What shall I do when my child has a Verruca?
Firstly, let’s explain what verrucae are:
- Verrucae are benign warty tumours, caused by the Human Papilloma Virus (HPV) through abrasion of the skin surface
- The virus can remain latent for up to 8 months, meaning you do not see it for this amount of time before it appears on your skin
- Verrucae spreads through exfoliation as it migrates to the surface looking for other hosts (you) to spread to
- The virus alters the character of the epidermis, resulting in the visible warty appearance
- The skin striae (lines) are interrupted and there may be small black bleeding points. It is important to stress that bleeding does not spread the virus, it can only survive and replicate in the epidermis
- A longstanding verruca is not indicative of a compromised immune system in a healthy individual, if it were then your child would be manifesting far worse recurring infections
Different types of Verrucae:
There are currently more than 100 known types of HPV. The most common warts on the hands and feet are the subtypes 1, 2 and 4.
HPV 1
Large, painful if on weight bearing sites, vacuolised (fluid filled cells), cell disturbance through entire epidermis
HPV 2
Mosaic. Less painful, large area, overlapping (scale like), superficial vacuolisation in spinosum & granulosum.
HPV 4
Multiple. Less painful, numerous small circles, vacuolisation in granular layer, compact Stratum Corneum.
Best treatment for Verrucas:
There is no definitive answer to this, because there are several ways that the HPV evades our immune system.
Verrucas best defence is to stop inflammation and the cells that fight off infections often do not get the message because the virus releases ANTI-INFLAMMATORY proteins resulting in the virus causing ‘HOST IMMUNE IGNORANCE’!
However, once our cells are exposed to the virus, they mount an inflammatory global attack (hence the cascade effect when one lesion resolves so do the others) and destroy all foot and hand lesions developing memory against future attacks. Therefore, the virus cannot inoculate in the same person.
The aim of all verrucae treatment is to initiate an INFLAMMATORY RESPONSE to allow resolution and inoculation occur.
As podiatrists we only recommend evidence-based medicine, (stealing meat and burying it in garden at midnight, applying banana skins or vinegar are not recommended)!
Furthermore, we do not recommend the use of over the counter wart treatments on incredibly young children. If the skin is not professionally reduced, then a build-up of acid can occur.
Often keratolytic treatments are more painful than having the lesion which will spontaneously resolve within 24 months in young people.
Caustics can cause pain, tissue breakdown, scarring and serious bacterial infections.
Sometimes just making the area comfortable with regular debridement and offloading whilst waiting for the inevitable immune response to kick in, is all the treatment necessary.
Please remember there are far worse viruses that our bodies are constantly fighting.
When your child has a Verruca:
We recommend the occlusive method. It is a non-evasive home treatment.
Apply a sticky zinc oxide tape. Approximately, 2mm larger than the lesion. Keep covered.
Remove daily, wipe surgical spirits over wart when necessary, reapply with the tape just removing long enough to put a fresh piece on.
Do not leave the tape off for longer than 2 minutes.
The tape will trap TEWLS (Trans Epidermal Water Loss) and engorge the hardened/painful corneocytes so that they soften and become painless whilst waiting for the adaptive immune response to kick in and enable future immunity against that strain of HPV. It can take up to 24 months to do so, so be patient.
If the lesion is painful or spreading please contact your local HCPC podiatrist for further advice and treatment.
Our initial recommended appointment type is ‘First Appointment & Treatment’ £36
