Verrucae
Verruca Treatment at The London Podiatry Centre
Verrucae (plantar warts) can be painful, stubborn and disruptive. We treat adults and children with verrucae (plantar warts), from simple cases to long-standing or painful lesions. Care is consultant-led and tailored to how long the lesion has been present, where it is, your activities, and (for children) what is age-appropriate and well tolerated.
Treatment overview
Depending on your diagnosis and what’s most appropriate for you, first-line care usually involves cryotherapy or Swift microwave therapy. Both are evidence-based options; we’ll explain the pros and cons for your verruca’s size, site and duration, as well as your preferences. Dry needling can be considered in selected cases. If a lesion proves persistent despite non-surgical care, we can perform surgical excision under local anaesthetic in our on-site theatre—an option not typically available in general podiatry clinics. Whatever the severity, the aim is durable resolution with the fewest visits necessary.
Why Choose The London Podiatry Centre for Verruca Treatment?
Why choose The London Podiatry Centre for verrucae?
- Multiple advanced treatments under one roof, from conservative care to surgery
- Consultant-led expertise in resistant and longstanding verrucae
- State-of-the-art equipment, including Swift and an on-site theatre
- Clear aftercare and pragmatic advice to reduce recurrence
Not sure if it’s a corn or a verruca?
They can look similar, see our Corns & Callus page; we’ll guide you to the right care.
Book an expert assessment at The London Podiatry Centre for a personalised treatment plan.
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VERRUCA TREATMENTS
Cryotherapy involves the application of liquid nitrogen to the verrucae site. The treatment is believed to work by destroying a small area of skin which contains the verrucae. The duration and type of freeze depends on the size, location and your skin type.
- Depending on the severity of the verrucae, a local anaesthetic injection may be administered to your ankle or in your foot to numb the skin and deeper tissues around the verrucae site.
- Once your foot is numb, a cryotherapy canister is used to spray the verrucae site with liquid nitrogen.
- A sterile dressing is then applied.
- Continued cryotherapy follow-up appointments may be necessary at later dates to ensure the verrucae is successfully removed.
- Crotherapy is a low-risk and effective treatment.
- The procedure can be carried out in the clinic, not requiring hospital admission.
- Blistering
- Pain or discomfort during and for several days following the procedure
- Infection
- Painful scar tissue formation
- Adverse reaction to local anaesthesia (if performed)
- Recurrence or regression of the verrucae virus
- Chronic Regional Pain Syndrome (CRPS)
Swift uses a small handheld probe to deliver a precise dose of microwave energy to the verruca. Applications take only seconds and are designed to stimulate a local immune response without cutting the skin. Most people can resume normal activities straight away, and dressings are typically not required.
- After assessment and consent, the skin is prepared and the Swift probe is applied in short, timed bursts (seconds per application).
- A sterile, single-use tip is used for each patient.
- Treatment is usually provided as a short course (commonly around three sessions about four weeks apart), tailored to your case.
- The sensation is a brief, sharp heat that settles quickly; injections are usually not needed.
- No wound care is typically required and you can walk out in your normal footwear.
- Follow-up appointments monitor progress and, if necessary, additional applications can be scheduled.
- Suitable for adults and, where appropriate, children—we’ll confirm suitability at assessment.
- Short, precise applications (measured in seconds) via a handheld probe
- Minimal downtime — most people resume normal activities the same day
- Usually no dressings or injections needed
- Evidence-based option for stubborn verrucae
- Targets the cause without cutting or freezing the skin
- Brief, sharp heat during treatment; temporary soreness may follow
- Redness, swelling or small blisters can occur and usually settle quickly
- Temporary skin discolouration is possible (more noticeable in darker skin tones)
- Multiple sessions may be required and results can vary
- Not suitable for everyone (e.g. certain implants or metal near the site); suitability is confirmed at assessment
Dry needling pushes the virus to the outer layer of skin (epidermis) into the deeper dermis layer of skin, aiming to induce a cell-mediate immune response that targets the verrucae virus directly.
- A local anaesthetic injection is administered to your ankle or in your foot to numb the skin and deeper tissues around the verrucae site.
- Once your foot is numb, a sterile needle is inserted into the verrucae several times until all of the surfaces of the verrucae has been punctured.
- A sterile dressing is then applied.
- Several follow-up appointments will be performed at later dates to ensure appropriate healing.
- Dry needling is a low-risk and effective treatment. Studies show that it works in 67-69% of cases (B. Longhurst, I. Bristow, 2013) which is higher than any other non-surgical verrucae treatment.
- It is different to other less invasive verrucae treatments, as it often only requires one or two treatments.
