A verruca is a type of wart that develops on the foot as a result of infection with certain strains of the human papillomavirus (HPV). The virus enters through tiny breaks or abrasions in the skin, which is one reason verrucas can develop after contact with contaminated surfaces or through close contact with an infected area.

Verrucas commonly appear on the soles of the feet, including the heels and the ball of the foot. They may look like small, rough or hardened patches of skin, sometimes with tiny black dots within them. These dots are small blood vessels within the affected tissue rather than roots.

Because the feet bear your body weight, a verruca on a pressure-bearing area can be pushed inwards and covered by hard skin. This can make it uncomfortable when standing or walking.

Verrucas can sometimes resolve without treatment, but this may take months or even years. Some remain stubborn, become painful or spread to other areas. If you're unsure whether a lesion is a verruca, it is best to have it assessed rather than assuming that every rough patch of skin needs the same treatment.

When should you see a podiatrist about a verruca? 

If your verruca is responding well to at home topical treatments, then you might not need to see a podiatrist. However, if you are experiencing any of the following, professional assessment is recommended: 

1. You're unsure whether the lesion is a verruca

It's not always easy to tell the difference between a verruca and other common foot conditions. Corns and calluses, for example, can also appear as areas of thickened, hardened skin 

Treating a lesion without knowing what it is can mean spending time and money on an unsuitable product. Some treatments can also irritate or damage the surrounding skin.

If you're unsure, a podiatrist—with access to a dermatoscope—can examine the area and help establish whether it is likely to be a verruca or whether another problem needs to be considered. You can also read our guide on corns and calluses and their treatment. 

If a skin lesion is growing rapidly, bleeding without an obvious reason, changing colour or looking unusual, arrange prompt assessment with your GP.

2. It's painful when walking

When a verruca develops on the heel or ball of your foot, the pressure created by standing and walking can compress the affected tissue. The verruca may also develop a covering of hard skin, making it more difficult to distinguish from other painful lesions.

You might notice a sharp sensation when putting your foot down, feel as though you're walking on a small stone, or find that the discomfort becomes worse after spending a long time on your feet. This can make everyday activities more difficult and potentially place additional strain on other parts of your feet or legs.

If your verruca is painful enough to affect your walking, it's worth having it assessed. A podiatrist can discuss suitable treatment options and advise on managing pressure and discomfort as the area heals.

3. It has been present for a long time

Verrucas ‘hide’ from the immune system by forming in the outer layers of the skin. Our immune systems are naturally very good at fighting off the HPV virus, but it can take a significant period of time for an immune system to identify the presence of a verruca. This means it can take several years for it to begin disappearing, sometimes even with at home topical treatments. 

If this is the case, more intensive treatment options may be required. 

At The Bell Practice, options include Swift Microwave Therapy and verrucae needling, alongside other treatments selected according to the individual case.

4. It appears to be getting larger

If you've noticed that your verruca is becoming larger, developing a thicker surface or changing in appearance, it's worth getting it checked by a professional. Enlarging verruca are often not cause for concern because they can significantly change over time without causing damage, however there is always the possibility that an enlarging patch of skin on your foot is something other than a verruca. 

In this case, it will require assessment and diagnosis to make sure the correct treatment is prescribed. 

If the lesion is changing rapidly or bleeding, seek prompt medical assessment

5. You have developed several verrucas

Verrucas are caused by a virus and can spread to other areas of skin. Clusters of warts can develop across the sole of the foot, sometimes forming what is known as a mosaic wart pattern.

When several lesions appear together, the affected area can become more difficult to manage from home. A podiatrist can assess the affected area and discuss an appropriate treatment plan, taking into account the number of lesions and any previous treatments you've tried.

6. It has spread to another area

Verrucas can spread through contact with infected skin or contaminated surfaces. The virus is more likely to spread when skin is wet or damaged, and it can take months for a wart or verruca to become visible after exposure.

You may notice a new lesion close to the original verruca, or you might be concerned about passing the virus to someone else.

A few simple precautions can help reduce the risk of spreading it:

• Avoid picking, scratching or cutting the verruca
• Wash your hands after touching the affected area
• Don't share towels, socks or shoes
• Wear footwear in communal changing rooms and showers
• Change your socks daily and keep your feet clean and dry
• Cover the verruca appropriately when swimming
  
  

7. Home treatment hasn't worked

Pharmacy treatments, including salicylic acid and cryotherapy (freezing) kits, are a common first step for people trying to get rid of a verruca. However, these treatments don't work for everyone. Some require repeated application over several weeks, and treatment can irritate the surrounding skin if it isn't used correctly. 

These treatments are likewise not suitable for anyone who has sensitive skin, immunosuppression or poor tissue viability (due to bad circulation, diabetes etc)

If you've followed the instructions and your verruca hasn't improved, it may be time to seek an assessment from an expert podiatrist.

Avoid repeatedly applying stronger products or trying to cut the verruca out yourself. This can damage healthy skin and cause bleeding or infection.

At The Bell Practice, we offer several professional verruca treatments, following assessment and diagnosis, including:

• Swift Microwave Therapy: Targeted microwave energy to treat the affected tissue and stimulate a local immune response.
• Verrucae needling: A procedure carried out under local anaesthetic that aims to stimulate the body's immune response.
• Cryotherapy: Uses freezing to treat the affected tissue.
• Verrutop: A topical treatment option that may be suitable for selected verrucas.
  
  

8. The verruca is affecting your confidence or daily activities

It’s important to recognise the emotional impact that persistent verrucae can have. The presence of a verruca can impact your confidence and influence how comfortable you feel in situations that were otherwise simple before. The discomfort can likewise influence how you feel when exercising or leaving the house, even driving your car. 

If any of the above sounds familiar, please don’t hesitate to contact The Bell Practice. Our clinical specialists have helped countless patients regain their confidence by removing stubborn verrucas down to the root. We offer a free verrucae consultation, giving you the opportunity to discuss your symptoms and understand which treatment options may be appropriate for your circumstances including Swift Microwave Therapy.