Warts and Verrucae Treatment in Canterbury

A wart is a contagious viral infection of the skin, usually taking the form of a small hard nodule, usually located on the hands and/or feet. The wart itself is a cluster of your own skin cells that have been infected and transformed by the virus. The wart virus can be passed from one person to another and from site to site on the same person.

Some people’s immune systems can suppress the wart virus at the outset and in these people warts are not seen. In others the wart virus ‘hides’ from the immune system allowing them to develop into the lesions we all recognise. However, most people will eventually develop immune recognition and then suppression of their warts, resulting in a spontaneous remission within 2-5 years.

Immunity to one wart virus does not necessarily prevent infection by another wart virus in a different skin type, causing plantar warts and verrucas. The wart virus cannot normally penetrate the skin and takes advantage of broken or macerated skin.

70% of all warts are on the fingers and hands. Warts commonly occur around fingernails, especially in children and can lead to a depression in the nail matrix, causing grooves to develop in the nails. 25% of all wart virus infections are on the feet and appear as Verrucas. These appear as round nodules, often with a small black pit at the surface. Because of the pressure exerted during walking, verrucas grow inwards rather than outwards.

Verrucas appear both singly and in groups (mosaic).They may be painful because of their depth – they can feel like a stone in the shoe and be deep enough to press on nerves in the foot. If the blood supply to the verruca clots (thrombosis), the verruca can become very painful. However, without a blood supply the verruca will rapidly die off.

70% of Verrucas resolve on their own within 1 year, 90% resolve within 2 years, but some can last much longer. During the time it takes for an individual wart to disappear, it is possible for the virus to spread, producing more warts in adjacent areas.

HOW CAN WARTS AND VERRCAE BE TREATED?

At the Canterbury Skin and Laser Clinic, there are a number of ways that warts and verrucas can be treated. Most infections are self-limiting and simply waiting will eventually work for most people.

Topical solutions 

Warts can be painted with a topical solution that can eventually kill off the skin the virus is living in; however this treatment can take many months of daily applications, and some warts still remain despite the diligence.

Cryosurgery

Cryosurgery is sometimes used very successfully. The treatment involves liquid nitrogen to kill off the infected tissue. Usually multiple treatments at 2 to 3 week intervals are required Success is greater if combined with wart paints in between cryotherapy treatments.

Electrocautery

Electrocautery uses a small probe to accurately introduce an electric current into the wart material with the aim of cauterising the blood supply. Occasionally, this is combined with curettage (scraping off the wart) with prior local anaesthetic injection to numb the area. This is often the treatment of choice for a single symptomatic wart.

Lasers

Lasers that target haemoglobin can also be successful, as the laser can accurately target the blood supply to the wart without causing painful peripheral damage. The laser energy penetrates the wart material, heating up and sealing the blood supply so that the wart cannot survive. The pain involved is generally less than cryosurgery or electrocautery and one treatment is sometimes enough to kill the growth entirely. If all of the blood supply is not killed, further treatment will be needed to ensure that the growth is killed.

Here at Canterbury Skin and Laser Clinic, we use all of the above techniques depending on type and distribution of the wart(s), and the patient’s age and preferences. From the laser perspective, we use a Vascular Laser which is strongly absorbed by the blood in the vessels. The blood is heated up until it clots, obstructing the supply to the growth. The growth will then shrivel and die, or simply be absorbed back into the skin.

Side effects with the laser are minimal; although the treatment will be uncomfortable the area is not usually that painful afterwards. Recovery is rapid and, in most cases, all signs of the infection and the treatment will have disappeared within a few weeks. In some cases, the wart will start to re-appear again after the skin has healed over. In this case, further treatment will be required. Multiple treatments can be necessary in some patients.

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