular ‘over the counter’ (OTC) treatments from your local pharmacy
Cryotherapy, which involves freezing the verruca with liquid nitrogen or nitrous oxide gas
Electrosurgery, which requires a local anaesthetic to be given
Excisional surgery, which is similar to the above
Laser surgery, particularly for larger areas of verrucae.
Two newer treatments that your podiatrist may offer are:
Microwave therapy, where the verruca has a microwave pulse sent through it
Needling, where the entire area of the verruca is pricked with a needle to stimulate the body's immune system.
How can I prevent them?
To avoid catching verrucae, keep your feet in a healthy condition. Always dry them thoroughly after washing and if your feet are sweaty, treat them with surgical spirit; if they are dry, moisturise them with suitable creams or lotions, but avoid applying between the toes.
Other tips include wearing flip-flops in communal areas, not sharing towels, shoes and socks, and treating conditions such as athlete’s foot with a specialist treatment from the pharmacist.
If you do have a verruca and want to go swimming, wear special verrucae socks to avoid passing on the virus. These can also be worn as a preventative measure.
When should I see a podiatrist?
If you have diabetes or poor circulation, are pregnant or have any other condition affecting your feet (or your immune system), it is important never to treat a verruca yourself and instead visit a podiatrist.
If you are worried about your verruca and/or self-treatment is not working and/or the verruca appears to be getting larger or more painful, visit a podiatrist.
If you experience any foot care issues that do not resolve themselves naturally or through routine foot care within three weeks, it is recommended that you seek the help of a healthcare professional.
To talk to a podiatrist (also known as a chiropodist) about the options available regarding treatment, you can contact an NHS podiatrist or a private practice podiatrist. In both cases, always ensure that any practitioners you visit are registered with the Health and Care Professionals Council (HCPC) and describe themselves as a podiatrist (or chiropodist).