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Price for Verrucae Needling

Discussion in 'General Issues and Discussion Forum' started by lucycool, Feb 22, 2011.

  1. lucycool

    lucycool Active Member

    Members do not see these Ads. Sign Up.
    I'm about to start advertising needling for verrucae at my PP. I currently charge £35/tt, but am wondering how much you would suggest for needling and how long I should book each pt in for? I have quite a lot of VP pts at the mo (maybe due to working in a gym!) so should I add something for loss of £ after the needling?

    Any advice gratefully received. I hate coming up with prices!!

  2. £485 per course of Rx which should include Rx (under LA), debridement after 2/52 and follow-up review after 1/12. Additional VPs + £100 each but Rx at same time. 1st appointment 45 mins follow up and review 20 mins.
  3. lucycool

    lucycool Active Member

    How much do people charge for nail surgery too? I'm thinking I may be under charging?!

    Thanks again,

  4. Mary Walden

    Mary Walden Welcome New Poster


    Can anybody tell me where I can get verrucase needling training

    many thank

  5. stevewells

    stevewells Active Member

    where are you mary?
  6. Catfoot

    Catfoot Well-Known Member

    In order to be able to treat patients with VP by 'needling' you first need to be trained and competent to administer LA. I notice that you are not annotated on the HPC register for this ?
    I would suggest, therefore, that your first task would be to obtain your LA qualification.


  7. Mary Walden

    Mary Walden Welcome New Poster

    Hi Catfoot

    Many thanks for your help, I will enquiry about the LA qualification.

  8. doonbeg

    doonbeg Welcome New Poster

    I'm also interested in offering dry needling for vp rx in pp. I'm HPC registered with local anaesthetics so does that cover administering LA into the plantar aspect???
    Regarding nail sx I currently charge £275- £295 for nail surgery.
  9. blinda

    blinda MVP

    Your LA certificate will cover you for podiatric use where indicated, ie anywhere on the lower limb, as long as you have had the relevant training for specific treatments, such as electrosurgery.

    Needling is rather different, as there is no formal training for this procedure. However, if you have not used LA for any procedure other than digital ring blocks (which is sadly the case with many pods), I would strongly advise you to find a pod who is willing to mentor you in different LA administration techniques. Tip; administering LA through the plantar aspect REALLY HURTS!

  10. VFC

    VFC Welcome New Poster

    This is my first time posting here. Im a private podiatrist practicing near Belfast in Northern Ireland. I have been interested in the dry needling technique for verrucae treatment for a while now but haven't actually tried it yet.

    I was wondering if tibial and sural LA blocks were the blocks of choice for plantar lesions? I have read several people on here talking about administering LA directly around the lesion before needling.

  11. W J Liggins

    W J Liggins Well-Known Member

    Hello VFC. Welcome.

    I think that the L.A.technique is largely a matter of choice. If working on the plantar surface I invariably use a tibial block. However, I was chatting to David Wiley in Glasgow a few years ago concerning serial LA infiltrations for plantar fasciitis and he said that he usually infiltrated directly - mind you, they do regard themselves as tough in that neck of the woods, although he was probably asking to be shivved by a razor king!

    The problems associated with the tibial block are briefly:

    you need to learn the technique

    the effect is variable - especially when inexperienced

    speed of onset is relatively slow, so you need to allow for this (have the patient sit in the waiting room and see someone else whist the block is taking effect)

    patient cannot drive until the block has worn off

    hyperaemia will result in the needled area bleeding

    In my experience, you will only need to carry out a sural block if the lesion is on the very lateral aspect in most people

    Hope this is helpful

    Kind regards

    Bill Liggins
  12. stevewells

    stevewells Active Member

    Could we please stop calling it "Dry Needling" - isnt that an accupuncture technique?
  13. I rarely use a tibial block for the reasons outlined by Bill, preferring to infiltrate plantar lesions. Providing the injection is given slowly allowing time for the anaesthestic to take - and adequate coaching given to the patient prior to the injection, there is minimal intraoperative discomfort.
  14. lucycool

    lucycool Active Member

    Hi All,
    Thanks for all your input. I've now done my first procedure on 2nd/3rd MPJ and injected through the ID space and then posterior to met heads. I also sprayed xylocaine onto the area first to minimise pain. I don't know whether my pt was just very brave or I was slow enough, but he seemed to be in minimal discomfort.

    Thanks again,

  15. Graeme Franklin

    Graeme Franklin Active Member

    What do you do if the first needling is unsuccessful Mark? Do you offer the second needling foc or at a discounted rate?


  16. Hello Graham

    I've had six patients out of 316 who have required a secondary treatment. I charge a course fee nso additional Rx is included in the initial charge.

    Best wishes
  17. Graeme Franklin

    Graeme Franklin Active Member

    Hi mark,

    Impressive figures.

    I haven't quite reached your number of needlings! Just curious if you needle as per Kirby and use a 27g needle to a depth of 7-8 mm and puncture until no resistence is felt? Just that to offer a follow-up re-needling can negate any profit made in the first place if the success rate is less than 80% or so.


  18. I guess it depends on how you work the financials and what's more important; profit or otherwise. I use an 18g needle otherwise the same as Kevin although I occasionally cauterise with phenol when there is obvious post op haemhorrage.
  19. Tracy.gill

    Tracy.gill Active Member

    Hi as well as providing the normal podiatry treatments, I also specialise in using electrolysis to dry needle around the verrucae using a mild electric current through the needle, then needle all over at a depth to make the lesion whiten and to finish treatment puncture through the middle of the vp which makes it bleed, stem with AGn03 as a styptic to stop any bleed and cover with pad/dressing. Just another treatment option which has a 25% success rate on first treatment, but often needs 4 to 6 treatments 2 weeks apart for 80% success rate. (data has been collected by myself over a four year period on my own patients- therefore I am quite happy that I am having a moderate success rate, as compared with cryo or acid treatments alone which takes many more treatments or patients simply give up!) I trained with Sterex in Birmingham on their Advanced Cosmetic Procedures course, as I am a qualified Beauty Therapist & Electrologist, so I can treat various lesions from skin tags and verruca and have separate Insurances for these procedures. Is there anyone else interested or use electrolysis for verruca? Would like to hear about success rates?
  20. blinda

    blinda MVP

    That`s interesting, Tracy. I`d be very interested to read any papers on the subject. 80% success rate is quite something! Do you have any references that you can pass on from your training, please?

  21. blinda

    blinda MVP

  22. blinda

    blinda MVP

    Nothing from Tracy? Genuinely disappointed.

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