Verrutop - Frequently Asked Questions
1. My patient has been using another product before they have come to see me. How long should I leave it since their last use of this product before I start using Verrutop?
It is always a good idea to leave a few days to allow previous treatments to “wash-out” of the patient’s system. This may be to give the skin some time to recover but it is also to ensure that any adverse events which may occur (however unlikely) can be attributed to one or the other product and not an interaction between the two which makes good clinical sense.
On that basis it is recommended that you ensure that the patient has been treatment free for at least 7 days before commencing Verrutop therapy.
2. I’ve read that it is nitric acid. There’s nothing new in this as I remember using nitric acid in the past. OR Isn’t Verrutop a caustic agent, just like salicylic acid?
Verrutop is not just nitric acid. It is a combination of organic and inorganic acids plus metal ions which act in a different way to nitric acid alone. This patented “nitri-zinc complex” creates a redox reaction on the wart, causing the production of nitrites which act to denature viral protein and mummify the wart tissue.
What is also different between Verrutop, and a purely caustic agent is that Verrutop treatment leaves behind a completely intact epithelium with no visible wound or area of damaged skin which can be prone to secondary infection.
3. How do I open the ampoule?
Like all medicinal ampoules there is a scored ring around the narrow part of the neck which is designed to break cleanly when snapped. To avoid any risk of glass cuts it is recommended to wrap a small piece of tissue around the neck to facilitate the breaking.
Once broken, the ampoule can be stored upright in the specially placed indentation in the top left quadrant of the foam liner of the carton. This safety feature also aids in the safe insertion of the capillary tubes and acts as a holding point during treatment.
4. How do I know which warts to pare down and which to treat with no intervention?
This you will learn from experience. As a general rule of thumb, longstanding warts, and verrucae on the base of the feet often respond better to Verrutop following some surgical activity to remove some of the hard, impervious wart from the surface.
5. Is it possible to treat a wart or verruca more than once in a single sitting?
Again, experience will point the way after you have got used to using Verrutop. With some larger and long-standing warts and verrucae it is more practical to apply smaller amounts of Verrutop, wait a few minutes to let it dry and then reapply again precisely for one to two occasions.
6. How can I tell if the product is effective?
You’ll be able to see a change in the colour of the verruca. Some warts go a pale-yellow shade, and some turn brown.
7. Can I use Verrutop if the surgical debridement has caused bleeding?
Any form of surgical intervention in removing the surface of a verruca can lead to some bleeding, but with Verrutop it is not necessary to employ aggressive techniques that are designed to induce bleeding as is required with some treatments. It is best to wait for any significant bleeds to close before applying Verrutop.
8. Does Verrutop treatment hurt, either upon application or after treatment?
Reports of pain associated with the use of Verrutop are few and far apart. Clinical studies generally report no pain and anecdotal comments from podiatrists and patients report minimal irritation in the vast majority of cases. Obviously, people’s pain thresholds vary but Verrutop appears to be remarkably free of pain.
9. How many treatments are needed to achieve wart clearance?
This depends upon the age of the wart, it’s size and the age of the patient. Studies have shown that an average of 3 treatments is required to clear a wart, with some detaching after the first session whilst others remain reluctant to detach after 5 or 6 sessions. We do not recommend continuation of Verrutop treatment if a verruca has failed to detach after 6 treatments.
10. Do I need to mask the surrounding area?
There is usually no need to mask the surrounding area since capillary application is very precise. It may be advisable to mask the nail if a wart is being removed from close to the nail margin as Verrutop can stain a nail permanently until it grows out. However, unlike cryotherapy, Verrutop does not damage the developing nail in the nail bed.
11. How do I get the liquid into the capillary?
Once placed in the opened ampoule the Verrutop liquid is naturally and automatically drawn up into the capillary-by-capillary action. There is no need for any mechanical force.
