A simple 15-minute procedure that heats up the foot using microwaves could be the end for stubborn verrucas.
The treatment uses short bursts of energy to stimulate the body’s immune system, helping it fight off the infection.
Studies suggest it can clear more than three-quarters of verrucas within six months, with podiatrists reporting success even in patients who have battled them for years.
About one in ten people are thought to have a verruca – a type of wart that develops on the sole of the foot. While some are little more than a cosmetic nuisance, others can be painful enough to make walking uncomfortable, with sufferers comparing the sensation to standing on a needle as the wart is pushed into the skin.
Verrucas are caused by strains of the human papillomavirus (HPV) infecting the skin on the soles of the feet. The virus usually enters via tiny cuts or breaks in the skin and is commonly picked up through direct contact or contaminated surfaces, particularly in communal changing rooms, swimming pools and showers.
Though verrucas can clear up naturally as the immune system fights off the infection, many persist for months or years. Part of the issue is where the virus lives.
‘Verrucas live in the very top layer of skin, where the body’s immune cells are sparse,’ explains podiatrist Alastair Oxberry from The Foot And Gait Clinic in Taunton, Somerset. ‘It effectively hides from the immune system, which doesn’t easily detect or attack it.’
There are numerous treatments for verrucas, but none is guaranteed to work.
A simple 15-minute procedure that heats up the foot using microwaves could be the end for stubborn verrucas
Verrucas are caused by strains of the human papillomavirus (HPV) infecting the skin on the soles of the feet, with the virus usually entering via tiny cuts or breaks in the skin
Pharmacies sell remedies containing salicylic acid, which gradually strips away infected skin, while cryotherapy freezes and destroys the affected tissue.
More persistent cases can be treated with needling, where the verruca is repeatedly punctured to provoke an immune response, or laser therapy to destroy the infected tissue, but this is not widely available. Surgical removal is also possible, but is generally reserved for difficult cases because it leaves a wound on the sole of the foot and carries a risk of painful scarring.
Even after treatment, verrucas can return, so specialists are increasingly interested in treatments to help the immune system attack the infection itself. This is where microwaves come in.
Available in Britain since 2016, the treatment, known as Swift, uses a handheld probe to deliver microwave energy a few millimetres into the affected skin in bursts lasting just a few seconds.
It is carried out without anaesthetic and typically takes just 15 minutes. Rather than destroy a wart, the heat is thought to provoke a local immune response – helping the body recognise HPV and attack infected cells.
‘Sometimes we see feet with loads of verrucas, nearly the whole foot’s covered,’ says Mr Oxberry. ‘Microwave therapy is particularly effective in these cases as it can trigger a strong immune response and tackle multiple verrucas in a single sitting.’
One striking case involved a pensioner from Essex, identified only as Jane, who had lived with a wart for more than 50 years but which was cleared by the Swift microwave treatment.
Swift does not create an open wound and, unlike needling, does not usually require anaesthetic.
However, it is not pain-free. Some patients describe ‘a very intense but very short little burn’ as the microwave energy is delivered in bursts lasting just two to three seconds.
Dr Matt Kidd, director of medical affairs at Emblation, the company that developed Swift, says some patients report feeling very little, while others experience a brief sensation of heat or a short, sharp pinprick-like feeling.
Patients can generally resume normal activities immediately afterwards, with no dressings or significant aftercare required.
Some studies report that 77 per cent of verrucas clear within three to six months, rising to almost 90 per cent after nine months. But despite those findings, there is still a shortage of large, independent trials comparing microwave therapy with established treatments.
Access through the NHS remains limited, meaning most patients who want Swift have to pay privately. Treatment typically costs £120 to £200 per session.
Manufacturers suggest patients need an average of three sessions, although Mr Oxberry says in his experience many require closer to six. Treatments are generally about a month apart to give the immune system time to respond.
Podiatrist Ernest Barlow-Kearsley, who has a special interest in verrucas, says the lack of stronger evidence remains an obstacle to wider NHS use. He adds: ‘Swift is promising, but there’s no big trial that’s said it should be your number one treatment. From my experience in the NHS it’s too expensive and the results aren’t good enough. If the evidence isn’t there, they simply won’t fund it.’
