Verruca Treatment: Professional Removal by Podiatrists and Chiropodists

Overview

A verruca (commonly called a plantar wart) is a viral infection of the skin on the sole of the foot caused by the human papillomavirus (HPV). Unlike common warts on other parts of the body, verrucae grow inward due to pressure from walking and standing, making them painful and often more persistent.

Many people attempt home treatments with over-the-counter products, but professional verruca removal offers better success rates and prevents spreading the infection to other areas. An HCPC-registered podiatrist experienced in verruca treatment can assess your condition and recommend the most effective approach, whether that’s targeted topical treatment, physical removal, or combination therapy.

What is a Verruca?

Understanding Plantar Warts

A verruca is a small, rough growth on the skin sole, typically appearing as:

• A circular lesion with a dark centre (the blood vessels within the infected tissue)
• Thickened, callused skin surrounding the wart
• One or multiple warts (sometimes forming a “mosaic” pattern of clustered lesions)
• A lesion that may cause pain when walking, especially if located on a pressure point

Verrucae are benign (non-cancerous) but highly contagious. They spread through direct contact or by walking barefoot on contaminated surfaces. This is why they’re common in environments like swimming pools, communal changing rooms, and gymnasium floors.

Causes and How Verrucae Develop

Viral Transmission

Verrucae are caused by specific strains of HPV that preferentially infect the skin on the sole of the foot. You contract the virus through:

• Walking barefoot on contaminated surfaces
• Direct contact with someone else’s verruca
• Sharing towels, nail files, or other personal items with an infected person
• Small cuts or breaks in the skin that allow viral entry

The virus invades skin cells and causes them to multiply abnormally, creating the characteristic bumpy growth. The body’s immune system usually fights back, which is why some verrucae eventually disappear on their own (though this can take months or years).

Risk Factors

Certain factors increase your likelihood of developing verrucae:

• Weakened Immunity: People with compromised immune systems are more susceptible
• Frequent Exposure: Those who regularly use communal bathing facilities face higher risk
• Skin Damage: Cuts, cracks, or abrasions make viral entry easier
• Age: Children and young adults are more commonly affected
• Genetics: Some people’s immune systems are less effective at fighting this particular virus

Symptoms and When to Seek Treatment

When a Verruca Requires Professional Attention

You should consider seeking verruca treatment from a podiatrist if:

• The verruca causes pain during walking or standing
• It’s spreading to other areas of your foot or to other people
• Home treatments haven’t worked after several weeks
• The verruca is in a location that makes home treatment difficult
• Multiple verrucae are present
• You have diabetes, circulatory problems, or a weakened immune system
• The lesion doesn’t look like a typical verruca and needs professional diagnosis

A podiatrist can confidently diagnose a verruca and rule out other conditions that might mimic one (such as calluses or corns).

Professional Verruca Treatment Options

HCPC-registered podiatrists and chiropodists offer several evidence-based treatment approaches. The most suitable option depends on the verruca’s size, location, duration, and your individual circumstances.

Topical Treatments

Salicylic Acid Application: This keratolytic agent dissolves the thickened skin layer and gradually destroys infected cells. A podiatrist can apply high-concentration salicylic acid more effectively than over-the-counter products, often combined with gentle removal of dead tissue. Treatment typically requires multiple sessions over several weeks.

Lactic Acid Preparations: Similar to salicylic acid, these dissolve tissue and may be gentler on surrounding skin.

Cryotherapy (Freezing)

Liquid nitrogen is applied directly to the verruca, freezing the infected tissue. This causes:

• Blistering within hours or days
• Death of infected cells
• Sloughing off of the blister and verruca over 1-2 weeks
• Potential regrowth requiring repeat treatment

Cryotherapy is quick and relatively painless during treatment, though some discomfort can occur as the blister forms. Multiple sessions are often needed.

Needling/Microtrauma

This technique involves repeatedly puncturing the verruca with a sterile needle under local anaesthetic. The controlled injury triggers an immune response that often clears the infection. It’s particularly effective for verrucae that haven’t responded to other treatments.

Combination Therapy

Many podiatrists use a combination approach, such as:

• Cryotherapy followed by salicylic acid application
• Needling combined with topical treatments
• Sequential treatments adjusting strategy based on response

Combination therapy often achieves better results than single-modality treatment.

Other Options

• Immunotherapy: Topical application of imiquimod or other immune-stimulating agents
• Laser Treatment: In some cases, specialist podiatrists may offer laser therapy
• Surgical Removal: For persistent or large verrucae, minor surgical removal under local anaesthetic may be considered

Prevention and Aftercare

Preventing Verruca Transmission

Once treated, protect yourself and others:

• Avoid walking barefoot in communal areas (pools, gyms, changing rooms)
• Don’t share towels, nail clippers, or foot care items
• Cover the area if it’s still healing or might be contagious
• Maintain good foot hygiene
• Keep feet dry, as moisture encourages viral spread

Supporting Recovery

• Follow your podiatrist’s specific aftercare instructions
• Attend follow-up appointments to assess treatment response
• Report any signs of regrowth or spreading
• Avoid attempting to remove the verruca yourself
• Use protective footwear if the area is tender

Frequently Asked Questions

How long does verruca treatment take?

Treatment duration varies widely. Some verrucae respond within a few weeks, while others take several months. Cryotherapy might require 3-5 sessions spaced 2-3 weeks apart. Salicylic acid treatment typically takes 4-12 weeks. Needling sometimes produces results after one or two sessions. Your podiatrist will give a more specific estimate based on your verruca’s characteristics.

Will my verruca come back?

Recurrence rates vary by treatment type (roughly 10-30% depending on the method). Once successfully treated, you’re unlikely to develop the exact same verruca, though you could theoretically contract HPV again if exposed. Following preventive measures significantly reduces recurrence risk.

Can I treat a verruca at home?

Over-the-counter salicylic acid products exist and may help with mild verrucae, but professional treatment is more effective, faster, and safer. Professional-strength products and techniques (like cryotherapy or needling) simply aren’t available for home use. A podiatrist ensures proper diagnosis and appropriate treatment.

Is verruca treatment available on the NHS?

Verruca treatment availability varies by region. Some NHS services offer it, while others may not prioritise purely cosmetic or non-painful verrucae. You can request treatment from your GP, though you may face waiting times. Private treatment through HCPC-registered podiatrists typically offers faster access and more treatment options.

Are verrucae dangerous?

Verrucae are benign and not serious from a medical standpoint. However, they can be painful, may spread to other areas, and are contagious. Treatment is recommended primarily for pain relief, to prevent spreading, or for cosmetic reasons. In people with compromised immunity or circulatory problems, professional assessment is wise to rule out complications.

Get Professional Verruca Treatment

Don’t let a persistent verruca cause pain or spread further. A qualified podiatrist can diagnose your condition and recommend the most effective treatment approach for your specific situation.

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