Research

Evidence level: Developing

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Actinic keratoses are rough, scaly patches on chronically sun-damaged skin. They are considered precancerous because a small proportion may progress to squamous cell carcinoma.

Mechanism (hypothesis): Localised heating may cause stress-induced death of dysplastic (abnormal) keratinocytes, together with local immune activation. A gene pathway analysis showed treated lesions returned many genes to normal state on cancer spectrum.

Research

• Jackson, D. N., Hogarth, F. J., Sutherland, D., et al. (2020). A feasibility study of microwave therapy for precancerous actinic keratosis. British Journal of Dermatology, 183(2), 222–230. doi.org/10.1111/bjd.18935

Evidence level: Emerging

Clinical summary: Anogenital warts are benign growths caused mainly by low-risk HPV types 6 and 11, which are sexually transmitted.

Mechanism (observed, preclinical): In HPV-positive tissue models of anogenital disease, microwave heating repressed HPV oncoprotein activity and induced stress-related cell death (Conley et al., 2023).
Mechanism (hypothesis): The immune response described for cutaneous warts may also apply here.

Research

• Clayton (2024). Case series, EADV 2024 poster.
• See also: Singapore General Hospital case series (EADV 2024), listed under Plantar and Common Warts.

Evidence level: Developing

Research in this area used a higher-energy ablation protocol.

Clinical summary: Melanoma can spread to the skin and the tissue beneath it. This research looks at local microwave treatment of these skin metastases, and at how the immune system responds. It does not cover primary melanoma.

Mechanism (observed, clinical): Direct thermal destruction of tissue. Gene-expression changes after treatment, including immune signalling pathways, were studied in the same pilot cohort (Losol et al., 2026).

Mechanism (hypothesis): Destroying tumour tissue in place may release tumour antigens that prime a wider immune response. This “in situ vaccination” concept is also being investigated with other novel treatments.

Research

• O’Driscoll, D., Losol, P., Pulido, A. V., et al. (2026). Microwave therapy for the treatment of cutaneous melanoma metastases – A pilot study. Journal of the European Academy of Dermatology and Venereology. doi.org/10.1111/jdv.70426
• Losol, P., O’Driscoll, D., Pulido, A. V., et al. (2026). Transcriptomic profiling of cutaneous melanoma metastases treated with microwave ablation – Pilot study. Clinical and Translational Science, 19(6), e70638. doi.org/10.1111/cts.70638
• Ardern-Jones, M. R., et al. (2024). EADV 2024 poster.

Evidence level: Emerging

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Cystic acne is a severe form of acne vulgaris with deep, inflamed and often painful nodules or cysts, most often on the face, chest and back. It is driven by excess sebum, follicular blockage, Cutibacterium acnes and inflammation, and can lead to scarring.

Mechanism (hypothesis): Localised heating of the sebaceous unit may reduce bacterial load and modulate local inflammation. Thermal targeting of skin glands is an established approach elsewhere: microwave energy for sweat glands, and 1726 nm lasers for sebaceous glands.

Research

• Gold, M. H. (2024). Case report poster, IMCAS 2024.

Evidence level: Emerging

Mechanism (hypothesis): Clearing HPV-associated thickened skin (hyperkeratosis), by the immune mechanism proposed for warts, may allow the underlying ulcer to heal.

Research

• Davies, T., & Long, C. (2024). Successful treatment of diabetic foot ulceration with concomitant hyperkeratotic HPV infection using microwave technology. SSRN (preprint). doi.org/10.2139/ssrn.4953849

Evidence level: Emerging

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Hidradenitis suppurativa is a chronic inflammatory skin condition. It causes painful nodules, abscesses and tunnels (sinus tracts) where skin rubs together, such as the armpits and groin. It can significantly affect quality of life.

Mechanism (hypothesis): Localised heating may modulate the abnormal inflammatory response in the hair follicle unit.

