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Verruca Needling

verruca needling treatment plantar warts

What is verruca needling?

Verruca needling is a procedure carried out under local anaesthesia. It is performed, subject to medical suitability, on adults with long standing, stubborn, or very painful verrucae, which have not responded to traditional treatment methods.

Verruca needling is a simple, yet effective procedure that aims to stimulate an immune response to the virus which causes verrucae. Using a local anaesthetic to numb the infected area, your podiatrist will then use a fine needle to puncture the verruca multiple times. 

How does it work?

Verrucae are caused by a virus. This virus sits in the top layers of your epidermis (skin) and is very good at hiding from your immune system. Having a verruca for a long time does not mean you have any problems with your immune system. It simply means your immune system has not discovered the virus yet. Needling is a means of introducing the virus to your immune system, so that it can start to fight it off.

During the needling process, infected cells are carried through to the deeper layers of skin where the immune system is more active. This is specifically done to produce an immune response so that the verruca virus is destroyed.

What are the benefits of verruca needling?

A recent study demonstrated significant reduction in the size of the verrucae and the pain they cause, following one session of needling. Previous studies indicate one session of needling can resolve around 69% of verrucae, but that it may take two or three treatments, over 6 to 12 months for full resolution.

As no acids are used there is little risk of damage to the healthy skin surrounding the verrucae.

A dressing is required for couple of days only, then you can go about your daily activities as normal.

Does it hurt?

Needling is performed under local anaesthesia so the procedure itself is painless. You may of course feel some sharpness when the anaesthetic is administered. After the anaesthetic wears off (usually around 2 to 4 hours later) there is rarely pain but the area may feel a little tender like a bruise.


There are a few medical conditions which may make you unsuitable for needling, the podiatrist will discuss this and your options with you.

We are unable to perform needling if you are pregnant or breastfeeding, have problems with your circulation or if you have peripheral neuropathy (damage to the nerves causing lack of sensation in the feet).

Needling cannot be performed if you have very recently used topical acid based verruca treatments.


Before the procedure

The podiatrist will need to check if there have been any changes since your assessment. Please inform the podiatrist if you think you may be pregnant, if you are breastfeeding, if your medical history has changed or you have changed medications.


Your circulation will be checked, and your podiatrist will perform a few tests to check the sensation in your feet is normal. Please remove all nail varnish from toenails before attending the clinic – this enables us to better assess your circulation.

Your podiatrist will make sure you are suitable for Verruca Needling and will fully explain the treatment prior to its use. Your podiatrist will discuss all the possible side effects at your consultation before proceeding with the treatment. You will be required to give written consent before the procedure can proceed.

What will happen during the procedure?


  • You will be awake during the procedure.

  • A local anaesthetic is injected (usually near the ankle) to stop you feeling pain in the foot. More anaesthetic may be injected nearer to the verruca, depending on its location.

  • The callus (hard skin) over the top of the verruca is removed.

  • Once the area is numb a small needle is used to puncture the verruca and cause repetitive trauma to the area. This aims to push the virus into the deeper layers of the skin where the immune system is more active. This can cause some bleeding which usually stops very quickly.

  • The area is then cleansed and a sterile dressing is applied.

After the procedure

You will be given advice about how to look after your foot and a follow-up appointment, will be booked before you leave.

You will be able to walk normally after the procedure although your foot will feel a little strange for a while! 


You will not be able to drive as a numb foot makes your insurance invalid and is very unsafe. You will need someone to collect you afterwards and drive you home.

You will normally be able to return to work and your regular activities the next day.

Interested in Verruca Needling? Please call 427 4937 to book a consultation appointment.

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