What is a verruca?
A verruca is a wart that is found on the plantar surface (sole) of the foot (also known as a plantar wart). It is a common skin condition caused by the Human Papilloma Virus.
How did I get a verruca?
Verrucae are contracted through skin contact with virus particles on an infected surface. These surfaces are often found in warm, damp environments such as communal showering facilities, pool sides and gyms. They are most likely to appear on the weight-bearing areas of the foot – the parts that contact the ground. These surfaces have a greater tendency to become damaged through micro-abrasions such as a tiny, superficial scratch or graze than the rest of the foot. Swimming and submersion in water can make the skin fragile, more likely to be damaged, and more vulnerable to picking up the virus.
Most people are unaware of catching a verruca and may not even notice it until it is quite apparent – most are painless, and it can be quite a shock for people to notice one for the first time! The virus can lie dormant in the skin for over a year, and as the virus is situated in the upper epidermis, it hides from the immune system. As your body is unaware of the verruca, it does not initiate an immune response.
Symptoms of a verruca
Some people may not feel any discomfort but may notice a raised, cauliflower-shaped lump of hard skin on the bottom of their foot. Other people may feel discomfort or pain – particularly when the lesion is squeezed sideways. The layers of hard skin can build up considerably, becoming thick and callus, which can be uncomfortable.
Diagnosing a verruca
As the sole of the foot is a hard place to examine, when self-diagnosing it can be easy to mistake a corn as a verruca or vice versa. A Podiatrist will always be your best option for receiving an accurate diagnosis of any foot-related problem.
Who is likely to get a verruca?
People who tend to spend time in communal changing areas are most likely to contract a verruca. Consequently, they most commonly affect children and young people. Some people do appear to have a greater tendency to catch a verruca as not everyone who goes to a swimming pool and uses the same shower will catch it! However, there is some evidence to suggest that those who are immunosuppressed may also acquire verrucae more readily.
What can I do to treat a verruca?
In most instances, time is the best healer. Most people with a verruca will notice that it 'spontaneously resolves within six months to 2 years. If it isn't causing discomfort, the best thing to do is to leave it alone. You may want to keep it covered with some Elastoplast Tape or similar to prevent it from spreading.
First things first, it is a good idea to have your foot health checked by a Podiatrist who can give you personalised advice and a discussion about the treatments that might work best for you.
Some people are at greater risk of foot problems – those with diabetes, lack of sensation in the feet and poor circulation, or those who are immuno-suppressed should avoid self-treatment due to the risk of complications and should firstly contact a Podiatrist.
If the verruca is painful, visit a Podiatrist for debridement with a scalpel (scraping away some layers of dead skin) and offloading of the site might be beneficial and can provide some relief. Once again, regular application of Elastoplast Tape can be helpful as it has a two-fold effect. It can stimulate the immune system and helps to trap water within the skin - the skin becomes macerated, softened and can be left feeling more comfortable.
Other treatments for verrucas
Treatments generally aim to irritate the area and promote an immune response.
Over the counter, treatments may be helpful. These include acid-based topical treatments or cryotherapy (freezing). Often, these can provide some pain relief, particularly in conjunction with regular debridement by a Podiatrist.
Advanced podiatry treatments
Verruca needling - This is a treatment conducted under local anaesthetic where the verruca is repeatedly pricked with a needle in order to initiate the body's natural healing mechanic in the form of an immune response.
Swift microwave therapy - This is a treatment offered by some Podiatry practices where a microwave pulse is sent through the verrucae to initiate an immune response.
How can I prevent verrucae in the first place?
Ensure that you look after your feet well, drying them thoroughly after washing. Wear flip-flops or sliders in communal changing areas or showers, and don't share towels, shoes and socks with other people. Check your feet on a regular basis and if you have any concerns – speak to a podiatrist to have you feet checked.