Thursday 27 June 2019

Dear Dr Nina: My daugther has two verrucas - should I bring her to the GP?

'There are a number of treatments you can do at home'
'There are a number of treatments you can do at home'

Nina Byrnes

Question: My daughter is six-years-old and already has two verrucas. I have tried all the over-the-counter remedies, but nothing has worked. Should I bring her to the doctor to get them removed? Also are there any preventative measures I can take to prevent recurrence?

Dr Nina replies: Verrucae are warts occurring on the soles of the feet. They can be more problematic than other warts as the weight of the body tends to push them into the skin making them a little harder to treat.

Most people develop warts at some stage and they are thought to occur in about one in 10 people at any one time. They don't do any harm, and most will resolve themselves over two years, but they can be unsightly and bothersome.

Don't allow your daughter to pick, bite or peel the verrucae. This increases the chance of spreading the virus to her hands or other parts of her feet. If the verrucae are not bothering her it may not need any treatment at all. Many parents want treatment because the verrucae can be unsightly.

There are a number of treatment options. Applying duct tape was shown in one study to be a painless effective treatment. Apply the tape. Leave it for six days. Take it off. File the skin then leave it off over night and reapply the next day. Over-the-counter products containing salicylic acid are a common treatment choice. This needs to be applied every 24 hours. The dead skin must be filed off each day before reapplying for maximum effect.

Your GP cannot remove the wart, but can freeze it. This is called cryotherapy. Liquid Nitrogen is sprayed from a short distance directly onto the verrucae until a frozen halo appears. During the thaw the tissue is damaged thus treating the wart. It may take several treatments to fully treat the verrucae. Complications include blistering, scarring or changes in skin pigmentation and feeling.

When deciding what, if any, treatment to use it is important to consider the side effects and consequences. Cryotherapy can be painful and wouldn't be the first choice in young children. Those who have diabetes or poor circulation shouldn't have cryotherapy either.

Watching and waiting is a reasonable option if the verrucae are small or superficial. Combining cryotherapy with salicylic acid (one used a few days after the other) may speed up the treatment process in others. If you are treating verrucae do treat until they are gone, as partially treated lesions may flare or spread to other areas.

The best way to prevent verrucae is to avoid contact with the virus. They can be contagious in open wet areas, so it is worth wearing special shoes in shared areas such as showers and pools if you want to reduce the risk of spreading or catching the virus. If treating, start early to reduce the spread.

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