A verruca is a wart on the foot that is caused by the human papillomavirus (HPV). Most people will experience infection with HPV at some time in their life. Although they can occur at any age, they are more common in children and teenagers (in the UK this has been recorded at 5%).
The look of verrucas can vary, with some being smooth, single verrucas while others grow in clusters forming a ‘tile-like’ pattern and are known as mosaic verrucas. You may notice that veruccas often have black dots in them. These are often wrongly thought to be capillaries (the smallest and thinnest blood vessels in the body). However there are no blood vessels in the epidermis (the outer most layer of the skin) where veruccas are found. The black dots are actually haemorrhages, created by pressure / tissue trauma between the dermis (the middle layer of the skin, beneath the epidermis, which does have blood vessels in it) and the epidermis.
Verrucas are spread by contact, either directly from person to person, or indirectly via surface contact. Infection via surface contact is more likely if the skin is moist and in contact with roughened surfaces (e.g. conditions which are common in swimming pools, or communal washing areas).
As verrucas are a virus, no one single treatment is 100% effective and different types of treatment may suit different people. Some verrucas may last for years and some may spontaneously clear up. Verrucas in adults, in people with a long duration of infection, and in immunosuppressed clients are less likely to resolve spontaneously, and so would require some input from a Foot Health Practitioner.
As a Foot Health Practitioner, I have a couple of different ways of treating a verucca.
One way is by debriding it with a scalpel, which removes the top layer of skin and would aim to get the black dots within the verruca to bleed. The bleeding will promote antibodies within the body, which should start to attack and heal the verruca virus from within. I would then cover the verruca with zinc oxide tape. The tape traps in epidermal water loss, encouraging the verruca to macerate. The macerated area becomes a controlled wound, alerting the immune system to the fact that there is a virus hiding in the epidermis, with white blood cells gathering in the area to assist with the wound healing. To encourage the healing of the verruca the zinc oxide tape should be changed daily (this can be bought online or from a chemist) with the patient visiting me every few weeks for some more verruca debriding with a scalpel to get rid of the top layer of the verruca.
The other way, is with a topical ointment called Salactol. The key ingredients in Salactol are Salicylic acid (16.7% w/w): A keratolytic agent that loosens and sheds hardened outer layers of skin, and Lactic acid (16.7% w/w) which works alongside salicylic acid to soften tough tissue and enhance the peeling effect.
Again I would firstly debride the verucca with a scalpel, apply the Salactol, cover it with a dressing, and then suggest the patient applies Salactol at home every evening. Salactol can be bought online or from a chemist. The patient should come back to visit me me every few weeks for some more verucca debriding (and application of Salactol).