:: Warts and Verrucas

:: What is a wart?

A wart is a contagious viral infection of the skin, usually taking the form of a small, hard nodule.

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.

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.

:: What is a verruca?

25% of all wart virus infections are to the feet and appear as verrucas.

Verrucas 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.

:: Do warts and verrucas need to be treated at all?

Because warts and verrucas rely on a blood supply that easily clots and because the virus is constantly under attack by your own immune system, warts and verrucas often ‘burn out’ without intervention; however, this can take a very long period of time. 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 verrucas be treated?

1. Warts can be painted with a topical solution that can eventually kill the virus; however this treatment can take many months of daily applications, and some warts will remain despite diligent applications. This is the treatment of choice in children, nonetheless.
2. 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 for clearance. Success is greater if combined with wart paints in between cryotherapy treatments.
3. 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 wart.
4. 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.

:: What methods do the Canterbury Skin and Laser Clinic use?

We use all of the above techniques depending on type and distribution of the wart(s) for treatment, and the patient’s age and preferences. From the laser perspective, we use a Dornier Vascular Laser; this laser produces high energy light of exactly 940nm, 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 Dornier are minimal, although the treatment will hurt, the area is not usually 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. This happens when some of the infected cells have not been destroyed and begin to proliferate again. In this case, further treatment will be required to destroy the remaining infected tissue.