The use of strong acids in Podiatry is mainly used for the treatment of Verrucae. The treatment can also be used to produce tissue destruction where a foreign body (usually animal hairs / splinters / fibres etc) are suspected to be present within the dermis of the skin.
For treatment on suspected foreign bodies the two caustics used at this Practice are
1 Monoclhoroacetic Acid (100% saturated crystals)
2 Salicylic Acid (70% paste)
The principle of the treatment is to produce tissue destruction down to the level of the suspected foreign body. Once sufficient tissue destruction has been achieved the necrotic tissue (dead skin) that the acids have produced, is removed exposing a small ulcer, the ulcer will then heal uneventfully over the next week or two. Hence the treatment is intended to ‘burn a hole in the skin’.
Although the treatment is painless when the acids are applied to the skin, patients will feel discomfort two days later as the caustics begin to affect the dermis. Discomfort varies significantly depending on how much acid has been applied, however it is common for the discomfort to be enough to cause patients to limp for at least two days.
If the levels of discomfort become intolerable then the cover and strapping should be removed and the foot soaked in warm salt water. Patients should then contact the surgery.
Necrotic tissue being removed exposing
small ulcer 7 days after applying caustics