Verrucaes are viral warts caused by the human papilloma virus (HPV) infection and are commonly benign. Warts often appear on the hands and/or feet. Warts appearing on the sole of the foot in podiatric terms are commonly termed ‘verrucaes’; these can spontaneously disappear within a couple of months or even years owing to natural immunity. However, owing to the social stigma that surrounds them and sometimes being painful especially when they are on the sole of the foot patients will often request treatment.

Verrucae are contagious; the virus thrives on warm, moist environments such as swimming pools, sports changing rooms and bathrooms. Therefore, it is not recommended to walk about barefoot.

The difference between a corn and a verruca is that a corn is simply a build-up of dead skin cells with a hard nucleus, whereas, a verruca is a viral infection. The verruca often has overlying callus (hard skin) and in addition, the skin line pattern (striae) will be interrupted and there may be an appearance of small black spots (small blood vessels) within the lesion.

If you do have a verruca (or verrucaes – pleural), try and not to touch or scratch the affected area because this may spread the virus. Verrucae can spontaneously resolve themselves in children; however, adults may find that they persist.

There are many products that can be found over the counter, however, if in doubt or you have vascular problems, diabetes, rheumatology, neuropathy it is best practice to seek professional advice from a podiatrist. However, please note that undertaking any treatment is not guaranteed to resolve the verrucae.

Available podiatric therapies include cryotherapy, silver nitrate, tea tree oil (antiseptic and antimicrobial), salicylic acid to name a few. Cryotherapy works by freezing the verruca and can be painful and can cause a blister. Treatment can sometimes take between 3 and 6 applications before gaining satisfactory results, but in some cases this treatment may not ultimately resolve verrucae. Silver nitrate is another therapy that is commonly applied, however, all patients undertaking this particular treatment should be warned that their skin will turn black where the nitrate stick is applied. When the patient returns for their reassessment a week later, the area of skin is debrided and in its place should be new healthier tissue. Again, a few treatments may be necessary and again, eradication of the virus may not be guaranteed.