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Preferred Method for Treating Verruca

Discussion in 'General Issues and Discussion Forum' started by Andre Hugo, Nov 14, 2010.

  1. Andre Hugo

    Andre Hugo Member

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    Hey everyone

    I just want to hear from you - in your experience: What have you found to be the most effective, quickest method of treating verruca? ESPECIALLY in kids!

  2. Vernon Lever

    Vernon Lever Active Member

    Re: Treating Verruca

    Hi there....Yu must be Ex..SA with a name like that. Best way (in my opinion) is electro-cautery, has the best success rates I believe. Hope this helps, Regards, Vernon.
  3. Re: Treating Verruca

    Depends on the lesion. I've had better results with blunt dissection than electrocautery.

    Dry needling would be my first choice though.
  4. George Brandy

    George Brandy Active Member

    Re: Treating Verruca

    Hey everyone

    I just want to hear from you - in your experience: What have you found to be the most effective, quickest method of treating verruca? ESPECIALLY in kids!


    Oh my goodness - I would not go near kids with electrocautery, nor dry needling nor cryo as a first line of treatment unless these are incredibly brave children or I want to put a fear of Podiatrists in them for life.

    With children I don't believe speed is the main criteria; effectiveness yes and this starts with breaking down the hysteria that surrounds the Human Papilloma Virus. I begin with educating the child and the parent. In many cases the parent may have been treated before and maybe the child but nobody has explained etiology, pathology, treatment options and outcome. All is explained in lay terms and using language that most children over 5 can understand. As a profession we are hopeless at making the time and effort to explain about foot pathology and treatments. There is a difference between telling for purposes of red tape and explaining.

    At this point the decision making is interactive and we (patient, parent and myself) decide what is the best treatment option. Sometimes it is no treatment but more often than not I use a keratolytic with the aim of making the VP more comfortable by removing callus/skin bulk in the kindest way possible. It is amazing how often one such treatment stimulates the immune response. But from this effective treatment it builds confidence in the child to explore other treatment options if needed.

    I do not believe there is a one size fits all treatment for children and VPs. I would add to Robert I's comment that not only does it depend on the lesion but on the child it is attached to. Therefore to treat a child effectively I guess I treat them holistically and adapt to their needs rather than mine as a clinician.

  5. Re: Treating Verruca

    Good point well made.
  6. JB1973

    JB1973 Active Member

    Re: Preferred Methd for Treating Verruca

    Robert, interested in the dry needling for verruca. How exactly would you do that. does the size of lesion relate to the size of needle? do you needle around the lesion. i use dry needling a lot for plantar fascia, PDN etc etc but have never thought of it for verruca
  7. footfan

    footfan Active Member

    Re: Preferred Methd for Treating Verruca

    Robert is right dry needling , Kirby and all the other big names like it. Theres a thread on it here admin will probably post soon. ********Remember only treat when needed*********
  8. Re: Preferred Methd for Treating Verruca

    Yeah, I'm sure someone will link to the Dry needling thread for you JB.

    The thread was on the preferred method for treating Verruca. As I say my preferred method is dry needling or blunt dissection.

    However this presumes that Its me treating and that treatment is required.

    If we're talking pathways...

    In kids, I won;t treat if its not painful. Ever.

    If it IS painful, I won't treat if the pain is caused by the patient / parent home treatment. And in my experiance it generally is. Small inoffensive vp sitting in the middle of a bloody great chemical burn is not a painful VP. In those cases I send the patient away with instructions to use duct tape for 6 months and come back if its still painful in 3. They rarely do.

    IF Its painful, and if it is the VP which is painful, not the damage the patient has caused in treating, then My next consideration is the patient themselves. Age, and more to the point maturity, tolerance, lifestyle, the nature of the lesion etc.

    Only then do I make with the needle, if appropriate.
  9. Re: Preferred Methd for Treating Verruca

    Here you go JB and I guess Andre if you want to see what their discussing it´s a long one - http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=25720
  10. footfan

    footfan Active Member

    Re: Preferred Methd for Treating Verruca

    Robert it amazes me that people forget this and still go gung ho with monochlor!!