- The procedure can be carried out in the clinic, not requiring hospital admission.
- Infection
- Painful scar tissue formation
- Adverse reaction to local anaesthesia
- Recurrence or regression of the verrucae virus
- Chronic Regional Pain Syndrome (CRPS)
Verrucae Controlled Depth Excision Surgery
For those patients who have become resistant to both over-the-counter ointments and cryotherapy treatments, surgical options such as a controlled depth excision can be considered.
Controlled depth excision is a minor surgical procedure used to completely remove the verrucae from the surrounding healthy skin. As well as excising the verrucae lesion, the procedure attempts to induce a cell-mediated immune response is induced, to fight off the verrucae virus.
- A local anaesthetic injection is given around the ankle or in the foot to numb skin and deeper tissues around the verrucae site.
- Once your foot is numb, the verrucae is carefully excised between the dead and live layers of the skin, at what is known as the dermo-epidermal junction.
- The underlying skin is then cauterized using an electric needle, destroying any remaining viral tissue.
- Such procedures tend to bleed readily, therefore a large sterile dressing is then applied once the procedure is complete.
- Several follow up appointments will then be provided in the following weeks to ensure successful healing.
- Controlled depth excision is a low-risk and effective verrucae treatment.
- While more invasive than most other verrucae treatments, it can still be performed in our specialist day surgery facility, thus not requiring hospital admission.
Uncommon, but they can include:
- Adverse reaction to the local anaesthetic
- Infection
- Painful scar formation
- Recurrence or regression of the verrucae
- Thrombosis
- Chronic Regional Pain Syndrome (CRPS)
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Verrucae FAQ
Below are answers to common questions regarding the diagnosis and treatment of Verrucae conditions.
Verruca is a virus. There are many types of human papilloma virus (HPV) that can cause verrucas. They can present in different ways. Some verrucas can be spread out and superficial while others seem more like corns, being deep and painful. Corns and verrucas can look very similar. There are a number of ways in which the difference between a corn and verrucae can be determined. This includes the use of diagnostic ultrasound (used at our Centre)
There are many ways in which this can be determined, Some types of verrucae look nothing like corns and are much more spread out. However certain types of verrucae can look very similar to corns. The practitioners know the difference using a combination of the history and presentation. For example, we can use a specialised ultrasound scan to assess the lesion as most verrucae have a different type of presentation on a scan. Also corns generally do not occur in the very young, are generally (but not always) more painful and usually present on specific weightbearing areas.
At the London Podiatry Centre, we have found that cryotherapy is one of the most effective ways of treating verruca. Some practitioners use the treatment for too short a period. It must be used for long enough to break down the verruca and effectively kill the tissues with the verruca in it. Other treatments used at The London Podiatry Centre include laser and surgery to excise. However, cryotherapy is one of the safest treatments because of the reduced risk of scarring.
Sometimes one verruca will stay exactly the same for many years and not alter its appearance. Other times if left untreated, it may spread and cause greater problems. Verrucae in children are more likely to go at some point without treatment than in adults.
At the London Podiatry Centre, we tend to use cryotherapy. However, surgical excision and laser is also used when appropriate.
A verruca is a virus. It can be contagious. It is transmitted through close skin contact and most commonly picked up in communal changing rooms. The virus begins to multiply in the tissues of the foot so causing the distinctive appearance.
The London Podiatry Centre will use various types of treatment depending on the presentation. We find cryotherapy effective although in some cases, other treatments are more appropriate. This might include dry needling and various kinds of chemicals.
Yes, The London Podiatry Centre finds cryotherapy is often effective. However, verrucas can be challenging, and in some cases, multiple treatments are needed, whilst other times only one treatment is required.
If the freezing has been entirely successful in killing all the verruca tissue, then there is less likely to be transmission. If there are still some remaining verrucoid tissue, then transmission is more likely.
Yes, this is a treatment offered at The London Podiatry Centre.
It can be quite painful, although we find that most patients can tolerate the treatment. If it proves too painful, then a local anaesthetic can be administered.
This depends on your pain threshold. When it is applied, we give the patient the option of continuing or not. If it is too uncomfortable, then we can administer a local anaesthetic.
The tissue effectively dies with the verruca inside it.
Side effects include blistering, which can sometimes be quite severe. When the tissue is broken down, there is some risk of infection. We have not really seen any examples of scarring from cryotherapy but there is a small risk. Recurrence and regression are other risks.
No, the tissue simply dies and is reabsorbed by the body.
A verruca is a type of wart that affects the bottom of the feet. A verruca can be painful when walking, as it can press on the nerves in the foot.
