Verrucas are plantar warts (ie on the sole of the foot), caused by the human papilloma virus. For most people, CKS guidance says there is a strong case for not treating warts or verrucae. However, treatment should be considered if the verruca is painful, cosmetically unsightly, or the person requests treatment as the verruca is persisting.23

Treatment options in primary care include:23

·      topical salicylic acid (15%-50%) applied daily for up to three months (suitable for younger children)

·      liquid nitrogen cryotherapy used fortnightly for up to six treatments (for older children only if they can tolerate the treatment)

·      combination, with topical salicylic acid applied between cryotherapy sessions once the cryotherapy scabbing has resolved.

The CKS guidance does not recommend occlusion (eg with duct tape) or silver nitrate, due to a lack of efficacy evidence. CKS advises of other treatments which it says should be reserved for secondary care, including glutaraldehyde. However, this is available in a Pharmacy (P) medicine, licensed for €the topical treatment of warts, especially plantar warts.€

The virus is not considered highly contagious, and it is not understood why some people are more susceptible to verrucae than others. As the virus can spread through infected skin scales on the floor of locker rooms or by swimming pools, it is advisable not to go barefoot in public places. People with a verruca are advised to cover it with a waterproof plaster or swimming sock to help stop the spread.24