12. How do I control the flow of the liquid from the capillary?
Usually, contact of the end of the capillary with the skin surface is sufficient to cause the Verrutop to be drawn out of the capillary. However, should the flow be too great, resulting in too much liquid leaving the tube you could place your index finger over the top of the capillary to reduce flow and dab the area as before.
13. Is dressing needed after treatment?
No dressings required following application and it does not interfere with your daily routine.
14. Can the patient bathe after treatment?
Washing and showering have no effect on the response to Verrutop. However, it is advisable to avoid long soaks in the bath as this will re-hydrate the treated area and counter the desiccating effects of the Verrutop.
15. How long does Verrutop take to dry?
Generally, the Verrutop dries within a few minutes. If it takes longer then it is possible that you have applied too much liquid. See usage instructions for more information.
16. What if the wart doesn’t change colour after treatment?
If you are treating an area for the first time and it doesn’t change colour within 4-5 minutes, it is possible to reapply the Verrutop at the same sitting. This should only be done at the first sitting.
17. What should the patient do between treatments?
It is best to advise the patient to avoid hot, long soaks in the bath. On a positive note, they can increase the desiccation process by dabbing the treated area with surgical spirit twice daily between clinic appointments.
18. How long should I wait to use Verrutop after a previous treatment with a different product?
This depends upon the “damage” to the skin caused by the previous treatment. If the skin is broken it’s best to leave it for a few days to recover prior to applying Verrutop.
19. What should I do if I accidentally put Verrutop on normal skin?
Rinse well with cold water.
20. Why should Verrutop not be used on more than 6 occasions?
It is likely that a small number of warts will not respond to Verrutop. Clinical studies suggest that 6 treatments produce the maximum effect to the recommended usage has been set at 6 as further treatments are likely to be ineffective and therefore not value for money.
21. Where should I store Verrutop?
Store Verrutop out of direct sunlight and out of the sight and reach of children. DO NOT refrigerate.
22. Can I use it in combination with another product such as cryotherapy?
No, Verrutop needs to be used as a standalone treatment.
23. What do I do if the capillary gets clogged?
Replace the capillary. Verrutop comes with 2 spare capillaries to cater for such a rare occurrence.
24. Can I use the same capillary on 2 verrucae on the same foot?
Yes, providing that the capillary is still able to draw up the Verrutop from the ampoule.
25. There’s no liquid in the ampoule?
There is only 0.1ml of liquid in the ampoule and this can easily “hide” in the top of the ampoule if it has been inverted. Hold the ampoule vertically and give the top a gentle tap and the liquid will transfer to the bottom of the ampoule.
26. Why do Espère only sell Verrutop to Registered Professionals and not to the general public?
Verrutop is a specialised product, requiring specialist pre-treatment and accurate placement onto the affected areas. For these reasons the CE marking stipulates it only to be used under the supervision of a Health Professional and in the case of the UK, Espère have decided that Verrutop should only be made available to qualified professionals who can apply the product as it is intended.
27. I’ve seen it available on websites that the public can access. Why is it there?
This is an issue with foreign parapharmacy websites who list all their inventory as though they were cosmetic products. As such they are outside the control of both Espère Healthcare and the owner of the Brand. Occasionally the product appears on the Amazon platform from similar groups, but these are quickly taken down as their supply is prohibited by their need to be used under medical supervision.
28. How many verrucae can 0.1ml treat from a single ampoule?
This is obviously dependent upon the size of each verruca bur as a general rule each ampoule can give a single treatment to between 3 and 4 verrucae. Whilst the contents of an ampoule can be used for up to 24 hours once opened, it is not advisable to treat more than one patient from the same one.
29. Can I use a single ampoule on multiple patients?
This is not advisable for infection control reasons. You should consider each ampoule to be a single treatment unit for a single patient.
30. Can I use a pack on multiple patients?
Yes, providing that only a single patient is treated from each ampoule. A 4-ampoule pack could be used to provide a single treatment procedure on 4 different patients.
