Did you know, research has found that most people in their lifetime will develop a wart? Not necessarily a verruca, but a wart on some part of their body? That's a lot of warts in the world! Most patient's who visit my practice have a few concerns about their verruca (a wart found on the foot) such as how big it is, how painful it is and how long it's been there. By the time most patients are sitting on my treatment couch they've tried, unsuccessfully to get rid of their wart at home using self treatment. And it's not really surprising because most patients have absolutely no idea what they are trying to treat or the science or biology behind the treatment they're using. And why should you know how to treat it effectively? You all have busy jobs, from stay at home mum's to retired school teachers, accountants to photographers, there aren't enough hours in the day to work out how on earth to destroy a wart too! Today I want to talk about children's feet and verruca's!
So let me talk you through the essentials. Warts are common, really common! They are caused by the Human Papilloma Virus (with 3 strains of this HPV causing verruca's). Most children develop warts on hands and feet during the formative years. The virus is transmitted via foot-to-floor, floor-to-foot contact, such as walking barefoot in the changing rooms at the swimming pool. The abrasive flooring/ tiles are enough to graze the surface of the skin allowing this virus entry into the body. Hey presto! Up to 6 months of incubation and maturation and there we have a verruca.
They can be unsightly and distressing for children, and in some instances they can become very painful and make walking or sports difficult to take part in. This can cause distress to both the child and their parent. As parents we never want our children to experience pain or emotional distress, we don't want them to become self-conscious of any part of their body, or to be made fun of because they're different. So we react in the best way we can, we try to make it better don't we? Most parents who bring their child in for a consultation and treatment have already tried to self-treat little Johnny at home. The reel off a list of treatment's they've tried...freezing ("it was too painful and he wouldn't let us do it more than twice"), using a popular brand of verruca gel ("we used it as the packet said but the skin got red and sore, but the verruca never went away"), tea tree oil ("nothing happened at all and we used it for months!")...there's a very long list of treatments that have been tried found on Google or Netmums.
As a podiatrist and a mum I understand that you think you need to treat this as it looks ugly and you know it can be contagious. Before you run off to the chemist, ask yourself these things:
1. Is it painful?
2. Is it causing my child emotional distress?
3. Has it been there for more than 2 years and is also either painful or causing distress?
If the answer to number 1 and 2 is no, just don't bother to treat it. Most verruca's spontaneously resolve in 2 years in children. Their immune system is incredible and will eventually see this clever little virus and seek and destroy!
If you answered yes to number 3 then you have good grounds to start treating the verruca. So what do you use? Freezing sprays...these really don't work terribly well. I know as a podiatrist that i couldn't get rid of a verruca with one of those! Why? Well, you can't form a good enough ice-ball within the verruca tissue, or hold the freeze for long enough with one of these products. You need to know that it's not how cold you can freeze the verruca tissue down to that kills the verruca, it's actually cell destruction caused by the thawing process to the verruca. Clever eh?!
Verruca gels containing salicylic acid...some have a brand name some do not! They all contain something called salicylic acid. Some parents have found them effective, a lot of parents have tried this form of treatment and found they have no success. In some cases colleague's have seen children who have been treated repetitively with these products, have a foot too painful to walk on and when investigated at a podiatry consultation, pus is released from an ulcer caused by the salicylic acid. Our children have fragile skin which can react violently to these chemical treatments. These products cause maceration (water logging) of the skin to enable it to peel away in layers and create and acidic environment that the verruca doesn't like to survive in, but they can also cause burns. We don't use these products on children at Melton Podiatry.
Tea tree oil....oh goodness, don't get me started! It does have some antibacterial, anti-fungal and anti-viral properties BUT, all of the clinical research into this oil has found it does not effectively treat the Human Papilloma Virus. It is however a volatile essential oil that can cause skin irritation, especially in direct sunlight.
So if none of these are much good, what are we meant to use I hear you ask?! Try taping over the verruca each day. DO NOT be tempted to use duct tape. I know Google and comments in forums say to do this, sometimes even a practice nurse or GP will advise this if they're not quite as well informed as us pods (it's really not their fault, they don't do our job day in and out)! Duct tape is an industrial product, the adhesive of this tape is used to tape up stuff that won't be held together or needs reinforcement, not skin. And not kids skin! Years ago this treatment was advised, using this tape, as it occludes (covers up) the verruca, it causes water logging of the wart tissue and changes the environment in which it lives. It's still a good treatment, just use ZINC OXIDE TAPE instead (as long as the child doesn't have a zinc allergy). Apply a small square of tape over the verruca every day, or ask the child to do this so they feel empowered and that they are doing something positive to treat their pesky verruca. It doesn't always work, but it's a good first port of call to see if you can resolve it in a gentle way at home before visiting me.
And if this fails, come and see me. Let's have a chat, let me have a look at the verruca, let me ask your child how it feels and how it makes them feel. It may just be the hard skin that forms over the top of the verruca, causing a pressure point, that's causing pain. I slyly and usually painlessly slice this away without the children even knowing what I'm up to (I've got lots of distraction techniques and a special teddy or one of those awful Squashies for them to play with). The kids generally find me funny, unlike my own children!
If your child 8 years old or over, I can use SWIFT microwave therapy(find full details on my website) to zap their verruca. I'm one of only two practitioners in Suffolk who have this breakthrough technology in my practice. It is the most effective form of treatment that we have (over 77% effective in clinical trials) to treat verruca's. No chemicals, no frozen skin, it's practically painless (it feels like a hot scratch for literally 1 second) and has already been chosen as a popular treatment for children who already attend our practice. Why settle for less effective treatment when you can choose a quick clean treatment like SWIFT?
We also have some cool stickers for the brave kids and some really bad knock-knock jokes to tell them too! Children love it here, we'll be placing some of their comments about their experience at our practice on our Testimonials page very soon.