Verrucas and warts are very common and are contagious so you should be careful when walking barefoot. They are caused by the human papillomavirus (HPV) that gets into your skin and starts to develop hard bumps of skin. As the hard skin builds on the bottom of the foot, the body’s weight compresses it and this is what makes it painful. If left alone, verrucae can go with time but they can also get bigger and spread.
It is impossible to predict how they will develop so you should keep an eye on them and try to prevent them spreading, especially to other people. Wart and verruca treatment can vary in severity and this depends on how painful they are and what treatments you have already tried.
Verrucas and warts are the same thing. We call warts on the bottom of the foot verruca, and in other parts of the world they call them plantar warts. They are all caused by viruses that enter the skin and start to develop hard skin, so there is no difference between them. There are different strains of virus that cause them to develop but the treatments remain the same.
Unfortunately none of the treatments available for verrucas are guaranteed because of their viral nature but there are different treatment options.
The different treatments have different reported efficacy, they also however have different possible side effects.
The least aggressive treatment is salicylic acid, which you can buy at a pharmacy. This comes in two different strengths of 12% or 25%. You apply this once a day and file it down once a week. This has the lowest reported efficacy but also the least side effects.
There are other treatments such as cryotherapy. You would usually have one session repeated every two weeks In this treatment short bursts of liquid nitrogen are sprayed on to the verruca. It can be uncomfortable and the area can blister but is more effective than salicylic acid.
More aggressive treatments involve verruca needling or excision. Verruca needling involves first giving you local anaesthetic injection to numb the area, and then puncturing the verruca all over using a needle. The idea is that it mixes the different layers of skin with your blood which stimulates your immune system. If your immune system can detect the virus it will then over a few months resolve it.
Excision is a surgical procedure usually reserved for persistent and painful verruca that are not responding to other treatments. For verruca excision a local anaesthesia injection is required first to numb the area and then the verruca is cut, scooped or burned away. There will likely be some scar tissue from this method
They can go in their own time but equally if left untreated they can keep growing or spread to other areas. Unfortunately they are unpredictable so they need regular monitoring. If your verruca is painful, or you feel it is getting bigger or spreading, you should see a podiatrist.