Verruca needling (also called Falknor needling) breaks down the verruca and creates a controlled inflammatory response, which stimulates your immune system to fight the infection. It is carried out under local anaesthetic, and one treatment is enough for about 80% of cases.
Compared with traditional salicylic acid treatment, needling does not need 2-6 treatments every week, and after the first few days the foot does not need to be kept dry for the acid to work. That makes it a good option for busy people. The technique has been used for over 45 years, was first described in a medical journal in America in 1969, and is used routinely by practitioners internationally. It has been reported to be highly effective, even for longstanding verrucae.
Patient A: several verrucae, one treated
The verrucae on the big toe were needled. As expected, the other verrucae also disappeared, because the immune system was activated.
How does it work?
Once the foot has been numbed with local anaesthetic, the verruca is pricked many times with a sterile needle. The viral particles are exposed to the fatty tissue under the skin, where the body is rich in immune regulators, so your immune system can recognise and destroy the virus. This immune response is often body-wide, so treating one verruca can be enough even when you have several, as they can all clear at the same time.
What happens during the treatment
- Local anaesthetic. An injection numbs the verruca and the area around it. It may be given around the ankle to numb the sole of the foot, or at the toes, depending on the location.
- Needling. Once numb, the podiatrist inserts a hypodermic needle into the verruca to a depth of 5-7mm. This is repeated 100-200 times around the whole verruca, to place the virus in the dermal layer of the skin where your immune system can reach it.
- Dressing. A dressing is applied once the procedure is complete.
Afterwards
Will it hurt? Some patients feel soreness once the anaesthetic wears off, best described as a bruised feeling lasting 1 to 2 days. Painkillers such as paracetamol are normally enough. Please do not use ibuprofen or other anti-inflammatory medication, because it reduces the inflammatory response.
Dressings and follow-up. Most patients are seen 1 week after the procedure and then 12 weeks after. You will need to redress the wound yourself daily for up to 10 days, and we give you details of the dressings to use.
Risks and complications
Although very rare, the following risks have been noted: infection, recurrence, delayed healing, adverse reaction to the local anaesthetic, and scar tissue.
Cost and booking
| Initial appointment, to discuss your options | £80 |
| Verruca needling, first treatment (includes a follow-up review 3-4 months later) | typically £250 |
| Second treatment, if needed, after 3-5 months | £150 |
The number of verrucae treated in a session varies with their location and size, and not every verruca needs treating for them all to clear. We usually provide needling after an initial consultation where we discuss whether it is suitable. We generally advise booking a new patient appointment so we can check suitability and your health. If another podiatrist or doctor has advised this procedure, or you have tried all other treatments, we can arrange a telephone consultation first.
Ready to book?
Book a new patient appointment to discuss verruca needling, or call 01923 856 235.
Verruca and wart appointments
Book a first appointment to discuss needling, or a 15-minute video consultation if you have questions first.
First appointment: verruca or wart (general) (£80, 30 min) Video consultation to discuss treatment (£55, 15 min)