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What are verrucae?
A verruca is a plantar wart (plantar means that it appears on the sole of the foot). Plantar warts appear flattened in shape when compared to other warts; this is because of the pressure caused by standing and walking. A verruca is a localised viral infection that affects the epidermis (the top layer of skin), caused by the Human Papilloma Virus (HPV). A common misconception is that verruca have roots, this is false. Verrucae do not have roots, instead what 'appears' to be the root is actually a cluster of tiny blood vessels.
The virus likes warm moist environments, therefore swimming pools and communal wash areas may harbour the virus.
What causes verrucae?
Verrucae are caused by the Human Papilloma virus (HPV). The virus invades the skin through direct skin-on-skin contact, as well as indirect contact (e.g. towels and the floor communal areas). The virus then enters the top layer of the epidermis (the stratum corneum) through any abrasion that may be present on the skin; once it has entered it then begins to multiply. The HPV virus causes a reaction in the skin; the result is an over-production of keratin (a protein found in the skin) and it is this which gives a verruca its rough, cauliflower appearance.
Who gets a verruca?
Verrucae are common; almost everyone will have a verruca at some time in their life. This is because anybody can catch a verruca; however some people are more susceptible than others, and these include:
- Children and teenagers
- People who have a weakened immune system
- People who use communal areas where they will have bare feet
- People who live with someone who has a verruca
What are the signs and symptoms of a verruca?
The signs and symptoms of verruca may include:
- Feeling like you are walking on a pebble
- Pain when pressure is applied to the sides of the verruca
- May have a cauliflower appearance
- Area of roughened skin (the skin may be spongy or scaly and may appear brown or grey)
- Tiny black dots may be visible; these are in fact blood vessels.
- A verruca may appear alone or in a cluster.
- Skin striations deviate around the lesion.
Types of verrucae
There are two main types of verruca, they are:
Verruca plantaris is the name given to a verruca on the sole of the foot
Mosaic verucca is the name given to a cluster of small verrucae. Mosaic verrucae occur due to a process called autoinoculation. Autoinoculation is a secondary infection by an infection that a person already has.
How are verrucae diagnosed?
Your podiatrist will diagnose a verruca based on the signs and symptoms and an examination of the affected area. It is important that you visit a podiatrist as a verruca can mimic other conditions.
What would podiatry for verruca involve?
Your podiatrist will begin by taking a thorough medical and social history; they will then assess and examine both feet, and the lesion itself. Upon diagnosis a treatment plan will be designed specific to you.
Treatment varies and is dependent upon the location, size and the number of verrucae present. Therefore what to do next will be based on a mutually agreed decision between you and your podiatrist. Treatment for verruca may include:
- Watch and wait: if you have a single verruca that is not painful it may be an option to watch and wait to see if the body kills the virus on its own. This requires patience and may take a long time. In the mean-time your podiatrist can remove the overlying surface of the verruca, which depending on the thickness can be done either with a file, burr or scalpel (sharp debridement). Sometimes the verruca may bleed, this is quite normal; it is due to the blood vessels (which appear as black dots) within the verruca bursting.
- Salicylic acid
A verruca is a wart caused by the Human Papilloma Virus. Anybody can catch a verruca, which spread through abrasions in the skin as a result of either direct or indirect contact with the virus. Some people are more at risk of catching a verruca than others, these include; children and teenagers, people with weakened immune systems and those who frequent communal areas with bare feet. There are a number of treatments for verrucae; your podiatrist will be able to advise you on the one that is right for you.
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