Debridement of the over lying callus on the verruca is carried out using a sterile scalpel. This is a painless procedure and there is a low risk of trauma to the skin. The uncovered verrucae allows for tropical treatments such as salicylic acid or silver nitrate to penetrate the affected tissues allowing for a greater success of complete removal. With debriding there is less risk of spreading the verruca compared to filing. Debriding allows for instant pain relief which maybe felt due to the over production of skin cells on high pressure area's, making your foot more comfortable when standing and walking.
Benefits of debriding
- It is a quick procedure carried out in clinic
- Usually a totally painless
- No need for anaesthetic
- less risk of spreading the virus
- low risk of damage to the surrounding healthy skin
- Carried out safely and is recommended for at risk patients
After Debridement what can I put on my Verrucae?
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Salicylic acid
Many over-the-counter verruca products contain salicylic acid ranging from 10% - 26%. Salicylic acid works by breaking down the bonds between the dead skin cells, allowing a peeling action to remove the verruca cells. An immune response is triggered and causes your body's immune system to recognise and fight the virus. Podiatrists have access to products containing 60% salicylic acid that can be applied to the verruca during the treatment. Over the counter products will need to be applied daily and it is recommended to apply this at night. Salicylic acid is not recommended for diabetics or for persons with a reduced blood flow. Side effects of salicylic acid can include skin irritation, discoloured skin and discomfort on the site of the verruca.
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Zinc Oxide tape
You may have come across the use of duct tape for assisting to remove verrucae. Duct tape is not medical tape and should not be used on the skin as it can cause skin irritation. Zinc oxide is a medical alternative used by physiotherapists, doctors and athletes, it works by occluding the skin making the verruca softer and more comfortable. Zinc oxide taping is a gentler approach as such it can take some time for the verruca to disappear and one day you will notice it has gone.
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Silver Nitrate
Silver nitrate is an over-the-counter product and is widely used to treat verruca. It should be applied precisely to the verruca avoiding healthy tissue. THe silver Nitrate chemically cauterises and destroys the verruca cells. It is recommended to treat daily for a maximum of 6 applications. There can be mild irritation to the skin during application and the skin will be stained.
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Leave it be
Debridement relieves discomfort caused by the thickened verruca lesion by removing the excess verrucae skin cells, especially in high-pressure areas. Verrucae are not harmful lesions and the only reason for the debridement may be pain relief and not for treatment. Verrucae can disappear on their own, for children in most cases this is within two years, for adults this is longer and may take between 5-10 years.
During your appointment
During the initial appointment your medical history, general well being and foot health will be discussed and the verruca lesion will be visually inspected. The most appropriate treatment plan will be made on a tailored individual approach as not all treatments are suitable for all. Some over the counter products are not recommended for diabetics and a taping with zinc oxide maybe more suitable. Each treatment plan will be on an individual approach and discussed between the patient and Podiatrist.
A photograph of your verruca will be taken and added to your records to monitor the size and number of lesions.
A sterile scalpel is then used to gently scrap away the dead verruca cells, taking the verruca as far down as possible and the chosen topical treatment applied if applicable. Usually there is no bleeding however if there may an active capillary bleed (little back dots) caused by the verruca cells pressing on the lower layers of your skin a dressing will be applied.
Depending on the location of the verruca such as on a high pressure areas, padding maybe used to offload the pressure for a few days.
Advice will then be given by your podiatrist on the treatment plan with direction on how to use the topical treatment.
This is not a one off treatment and multiple treatments are usually needed. It is recommended to have 2 weekly follow ups to remove the overproduced skin cells and allow for a greater success rate. Every patient and immune system is individual and the verruca will disappear when it is ready. Be prepared it can still take weeks or months for verrucae to disappear.
Costs
Initial consultation - £35
A longer appointment is needed firstly to discuss medical history, general well- being and foot health. A treatment plan will then be discussed and agreed by both the podiatrist and the patient. The verruca will be debrided and the topical treatment applied if appropriate.
Follow up appointments - £25 with topical treatment
- £20 without topical treatment
These appointments are shorter and allow for the verruca to be debrided following the treatment plan.
No verruca treatment is guaranteed and if this approach is not working, your podiatrist will discuss other treatment options.
