Why won’t my verruca go away? What Verruca Needling involves and whether it’s right for you.

By Katrina Corby, Podiatrist | Havant Foot Clinic

If you’ve had a verruca for months — or in some cases years — and you’ve tried more or less everything the pharmacy shelf has to offer, I want you to know two things straight away. First, you haven’t done anything wrong. Second, there is another option, and it’s one I use regularly at Havant Foot Clinic for exactly this situation.

I see a lot of patients who’ve reached the point of being genuinely fed up. They’ve frozen it, painted it, taped it, worn the silly verruca socks at the pool. It’s still there. It still hurts when they stand on it a certain way, or every time they put their boots on for work. That frustration is completely valid, and it’s exactly what this post is for.

Let me explain why some verrucas are so stubborn, what your options actually are, and what a procedure called verruca needling involves — including what it’s really like, not the sanitised version.

Why Some Verrucas Just Won’t Go Away

What’s actually happening under the skin

A verruca is a wart caused by a viral infection — specifically the human papilloma virus, or HPV — living in the outer layer of your skin. It’s not a hygiene issue, and you haven’t caught it from doing anything wrong. The virus tends to get in through tiny breaks in the skin, often picked up from damp communal areas like swimming pools, showers and changing rooms, where it can survive on surfaces for a while.

Once it’s in, the virus causes the skin cells in that area to grow and thicken faster than normal, which is what creates the rough, raised patch you can see and feel. On the sole of the foot, where there’s constant pressure from walking and standing, that thickened patch often gets pushed inward rather than outward, which is part of why plantar verrucas can be so uncomfortable compared to warts elsewhere on the body.

Why your immune system sometimes struggles to clear it

Here’s something that surprises a lot of patients: verrucas usually do go away on their own eventually. Your immune system will, at some point, recognise the virus and clear it. The trouble is “eventually” can mean anywhere from several months to a couple of years in adults, and for some people, longer still.

Part of the reason adults often take longer to clear verrucas than children is simply about where the virus lives. It sits in the very outer layer of skin, an area your immune system doesn’t naturally patrol as closely as it does deeper tissue. Some people’s immune systems pick up on it quickly. Others, for reasons we don’t fully understand, seem to tolerate it for a very long time without mounting much of a response at all.

I had a patient earlier this year, a young man who works on a building site, who’d had a verruca on his foot for over seven years. Seven years! He’d tried pretty much every over-the-counter option available, plus the usual freezing treatments. Every day at work, in steel-toe boots on concrete, that verruca reminded him it was there. He’d been quietly adjusting how he stood, how he walked, just to take the pressure off it, for years. That’s the kind of patient where I think: this verruca has had every chance to resolve on its own, and it hasn’t. It’s time to talk about something more direct.

What You Can Try First and When It’s Time for Something More

The standard first-line options, and why they sometimes aren’t enough

If a verruca isn’t painful and isn’t bothering you, the honest clinical advice is often to leave it alone and let your immune system do its job in its own time. Treating something that isn’t causing a problem can sometimes cause more discomfort than the verruca itself.

When treatment is wanted, salicylic acid is usually the first thing to try. It’s inexpensive, available from any pharmacy, and works by gradually breaking down the thickened skin. The catch is that it needs to be applied daily for at least twelve weeks to have a real chance of working, and a lot of people either lose patience or find their skin becomes too sore to continue.

Cryotherapy, freezing the verruca with liquid nitrogen, is the next step up, usually repeated every few weeks over a few months. It can be effective, but it’s not a single appointment fix, it can be quite painful at the time, and it doesn’t work for everyone.

Swift, which is a microwave treatment and needs to be carried out regularly (fortnightly)

Verrutop, a liquid that affects the DNA of the Verruca, also needs to be carried out regularly (fortnightly)

These are perfectly reasonable starting points, and for a lot of patients, they’re all that’s needed. But if you’ve genuinely given a treatment a proper go, the full course, done correctly and the verruca is still there, that’s useful information. It tells us something about how that particular verruca is behaving, not that you’ve failed at home care.

When needling becomes worth considering

Verruca needling tends to be the right conversation to have when a verruca is painful, has been there a long time, hasn’t responded to salicylic acid or cryotherapy, or is significantly affecting daily life, whether that’s how someone stands at work all day or whether they can comfortably go barefoot on holiday.

I want to be honest with you about the evidence here, because I think you deserve a straight answer rather than an inflated one. Needling has a good track record in clinical practice, and many patients do well with it but like every verruca treatment, it isn’t guaranteed to work for everyone, and no responsible podiatrist should tell you otherwise. What I can tell you is that it offers something the other options don’t: a single, more direct intervention, rather than months of repeated visits with uncertain progress.

The major consideration for my client was that he was not able to commit to continual appointments every 2 weeks for treatment.

We agreed needling was his best course of action

BEFORE Needling

AFTER needling