VERRUCAe pedis (Plantar Warts)
What are verrucae?
Verrucae are benign growths on the skin that are highly vascular in nature. They are caused by a virus known as the human papilloma virus (HPV). Some 15 HPV types have been identified and classified according to molecular differences. These viruses are “oncogenic” this means that environment is a causative factor in the production of their growth.
Verrucae may occur as single or multiple growths affecting any aspect of the feet. There is a considerable variation in the appearance of verrucae. Those on the sole of the feet may have their appearance modified by the weight of the body, which forces the verrucae’s mass into the foot giving them a flattened look, over which can be a hyperkeratotic layer, i.e. hard callous surround. For this reason verrucae may be mistaken for corns or hard skin. Other verrucae, e.g. Mosaic verrucae, tend to be shallow and pain free, whilst the deep plantar verrucae, depending on their location, can be extremely painful.
Verrucae are very contagious. They gain entry into the skin through micro-injury. This may occur during barefoot activities, especially when the skin has been wet for some time, as in swimming, or due to sweating after intense exercise, followed by showering. Other areas where verrucae contamination may occur are: trying on shoes in shoe shops without wearing hosiery; Hotel rooms; Saunas; Gymnasiums or Health Farms. It is also known that a stress factor may be involved in verrucae infection. (They have been seen to be more prevalent at school examination times.) Certain illnesses can make a person more susceptible to infection by verrucae. A lowering of the body’s immune system may cause this.
How do I know if I have a verruca?
If you suspect that you have a verruca you must refrain from touching it or picking at it with your fingers. As mentioned, verrucae are very contagious and you could spread them over the feet or onto your hands. Verrucae are generally not painful with direct pressure but they are with side pressure. Pushing the verrucae from the side compresses the nerve ends within which causes pain. They are also very vascular and will bleed easily if cut into.
With some verrucae there may be a visible collection of black or brown dots. Some people believe that this is the root, and if they could pull it out the verruca would disappear. In fact, the black or brown dots are the blood vessels and the nerves that have been forced into the verrucae to feed it.
In general, a verruca has only one purpose in life, and that is to annoy the person who has it. However, there is a method in its madness. By causing great irritation to the person, it manages to produce a lowering of the body’s immune system and therefore gets a tighter hold.
The first rule of the treatment of a verruca is to have a positive attitude, so, “Don’t let it get you down”. You have the virus, so let’s see what treatments are available.
Verrucae have a life span and when this life span is over, they will completely disappear. It is, at times (especially on initial contamination), better to let the body fight infection. This way the body can build a certain immunity to the virus. As stated previously, verrucae are not generally painful, but if they become painful or start to spread, this is an indication that treatment is necessary.
What is the treatment?
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Verrucae treatments vary considerably . There is no magical solution.
Preparations freely available from Chemists, e.g. Salactol, Cuplex, Veracur Gel, Bazuka, all contain substances that cause the destruction of the morbid tissue of the verrucae and hopefully destroy the virus. These substances must be handled with care, and the manufacturers instructions followed carefully. They may also cause severe inflammatory responses, and septic reactions, to develop. Diabetics or anyone with Arterial Insufficiency or Venous problems must not, under any circumstances, use them, and the elderly must not use them.
Low Intensity Laser Therapy (LILT)
This is another agent used to treat verrucae. Generally used in conjunction with chemicals, treatments can be prolonged. In fact, if treatment is successful, we are still unsure if this is a result of the Laser therapy, or the chemicals used with it. Further investigations are required.
To this date, the commonest form of treatment for verrucae is through the chiropodist, where a variety of chemicals are used over a period of time, to cause destruction of the verrucae.
Prevention is always better than cure.
There is no easy answer to verrucae infection. Being aware and taking measures to protect oneself is important. Wear Guard socks when swimming and when in areas such as common changing rooms. Children especially should be protected. Some schools unfortunately still adopt the policy of allowing PE lessons with bare feet. We do not condone this practice.
PROTECT YOURSELVES
If you need treatment or advice for a verruca infection, contact the Kirkintilloch Foot Clinic and arrange an appointment.
Freezing.
Verrucae can be frozen using: -
1. Liquid Nitrogen
2. Nitrous Oxide
3. Carbon Dioxide
All freezing techniques are potentially painful. Liquid nitrogen is the coldest, freezing to minus 190 degrees Celsius. This can cause great distress to young children, and also to adults. Nitrous Oxide and Carbon Dioxide are milder in their action, but nevertheless, can be extremely painful.
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