Research

• Bielecki, N., & Hoover, A. (2024). Microwave energy for managing hidradenitis suppurativa. SKIN The Journal of Cutaneous Medicine, 8(6), s479. doi.org/10.25251/skin.8.supp.479

Evidence level: Preclinical

Clinical summary: High-risk HPV types, such as HPV-16, cause cervical intraepithelial neoplasia (CIN) and other anogenital pre-cancers, which can progress to cancer over many years.

Mechanism (observed, preclinical):

• Repression of the HPV oncoproteins E6 and E7, and cell death associated with cell stress (Conley et al., 2023).
• A rapid stress-related gene response with induction of innate immune pathways (Kirk et al., 2026).

Mechanism (hypothesis): Repressing E6 and E7 may restore the p53 apoptosis pathway in infected cells.

Research

• Kirk, A., Stevenson, A., Gu, Q., & Graham, S. V. (2026). Microwave treatment of human papillomavirus-positive in vitro grown epithelial tissues results in a rapid stress-related transcriptional response and induction of innate immunity. International Journal of Hyperthermia. doi.org/10.1080/02656736.2026.2692406
• Conley, M. J., Epifano, I., Kirk, A., Stevenson, A., & Graham, S. V. (2023). Microwave hyperthermia represses human papillomavirus oncoprotein activity and induces cell death due to cell stress in 3D tissue models of anogenital precancers and cancers. eBioMedicine, 91, 104577. doi.org/10.1016/j.ebiom.2023.104577
• Kirk, A., et al. (2024). RNA sequencing of HPV-positive 3D tissue models after microwave treatment, IPVC 2024 poster.

Evidence level: Developing

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Molluscum contagiosum is a viral skin infection caused by a poxvirus. It produces small, firm, dome-shaped papules with a central dimple. It spreads by skin contact and is most common in children and in people who are immunocompromised.

Mechanism (hypothesis): The molluscum virus carries genes that help it avoid the immune system. Heat-induced danger signals may help override this local immune evasion, as proposed for HPV.

Research

• Cronkwright, D., Cohen, J. (2026). Microwave therapy as a novel, safe, and effective treatment for children and adults with molluscum contagiosum. Journal of Skin, 10(1), 2834–2843. doi.org/10.25251/cyfh1015
• Paediatric case series, EADV 2023 poster.

Evidence level: Developing

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Neurovascular corns, also called intractable plantar keratosis (IPK), are painful, thickened lesions on areas of the sole exposed to chronic pressure or friction. They often have a deep central core and can be difficult to manage.

Mechanism (hypothesis): The mechanism is dependant on HPV presence and nerve involvement. Proposed explanations include effects on the nerve and blood-vessel elements within the lesion.

Research

• Bristow, I. R., & Lilker, R. (2024). Microwave energy for the treatment of painful intractable plantar keratosis: A retrospective medical record review of nine patients. Journal of the American Podiatric Medical Association, 114(3). doi.org/10.7547/23-019
• Bristow, I. R., & Webb, C. J. (2020). Successful treatment of hard corns in two patients using microwave energy. Case Reports in Dermatology, 12(3), 213–218. doi.org/10.1159/000509791

Evidence level: Emerging

Clinical summary: Onychomycosis is a fungal infection of the nails, most often the toenails, causing thickened, brittle, discoloured nails. It is caused by dermatophytes, non-dermatophyte moulds or yeasts, and is more common with older age, diabetes, immunosuppression and poor circulation.

Mechanism (hypothesis): Nail plate material is transparent to microwave energy, allowing direct heating of fungus within the nail plate and nail bed, possibly with a host immune response.

Research

• Gupta, A. K., Cooper, E. A., & Wang, T. (2024). Safety and efficacy of the Swift microwave device in patients with mild-to-moderate onychomycosis: Protocol of an open-label, randomized, dose-finding pilot study. Skin Health and Disease. doi.org/10.1002/ski2.455
• Conenello, R. M. (2023). Microwave energy as a treatment for onychomycosis. Case series poster, TPMA. doi.org/10.13140/RG.2.2.18564.95369
• Gupta, A. K., Polla Ravi, S., Haas-Neill, S., et al. (2023). Utility of devices for onychomycosis: A review. Journal of Dermatological Treatment, 34(1). doi.org/10.1080/09546634.2023.2265658

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Cutaneous warts are benign skin growths caused by human papillomavirus (HPV). Plantar warts (verrucae) on the soles of the feet can be painful when standing or walking, and are often resistant to treatment.

