Verruca Won’t Budge? Why Falknor’s Needling Works When Everything Else Fails
- Millie Brown
- Jul 14
- 4 min read
You’ve tried Bazuka. You’ve tried Wartner. You’ve been diligent with the emery board, the salicylic acid, the duct tape someone recommended. Months later, the verruca is still there — possibly spreading, possibly more painful, definitely more frustrating.
This is one of the most common presentations I see at Yorkshire Foot Clinic. Patients arrive having done everything right by over-the-counter standards, and getting nowhere. The problem isn’t that they’ve failed. It’s that over-the-counter treatments work on the surface of the skin — and verrucas don’t live on the surface.
Falknor’s needling works differently. Here’s why.
Why verrucas are so hard to shift
A verruca is caused by the Human Papillomavirus (HPV), which infects the outer layers of skin. The virus is clever — it replicates in the avascular (blood-free) outer skin layers, which means your immune system largely ignores it. There’s no fever, no obvious inflammation, no immune response. The virus just sits there, quietly, while you go through tube after tube of Bazuka.
Over-the-counter treatments work by destroying the surface tissue, with the hope that the immune system will eventually notice the virus and mount a response. For mild or recent verrucas in people with a strong immune system, this can work. For stubborn, long-standing, or mosaic verrucas — it often doesn’t.
The tissue keeps growing back. The verruca remains.
What is Falknor’s needling?
Falknor’s needling is a specialist podiatry procedure, first described by Dr Falknor in 1969, that takes a completely different approach. Rather than attacking the surface, it deliberately punctures the verruca tissue multiple times with a fine needle — under local anaesthetic, so you don’t feel it — pushing viral particles into the deeper, vascular layers of the dermis.
Why?
Because the dermis has a blood supply. And blood means immune cells.
By introducing the viral material into this deeper tissue, needling triggers a proper immune response — often for the first time. The body recognises the virus as a threat, mounts a response, and clears not just the treated verruca but frequently other verrucas elsewhere on the foot at the same time.
That’s the key distinction: needling doesn’t just treat the lesion. It activates your immune system to do the work.
What does the evidence say?
Needling has a strong evidence base compared to many verruca treatments. Studies report resolution rates of 69–85% — significantly higher than cryotherapy or salicylic acid for stubborn cases. A 2019 randomised controlled trial published in the British Journal of Dermatology found needling to be more effective than cryotherapy for the treatment of verrucas that had failed to respond to standard treatment.
It’s also worth noting: needling only needs to be performed on one verruca (typically the dominant one) to provoke a systemic immune response that can clear multiple lesions. This makes it particularly effective for patients with mosaic or clustered verrucas.
Who is it suitable for?
Needling is suitable for most adults with a persistent verruca that has failed to respond to over-the-counter or GP-level treatment. It is particularly well-suited for:
Verrucas that have been present for more than six months
Mosaic verrucas (clusters of multiple lesions)
Patients who have tried cryotherapy or salicylic acid without success
Verrucas on weight-bearing areas of the foot that are causing pain
It is not suitable for patients who are pregnant, immunocompromised, or who have certain skin conditions affecting the treatment area. We’ll discuss your full medical history at your appointment to confirm needling is the right option for you.
What to expect at your appointment
Local anaesthetic: The area is numbed first, so the procedure itself is painless. This is the only part where you might feel a brief sting.
The needling: The verruca is punctured multiple times with a fine needle to introduce viral particles into the deeper skin layers. The procedure takes around 15–20 minutes.
Dressing and aftercare: The foot is dressed before you leave. You’ll be able to walk out of the clinic and return to normal activity the following day.
The wait: The immune response takes time. You won’t see results overnight — resolution typically occurs over six to twelve weeks as the immune system does its work. Most patients need only one session, though a second can be performed if needed.
Why see a podiatrist rather than trying more over-the-counter treatments?
The honest answer: if what you’re doing isn’t working, more of the same isn’t going to change the outcome. Verrucas that have been present for months or years are unlikely to respond to surface-level treatments, no matter how consistently they’re applied.
Needling addresses the reason they’re not shifting — the lack of immune recognition — rather than just attacking the tissue from the outside. It’s a more targeted, evidence-based approach, performed under local anaesthetic by an HCPC-registered podiatrist.
If you’ve been battling a verruca for a long time, it’s worth a conversation.
At Yorkshire Foot Clinic we’ll assess your verruca, confirm whether needling is the right approach, and talk you through the procedure
📍 Yorkshire Foot Clinic, Horsforth, Leeds
📅 Open Tuesdays and Thursdays
👉 Book online at yorkshirefootclinic.com
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