    Oh and i loved the exchange on youtube with the scholl prefab dissing crew, i was going to comment after he decided to place a minature CV because he couldnt counter your argument but thought he obviously doesnt know who hes talking to. He did get a bit personal at the end though.


    Loving your biomechs in Pod Now keep them coming =D
  11. James Welch

    James Welch Active Member

    If it's not painful and/or isn't spreading/increasing in size why on earth is it being treated in the first place? :bang:
  12. Yeah, he is a bit of a silly man!

    Its a common complaint. People who are isolated and speak to only patients and students often get the idea that anything they say / think is de facto true, then get all upset and tell us how many patients they've seen in how many years. I used to be exactly the same before I discovered pod arena.

    Bit naff though wasn't it!
  13. Often happens.

    Ironically, with VPs as with orthoses, sometimes it takes more confidence NOT to treat something than it does to attempt to treat it.
  14. JB1973

    JB1973 Active Member

    Thanks for the link guys. I tend not to treat v/p if at all possible - especially in kids but the dry needling idea interested me for the couple that I would.
  15. James Welch

    James Welch Active Member

    I couldn't agree more :D
  16. magda66

    magda66 Active Member

    Re: Treating Verruca

    Oh thank goodness for that! i was feeling very lonely and isolated recently.

    In my practice i've tended to not treat unless painful/spreading and focus on discussing the nature and progression of vps, but i recently urgently covered for a colleague who uses 60- 70%sal acid/ sal acid-monochlor combo routinely and had a few (mostly children) coming in weekly with bandages and padding stuck on because that's how they were treated in that clinic.

    The parents were trying to direct treatment because of the stigma associated imo and weren't interested just wanted rid of them. it was just an awful experience. Some had been attending for up to two years! with breaks for holidays. i'm glad that's over. learned a lesson tho to check about vp treatment before agreeing so easily in future:eek:
  17. footfan

    footfan Active Member

    Remember if its spreading excessively think immuno compromised and refer to be checked
  18. Here is fun.

    Vps are presumed to be contagious. I've always wondered about that. If vps are contagious how is it that a man can shower barefoot for years and his wife can share the shower but not catch the lesion? Viral infections are obviously hard to study in vitro and there are ethical considerations to studying them in vivo.

    I've always had a hankering to do a trial on this, trying to deliberatly infect someone to see if it can be done. Trouble is the ethics commitee would probably have an issue with me rubbing warty people against un warty people to make them warty.

    However. My daughter has a verruca.

    I wonder. Were I to tape scrapings from the lesion to my own foot, could I create an infection?

    I summon the dermatolgists among you to give me a protocol... (psst, that you missy)
  19. airamasor

    airamasor Active Member

    The problem is that some health professionals (GPs) will advice the parent to leave the VP alone because "it will go". I've tried to refer a couple of patients because I believe they could be immuno compromised and no tests have been done. So, what else could I do?
  20. Andre Hugo

    Andre Hugo Member

    Hey Everybody

    Thanks for the valuable comments!:drinks

    Vernon - yes I am ex-SA, my becoming a pod is really because of your practice - my sis had some ingrowns done with you and I had mine done with Warren!!

  21. Deborah Ferguson

    Deborah Ferguson Active Member

    Hi All
    I have found ( anecdotally) that occlusive tape and gentle paring if required works really well in children. I know there is no evidence, not in Cochrane etc. but it seems to work and I have had very good results. I'm happy with minimally invasive treatment with children and I reduce the charge to the parent accordingly.


