Verrucae, warts and all.

Verrucae, or warts can appear anywhere on the skin. They are caused by a viral infection and is a very common condition affecting most people at some time in their life. The appearance of the wart is dependant on where it occurs on the body; those on the feet are flattened by weight bearing and are forced deeper into the dermis (skin), often these types are mistaken for corns or callous. Where as warts on the hands appear raised, discoloured and bleed easily due an abundance of raised blood vessels.

The Virus responsible for causing warts, which are effectively benign tumours, is known as the Human Papilloma Virus (HPV). This virus also causes some malignant tumours in humans that are thankfully rare.  The common wart on the palmer surface of the hand and the plantar surface of the foot is caused by HPV2 and the deep pinprick type warts are caused by HPV4.

Treatment of Verrucae varies enormously depending on the practitioner. Methods used in a modern practice have not altered much since the "old days". However, these days, most chiropodists, doctors and dermatologists are of the opinion that the wart should be left alone, as it will eventually disappear of its own accord.  Most cases do resolve spontaneously within six to eight months of infection so, unless the lesion is very painful or if it persists for more than a year, (some cases I have encountered have persisted for more than ten years) then a costly course of treatment should be avoided.  It is Very Important that if a person is not sure that what they have is actually a wart (and not some thing more sinister) then they should seek a professional consultation.

melanoma.

When the decision is made to treat the verrucae, the choice would be made according to the lifestyle and medical circumstances of the patient. Almost always, all treatment involves the destruction of all the tissue that contains the virus.  This is drastic as it often causes collateral damage to healthy cells.  One method is to cut away all the callous covering the verrucae and apply salicylic acid at 70-80% strength; it is then covered and left in place for one week. The patient then returns to have the plaster removed and the lesion pared away again. This is repeated each week until the verrucae has gone. Obviously, this method means that bathing the foot is limited. And is considered by most, impractical.

Another method employed is cryosurgery. This is a treatment that involves freezing all virus- infected tissue using carbon dioxide, liquid nitrogen or nitrous oxide. This method requires the patient to remain still while the wart is frozen. In theory, this will freeze all of the affected area, reducing the blood supply and then hopefully killing off the virus. Unfortunately, it is painful but reasonably successful.

One of the most frequently asked questions is about home treatments.  A lot of medicines are available from the Pharmacist, such as Bazooka, Salactol or Compound W. If the patient follows the instructions carefully, then a successful outcome may be achieved. At any time, if any problems arise then a chiropodist should be consulted. They will, I'm sure, be only too happy give advice.