Information for patients
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This leaflet tells you about a treatment called dry needling to treat your verruca.
What are verrucae?
Verrucae are warts that can occur on the foot. They are caused by an infection in the outer layer of the skin (epidermis). The infection is caused by a virus, called the Human Papilloma Virus (HPV).
Verrucae can be caught by contact with infected skin. They are often caught from the floors of public swimming pools and changing rooms. Infection occurs through tiny breaks in the skin on the foot, especially when your feet are wet.
What are the benefits of dry needling?
There is no definite cure for a verruca, but some treatments can help to clear the warts. Dry needling has been found to be a safe and effective treatment. There is evidence that it works in over 6 out of 10 of cases which is higher than any other verruca treatment. It is different to other treatments for verrucae, as it requires only one or two sessions. Other treatments such as acid therapy require repeated treatments.
What does dry needling involve?
Verrucae needling is performed under local anaesthetic. Injections are given around your ankle or in your foot to numb the skin and deeper nerves around the verruca site. You will be awake during the dry needling but will not be able to see the dry needling or feel any pain.
Once your foot is numb, a sterile, dry needle (a needle without any medication), is inserted into and out of the verruca several times until all of the surface of the verruca has been punctured. This pushes the virus from the outer layer of skin (epidermis) into the deeper dermis layer of skin so that the body’s immune system can come into contact with the virus and destroy it.
What are the risks and possible complications?
Risks and complications with this procedure are very rare but can include:
- Infection. It is important that you follow the advice given to you after your dry needling to avoid developing an infection. However, as you will have an open wound for a few days there is a small risk that infection can occur. Signs of infection include heat, swelling and pain. If this happens you should contact the Podiatric Surgery Department or you GP immediately for antibiotics.
- Scar tissue.
- Problems with local anaesthetic. A reaction to the local anaesthetic is rare and can happen to less than 1 patient in every 10,000.
- Your verruca may not respond to this treatment. You may need to have more treatments.
- Recurrence of the verruca.
How should I prepare for the dry needling?
You must arrange for someone to take you home after the dry needling. You must not drive until the numbness in your foot has worn off as this may invalidate your car insurance.
- Have something to eat before your dry needling appointment so you do not feel faint.
- Bring any inhalers for asthma or medication for angina with you to your appointment.
- Remove any nail varnish and acrylic nails from your toes.
- Be able to return to work or school the day after the dry needling.
- Be able to get back into your normal shoe after the dry needling as the dressing applied to the dry needling site is small.
- Keep the dressing on your foot in place and dry until your next appointment. This is usually within 7 to 14 days following the procedure.
- Only walk short distances for the first few days after the procedure and avoid running as your foot may be sore.
- Rest your foot for the first 2 hours after the dry needling to help prevent bleeding.
- Take a painkiller such as paracetamol if your foot is painful after the local anaesthetic wears off, however avoid ibuprofen because it could stop the dry needling working.
What other treatments are available?
Other treatments can include:
- No treatment.
- Over the counter verruca acid treatments.
- Surgical excision.
- Cryotherapy – a form of treatment that uses cold temperatures.
If you need advice or have any problems, please contact the Podiatric Surgery Department.
North Tees and Hartlepool NHS Trust
Podiatric Surgery Department
Specialist Services Administration Team
Ward 2, Floor 1
University Hospital Hartlepool
Central booking office: 01429 522471
Monday – Friday, 8.30am – 4.30pm
Further information is available from:
Royal College of Podiatry
2nd floor, Quartz House
207 Providence Square
Mill Street, London
Telephone: 0207 2348620
or via website at https://rcpod.org.uk/
Telephone: 111 (when it is less urgent than 999)
Calls to this number are free from landlines and mobile phones or via the website at www.nhs.uk
Longhurst B, Bristow I. (2013). The treatment of verruca pedis using Falknor’s needling method: a review of 46 cases. J Clin Med, Vol 2, pages 13-21.
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This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:
Email: [email protected]
Leaflet reference: PIL1204
Date for review: January 2027