Verrucae Pedis (plantar warts)

This is a lesion that forms on the skin that occurs as a result of picking up the Human Papova Virus, (HPV). It can present as a single isolated lesion, multiple lesions, clusters, raized, flat large lesions. How they present will depend on the type HPV Virus that has taken hold. There are over 100 types of HPV viruses.

Some are painfull, and others are not. Some are benign, and others volatile. Some spread, some just sit there for years. There is a tendency to pick them up in public places, like gyms, swimming baths, beach front, and the potential to cross infect from family members. They can often appear after having picked up a foreign body , like glass or wood splinter.  Some can be uncomfortable if they reside over bony areas of the foot, they can hurt to walk on. There is a suggestion of immune compromisation as a cause.

Children are more prone to picking them up because they obtain more scuffs and scratches on their hands, elbows, knees and feet during play. Once the skin has been broken, the potential for infection increaces. Children are often prone to multiple lesions which may be linked to poor dietary choices.

They have a cauliflower appearance with small brown, black dots which represent blood supply. Some however appear flesh coloured and are not as easy to identify. They are often confused with corns, as some appear to have clearly defined borders. Generally  there are distinct differences.
They bleed when cut, whereas corns do not. Corns hurt on direct pressure and Verrucae on sideways or lateral  pressure. One way to test to see if it is a verrucae is to pinch it. Pinching normally hurts, but pressing does not.(Although if the verrucae has a thick rim of callus over the top, that can hurt on direct pressure too)
Sometimes the body forms a protective layer of callus over them, so at first sight it can look like a corn. This can often confuse the diagnoses. The Podiatrist will remove some of the top layers of skin, in order to assist with the diagnoses.

Treatment options will depends on the size and  site of the verrucae, as well as the age and health of the individual.

Treatments:

With Children we prefer to use Marigold Therapy as it is totally painless and well tolerated. Marigold Therapy is a natural Homeopathic approach involving the application of a paste derived from Marigold Flowers. Four-weekly applications of paste, followed by a tincture and oil for homework application. Children are generally responsive to this approach, as well as those that have large clusters. We often do not have to go through the whole protocol before success is achieved.

Liquid Nitrogen is another method. It does sting on application, and discomfort can linger for a day or two. Application  leads to a  haematoma which is a blister with blood cells. This separates the epidermis from the dermis with the intention of lifting the Verrucae, so that it can be removed.  After two weeks one follows up to remove the dead skin. It often requires a number of visits to clear the lesion. We do not use LN in the clinic anymore.

Electrosurgery utilising the Radiolaze. This is the quickest way of removing a verrucae. Best for isolated lesions, It has shown to be approximately 85% successful. Under local anaesthesia, once the area is numbed. A probe with a small wire loop, has a electical current passing through turning it into a ‘blade’ which is used to skim the epidermis with the viral tissue, off the dermis. It leaves a neat wound, that will heal in time.

Needling, a relatively little known technique based on the principle of assisting the body to recognise that it has a virus and take action. It is usefull for people with multiple, and complicated lesions. It involves targeting the ‘mother’ lesion, anaethetising the area, then using a relatively thick needle, to repeatedly puncture the lesion, hopefully driving the infected tissue deeper into the body, so that the body my take action on the virus presented, This will go on to clear other lesions as well, since the immune response has been alerted. Success has been reported at approximately 70 percent.

Chemotherapy, involves the use of strong skin acid preparations, to reduce the verrucae. There are a variety of preparations available. We no longer use this approach at the clinic

Cellfood, is a product that is useful in assisiting the body by providing 78 minerals, 17 amino acids, 34 enzymes, and oxygen. The idea is to make sure the immune systems functions at an optimum utilising good quality nutrition.

The Latest technique for Verrucae treatment is The S30 Podylas. This is a thermal laser utilising 1064nm to burn the verrucae. It can be done with and without local anaesthesia. it is however quicker to get a response once the area is numbed. Without LA it may take a few sessions to get rid of the lesion.