Mechanism (observed, preclinical, human skin samples): HSP70 danger signalling in keratinocytes, dendritic cell activation (CD80, CD86, CD40) and presentation of HPV antigen to CD8+ T cells (Bristow et al., 2017).
Mechanism (hypothesis): T-cell-driven apoptosis of infected cells. Reports of untreated lesions resolving suggest a wider immune response.

Research

• Clinical studies
  • Bristow, I., Lim, W. C., Lee, A., et al. (2017). Microwave therapy for cutaneous human papilloma virus infection. European Journal of Dermatology, 27(5), 511–518. doi.org/10.1684/ejd.2017.3086
  • Bristow, I. R., Webb, C., & Ardern-Jones, M. R. (2017). The successful use of a novel microwave device in the treatment of a plantar wart. Case Reports in Dermatology, 9(2), 102–107. doi.org/10.1159/000477377
  • Bristow, I., Joshi, S., Williamson, J., & Ardern-Jones, M. (2022). Post marketing surveillance for microwave treatment of plantar and common warts in adults. medRxiv (preprint). doi.org/10.1101/2022.02.08.22270290
  • Hagon, W., Hagon, J., Noble, G., et al. (2023). Microwave therapy for the treatment of plantar warts. Journal of Foot and Ankle Research, 16(1). doi.org/10.1186/s13047-023-00638-8
  • Gupta, A. K., Wang, T., Cooper, E. A., et al. (2023). The treatment of plantar warts using microwave – A review of 85 consecutive cases in the United States. Journal of Cosmetic Dermatology. doi.org/10.1111/jocd.15802
  • Solomon, K., & Yip, V. (2023). The novel treatment of children with viral warts using microwave technology. Skin Health and Disease, 3(6). doi.org/10.1002/ski2.291
• Conference presentations
  • Dhinsa-Vlahovic et al. (2023). Microwave therapy for plantar warts. American Academy of Dermatology, podium presentation.
  • Paediatric case series, EADV 2023 poster.
  • Singapore General Hospital case series (hands, feet and genitals), EADV 2024 poster.
• Practice reports
  • Hochstein (2020). Microwaves: A painless, efficient new treatment for plantar warts
  • Odermatt, H. (2023). Neue Option in der Warzentherapie. Universimed. universimed.com
  • Rümmelein (2025). Management, Therapieoptionen, Update. Universimed. universimed.com
  • Miranti (2025). Case report: mosaic wart. digital edition
• Reviews and commentary
  • Bristow, I. (2022). Paediatric cutaneous warts and verrucae: An update. International Journal of Environmental Research and Public Health, 19(24), 16400. doi.org/10.3390/ijerph192416400
  • Bristow, I. R., & Borthwick, A. (2018). Verrucae: An update and contemporary approaches to management. Podiatry Now, 21(5), S1–S8.
  • Potter, Bristow, et al. (2018). Roundtable discussion: Verrucae. Podiatry Now, 21(9), 18–24.
  • Bristow, I., Arden-Jones (2017). Treating verruca effectively with microwave energy – Are we getting warmer? Podiatry Now, 20(7), 22–25.

Evidence level: Emerging

Research in this area has used pulsed microwave delivery (HeatBeat™).

Clinical summary: Squamous cell carcinoma in situ is an early, non-invasive form of squamous cell carcinoma confined to the epidermis. It usually appears as a persistent, scaly red patch on sun-exposed skin. Untreated, it may progress to invasive squamous cell carcinoma.

Mechanism (hypothesis): Stress-induced death of dysplastic keratinocytes, together with local immune activation. Where HPV is present, the oncoprotein effects seen in laboratory models may also apply.

