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HI,

I have been using dry needing to treat verruca for 2 years now and have had about a 75% success rate, for those which have been unsuccessful I used to carry out the dry needling procedure again but have never had any success the second time if the first attempt has failed.

I would be interested to hear from anyone else who has carried out dry needling the following:
1. If the initial treatment has failed do you offer a second course of treatment.
2. If so, what is the success rate for a second attempt.
3. How many attempts would you try before advising on alternative treatments.

Due to the lack of success of follow up treatments I no longer offer this but refer to another practitioner who carries out Liquid Nitrogen treatment for the verruca. I would be grateful for your thoughts.

Many Thanks

Alan

 

Hi Alan,

I don`t carry out `Dry Needling` for VPs, but I do needle VPs first described by Falknor in 1969.

To answer your questions;

1. Yes, I do.
2. Aprrox 50%, albeit anecdotally
3. 3 times

No one tx is 100% successful. The very nature of a virus is that it is unpredictable and cure/control relies on the complex mechanisms of both our innate and adaptive immune systems, otherwise we would have a cure for more aggressive viral infections such as HIV, influenza,etc.

IMVHO, the future is in the preventative treatment already used for addressing the specific (prospectively malignant) sub-types of HPV. Namely; HPV-16, HPV-18, HPV-6 & HPV-11 by the HPV4 vaccination now offered to adolescent gals `n boys. This technology could be utilised to treat the benign sub-types HPV-1, HPV-2 & HPV-4 which manifest as hand `n foot warts.

Cheers,
Bel

 

Going deeper and wider normally does the trick. Greater risk of infection though.

G

 

Makes sense, increased cytokines. No riskier than nail surgery imo.

 

Hi Belinda and Graeme,

Thank you for both replying.

Belinda: I must admit to previously only trying two attempts at needling before referring on for another treatment option, I will now look to increase this to three. Although anecdotal; the statistics you supplied are a useful guide when discussing the options with my patients so thanks again for this.

Graeme: If the treatment has not worked I have tried going deeper but not wider; I will look at trying this if the first attempt has not been successful.

Thanks again,

Alan

 

I have been led to believe the virus also exists a few mm beyond the VP border hence my "wider" comment. I routinely needle these areas as well as the greater mass with good results.

Regards,

Graeme

 

Yep. Ivan highlighted the fact that HPV recurrence can be attributed to "latent virus particles in adjacent cells [which] are not destroyed in keratolytic treatments"..

Bristow, I.R.; Stiles, C.J. The treatment of stubborn plantar warts using topical 5% imiquimod cream. Podiatry Now. 2012, 69, 6.