All you need to know about foot and hand HPV

Here's the boring bit .... Pathology

It's not boring for us at the Foot Clinic, this is the important bit that, once you understand the pathology (the path way, how it comes about ...) then you can make better choices about your treatment, or not to treat.

Verrucae and hand warts are Human Papilloma viruses  (HPV), and there are 100s of HPV strains. Specifically, verrucea manifest in 3 different forms, each developing in a specific area of the epidermis, the outer layer of the skin. 

The epidermis has no vascular supply. No blood vessels, no nerves. Nothing.

The virus has to have a host cell, one of the epidermal skin cells. Once the virus enters the cell, it is now active. It takes control of the cellular appartus and 'pretends' to be a cell. This results in the immune cells of the epidermis (no vascular supply, remember) ignoring the infected cell.

Now you have a verruca - or a hand wart

Adults vs Children

Our immune responses are very different, pre and post puberty. Hand and foot warts in children are highly likely to self resolve without any intervention. Simply because the immune responses in a child are always on 'high alert'. The evidence around the use of acids and freezing agents is shaky, since childhood warts, left alone, will self resolve. 

In children our best advice is DO NOTHING! Make them comfortable. If you book an appointment with us we can show you how.

Buring a skin with acid or freezing agents is advised against by both NICE and MHRA. In children, the results of doing nothing vs doing something are the same.

How long will you need to wait for self resolution in CHILDREN?

It takes a number of months for the immune cells to both recognise an infected cell AND manufacture an appropriate response. Give it about 6 - 12 months. Yes, that long.