  22. Rosemary C

    Rosemary C Welcome New Poster

    I'm with you though I advise painting the verucae with clear nail polish to occlude. That way you can see the verucae, it is sealed so less likely to be spread to other people and kids can do it. I debride first.
    Also ask parent if childs diet is good (had one who was a vegan and having a growth spurt= multiple verucae)
    The other I recomend is Thuja a homeopathic treatment. Always discuss cause, options etc.
    Will offload with padding if necessary
    Last edited: Nov 24, 2010
  23. Not a word Harland!! I know where you live!:butcher:
  24. DTT

    DTT Well-Known Member

    TTTT TTTT TR TR TR ............... Can't do it:eek:

    My lips are sealed as promised young man:D

    Be quick with Eleanors VP's mate they will be gone soon if you apply as I directed :rolleyes:

    Cheers Buddy
  25. blinda

    blinda MVP

    Anything to declare Isaacs?
  26. [​IMG]

    Yeah but... no but anyway I never even said nuffin and even if i did it wasn't like there was nuffin goin on, but there was this fing that was like WELL not bad, like the one what you saw but it wasn't even like that so shuddup, and it was like WELL sub clinical only there was this woman who probly didn't even know what it was but was like WELL keen to get rid of it only it was just gettin sore and mingin' but the kid was like "I want it treated" and I was like "SHUDDUP" cos it was not even like bad enough to treat but they was like "go on then" and I was like "I ain't gonna" and they was like "but you got to" and I was like "but I ain't though" and then this bloke harland, you know the one what uses arnica on like bruises and stuff but I didn't even do that cos that is like WELL wrong and there ain't no evidence or nuffin cos bruises get better by themseldves and it is SOOOO just regression to a mean so don't listen to him, and anyway he has a well munted foot which has like a fixed STJ and stuff but anyway he like gave me a look and I was like "whatever" cos I wasn't going to do nuffin but anyway i had to cos the patient wanted to so...

    I may have recommended tea tree oil once or twice for verrucas which did not hurt and I didn't want to treat but the patients were determined they wanted to. And maybe my daughter.

    I feel dirty.
  27. DTT

    DTT Well-Known Member

    Could you say that a bit louder so we can all hear ??:rolleyes:

  28. blinda

    blinda MVP

  29. James Welch

    James Welch Active Member

    Hhhmmmm, I'm feeling a definite love for Thuja in the room :dizzy:
  30. blinda

    blinda MVP

  31. Is that it ??????????

    If either of you wrote OVERPRONATION,

    Well I´d hate to think......... be nasty

    here is a mirror take a good hard look at yourself, Isaacs tut tut tut

    Attached Files:

  32. DTT

    DTT Well-Known Member

  33. blinda

    blinda MVP

  34. I WAS WEAK!!!! I STRAYED!!!


    Did you not get the memo?:eek:

    I really am more than slightly ashamed! But everyone else was doing it! It looked safe enough so I tried it a bit! I liked it! But I could stop any time I liked!

    Look. I have never, for even 0.00001 seconds believed that Tea Tree oil (I cringe even to write it!, can you ever forgive me bel?) is any more likely to work than aqueous cream, eye of newt or anything else. But I looked at it this way.

    With some patients the wart is not the painful bit. The bit that hurts is the persons attempts at treating the wart causing a chronic chemical / thermal burn aggravated by regular trauma from a file. Thus my treatment objective is to prevent said burn. Now I judge that the patient is unlikely to take my word for it and leave the thing alone. They are GOING to treat with SOMETHING whatever I say. Thus the treatment is a sort of "blocker" to prevent them from hurting themselves. Thus, it cures the pathology (the self induced damage), allowing the VP to clear up in its own good time.

    I'm not selling this am I... I'll just go and start boil the tar for Belinda (she's a busy woman and you know how long it takes for a whole cauldron!)
  35. DTT

    DTT Well-Known Member

    Ahhhhmmm Isaacs

    Have I not heard something very very similar before.......:rolleyes:

    But I wouldnt say from where ...would I ...:D

  36. Well if the wheels are falling off and the beens being spilled do tell - its PA day time soap. It´s got me !!! what skeleton will fall from the closet next.........................
  37. DTT

    DTT Well-Known Member


    I'm afraid Isaacs will have to divulge that information..wild horses or pins in the eyes wouldnt drag the information from me :D
  38. Actually you have me there! I actually am not sure what you are talking about there. And no I'm not just wriggling!
    I'm a transexual tree worshipper who enjoys sexual congress with farm animals and watches Emmerdale if that helps Mike (sotto voice :- trying to distract attention away from the more embarrassing revalation which went before. )
  39. I was hoping for marigold therapy on the bunions.

    Thats pretty boring

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