Research

• Nestor, M., Marrero-Perez, A., Chaudry, A., & Vanaria, R. (2024). Microwave energy for treatment of superficial and in situ squamous cell carcinoma. SKIN The Journal of Cutaneous Medicine, 8(6), s482. doi.org/10.25251/skin.8.supp.482

Viral lesions (warts and other HPV infections)

• Why HPV persists: HPV infects the basal layer of the skin and causes little inflammation, so it can avoid immune detection for long periods. Infection is mainly controlled by T-cell-mediated immunity.
• What the research suggests: localised heating is thought to create a “danger signal”, such as HSP70. In human skin samples, this was associated with dendritic cell activation and the presentation of HPV antigen to CD8+ T cells.
• How infected cells may be removed: activated cytotoxic T cells remove infected cells mainly by triggering apoptosis, the cell’s built-in self-destruct pathway (through perforin and granzyme, or Fas signalling). Whether this is how lesions clear after microwave treatment is a working hypothesis.
• Untreated lesions: a post-market survey of clinics reported that some untreated lesions resolved without being treated directly. This is consistent with a wider immune response, but has not been confirmed in controlled studies.

Precancer and cancer

• HPV oncoproteins: the HPV oncoproteins E6 and E7 inactivate p53 and Rb, two proteins that normally stop damaged cells from dividing and trigger apoptosis.
• What the laboratory models showed: in HPV-positive 3D tissue models of anogenital precancer and cancer, microwave heating repressed oncoprotein activity and induced cell death associated with cell stress (Conley et al., 2023). It also induced innate immune gene responses (Kirk et al., 2026).
• Proposed mechanism: restoring the apoptosis pathway in infected cells is a proposed mechanism and has not been confirmed in patients.
• Melanoma metastases: microwave ablation of cutaneous melanoma metastases has been studied alongside gene-expression profiling of immune signalling (Losol et al., 2026).

Not yet established: whether these local signals lead to lasting adaptive immune memory in patients has not yet been established in clinical studies.

• Gupta, A. K., Cooper, E. A., Gaastra, M. T. W., & Gold, M. H. (2026). Dermatologic indications for microwave-induced local hyperthermia. Journal of Dermatological Treatment, 37(1), 2605619. doi.org/10.1080/09546634.2025.2605619
• Gupta, A. K., Venkataraman, M., Joshi, L. T., & Cooper, E. A. (2022). Potential use of microwave technology in dermatology. Journal of Dermatological Treatment, 33(7), 2899–2910. doi.org/10.1080/09546634.2022.2089333
• Gartshore, A., Kidd, M., & Joshi, L. T. (2021). Applications of microwave energy in medicine. Biosensors, 11(4), 96. doi.org/10.3390/bios11040096

Emblation’s research is carried out with independent clinicians and academic groups. Collaborators have included:

• University of Cambridge (HPV virology)
• University of Dundee (actinic keratosis)
• University of Glasgow (HPV virology)
• Glasgow Caledonian University (podiatry applications)
• University of Plymouth (microwave applications in dermatology)
• University of Southampton and University Hospitals Southampton NHS Foundation Trust (dermatology and immunology)
• Weill Cornell Medicine, New York (dermatology applications)
• Alder Hey Children’s Hospital, Liverpool (paediatric warts)

Emblation’s research and development has been supported by grant funding and co-funding from:

• Innovate UK
• Eurostars
• Scottish Enterprise
• Chief Scientist Office, Scottish Government

Researchers and clinicians interested in collaborative studies, investigator-initiated research or access to research devices can contact us.

The SwiftPro^® Education Programme supports podiatry education in the UK and USA. Participating schools of podiatric medicine receive SwiftPro^® systems at no cost, for use in student training and in on-site teaching clinics, so students gain supervised hands-on experience with microwave technology during their training.

Alongside the devices, Emblation provides lectures to students covering:

• HPV infection and the immune response
• The principles and medical applications of microwave energy

Schools and course leaders interested in joining the programme can contact us.