Verrucae is the term used for tumors of the human papiloma virus (HPV) when they occur on feet (called warts when on other areas of the body) They can infect any area of skin but are most common on feet and hands as they are contact areas allowing passing of the infection.

They can sometimes disappear without treatment but often they persist for many years. Even if they do resolve on their own, in the time they are present they can spread to other areas of the body and other people. Being contagious it is best to treat them as soon as possible.

Another reason to treat early is that verrucae are much more difficult to treat if they have been allowed time to grow. This is less of an issue for warts on hands as they grow outward from the skin, however a verruca on the sole of the foot will get pushed deeper into the skin, gathering blood supply from the surrounding tissue. The deeper they are the more difficult it is to apply sufficient treatment without damaging surrounding tissue and treatments therefore tend to be more painful and less successful for older verrucae.

As it is becoming very common to hear of patients being advised to try duct tape (or duck tape / gaffer tape) it is worth explaining the history of this treatment and why it is unlikely to work for verrucae. Anecdotal evidence that this treatment can work seems to have originated from the army where soldiers are trained to inspect their feet every day and therefore will notice a verruca in it's early stages. Applying any occlusive (water-tight) tape will macerate (waterlog) the tissue causing superficial destruction so that the top layer of skin can be peeled off (very much like the top of a blister) taking the superficial new verruca with it. A small study was then performed which showed that using duct tape was a little more effective than cryotherapy (freezing) but crucially the majority of subjects were children with warts on their hands. Unfortunately this study of 50 children has been widely misinterpreted and used as evidence that duct tape is also likely to work for any verrucae. Two later studies on adults and children have since shown that it does not usually work on feet but these have been widely ignored (links at bottom of page).

However if you or your child have a very new verruca, no more than a few millimeter in diameter and that doesn't feel at all like a lump, it is still worth trying. Cut a piece of any waterproof tape just a little bigger then the verruca and hold it in place with a non-waterproof white medical tape (Mefix/Hypafix/Micropore etc). Leave it on for up to a week, if you think it has moved re-apply in the correct place, do not let the skin dry out between applications. You are aiming to make the skin just around the verruca turn brilliant white at which time it might come off when you remove the tape or can be carefully peeled off like the top of a blister. If the verruca has gone you should see no disruption of the lines in the skin, if in any doubt try it again a few times. If after a month it's not gone, or there is any redness/irritation of the skin, seek professional help before it gets any bigger or spreads.

If you or your child have verrucae more than a few millimeters diameter, if it feels lumpy or there are more than one of them it is too late to expect tape to work. Salicylic acid works in a very similar way by water logging the tissue and on established verruca even high doses of high strength acid has trouble so tape alone really has no chance of working. It is best to seek professional help.

The Paulton Podiatry Clinic offer a number of treatment options including chemical treatments, cryotherapy and electro-surgery (desiccation/hyfrecation) and these will be explained for you before any treatment begins. Occasionally it is decided to opt for one of the milder treatments available in the pharmacy, especially with very young children, however a podiatrist is the best person to advise you on which treatment to use and most importantly how to apply it properly, there is a technique that works best. Also if it is on a pressure point the verruca might be covered in hard skin which would need to be removed for the treatment to work and this can only be done by a podiatrist.

Links to tape studies -

• Focht DR 3rd, Spicer C, FairchokMP; The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med. 2002 Oct;156(10):971-4. [abstract] [full paper]
• Wenner R, Askari SK, Cham PM, et al; Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial. Arch Dermatol. 2007 Mar;143(3):309-13. [abstract]
• de Haen M, Spigt MG, van Uden CJ, et al; Efficacy of duct tape vs placebo in the treatment of verruca vulgaris (warts) in primary school children. Arch Pediatr Adolesc Med. 2006 Nov;160(11):1121-5. [abstract]