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​Verrucae and Warts – a stubborn problem

Aug. 24, 2018

Verrucae and Warts – a stubborn problem

Verrucae and warts on the feet have traditionally been difficult and stubborn to resolve, with remedies varying from natural treatments such as tea tree oil or banana skins, through a range of topical acids, to cryotherapy (with liquid nitrogen) and even surgery. But there is now a new option, with the development of microwave technology.

HPV or Human Papilloma Virus, is a contagious virus that causes verrucae and warts. It is also the virus that causes genital warts, cervical cancer and head and neck cancers. We currently vaccinate 12-year olds against HPV, and anecdotally, these vaccinations have been reported to result in clearance of non-genital warts (ie verrucae and warts) in some people. The strains of HPV that cause verrucae and warts thrive in moist, warm conditions such as swimming pools, gym changing rooms and communal shower facilities

HPV is spread by direct skin-to-skin contact or autoinoculation. This means if a wart is scratched or picked, the viral particles may be spread to another area of skin. The incubation period can be as long as twelve months. Children and young adults are the most commonly affected, until they develop immunity.

Warts tend to protrude more from the skins surface. Verrucae are most common on the soles of the feet and warts are typically found on hands. Verrucae typically appear small and punched out, with black dots and a cauliflower appearance. However, there are many different presentations. Sometimes they can be a mosaic type spread over a wider area. They can be tender when callus (hard skin) develops over the top.

No treatment is universally effective at eradicating viral warts or verrucae. In children, even without treatment, 50% of warts disappear within 6 months, and 90% are gone in 2 years. They are more persistent in adults but they clear up eventually. They are likely to recur in patients that are immune supressed, e.g., organ transplant recipients. Recurrence is more frequent in smokers. Many people don't bother to treat viral warts because treatment can be more uncomfortable than the warts—they are hardly ever a serious problem. Warts and verrucae that are very small and not troublesome can be left alone. However, they may be painful, and their appearance may cause embarrassment.

Traditional treatment methods with salicylic acid or liquid nitrogen, have not changed for decades. These treatments are not very effective and are destructive in nature. We frequently recommend watching and waiting for verrucae and warts to resolve spontaneously.

The development of a new technology finally gives us a more effective and gentle treatment. The Swift microwave unit has enabled microwaves to be localised at the site of the verrucae or wart and to offer treatment if treatment is required.

Microwaves are a form of non-ionising radiation which agitate water molecules within skin without causing damage to DNA. The rapid waveform of the microwave causes the water molecules to vibrate and collide, resulting in generation of thermal energy. Swift microwaves penetrate to a predetermined depth with no lateral splay of energy. They do not break the surface of the skin or destroy tissue like salicylic or liquid nitrogen. The microwave's gentle warming (to 42degrees) causes an immune response to develop and to destroy the HPV. A number of studies in the UK, have shown up to an 83% resolution rate with 3 treatments over 12 weeks. Treatments take a few minutes, at 4 weekly intervals.

At present, Shore Footed Podiatry in Milford (09 489 1011) have the only Swift Microwave unit in NZ, but there are over 200 users in UK and growing numbers in Australia. Talk to your Medplus Doctor about your warts and verrucae, and ask about whether you may benefit from microwave treatment, which may be partially covered under some health insurance policies.