Common Warts (Verruca Vulgaris)

What common warts look like

• firm, raised, rough surface, like a tiny cauliflower
• skin-colored, gray, tan or white
• usually 1 mm to 1 cm across
• tiny black dots (clotted capillaries) visible when the surface is pared
• skin lines do not pass through the wart
• may occur singly or in clusters, sometimes in a line where skin was scratched

Warts around and under nails (periungual warts) are harder to treat and can affect nail growth. For an overview of all wart types and look-alikes, see our guide to warts.

How common warts spread

HPV enters through tiny breaks in the skin. Warts are more likely with:

• nail biting, picking at hangnails or cuticles
• cuts and scrapes on the hands
• handling raw meat, fish or poultry (butcher's warts)
• eczema
• weakened immunity, such as after organ transplant or with HIV

The virus can survive on towels and surfaces. Warts can take 2 to 6 months to appear after exposure.

Diagnosis

Common warts are diagnosed by appearance. They differ from plantar warts on the soles and flat warts on the face and legs. A doctor may pare the surface to show the black dots. Biopsy is reserved for atypical, bleeding or treatment-resistant lesions, because squamous cell carcinoma can occasionally look like a wart.

Treatment

Treatment is optional. Warts that cause no trouble can be left to clear on their own, which is reasonable especially in children.

First-line options

OTC freezing sprays reach higher temperatures than liquid nitrogen and are less effective.

Second-line options for stubborn warts

• Cantharidin: a blistering agent applied in the office.
• Immunotherapy: injecting candida antigen, or applying chemicals such as diphenylcyclopropenone (DPCP) or squaric acid, to trigger immune clearance.
• Topical 5-fluorouracil or imiquimod (off-label for common warts).
• Bleomycin injections.
• Laser treatment, electrosurgery or curettage, which can scar.

Tips for home treatment with salicylic acid

1. Soak the wart in warm water for 5 minutes.
2. Gently file dead skin with a disposable emery board or pumice stone; do not share it.
3. Apply the acid to the wart only, protecting surrounding skin with petroleum jelly.
4. Cover with a plaster or tape.
5. Repeat daily. Stop if skin becomes sore and restart once healed.

People with diabetes, poor circulation or nerve damage in their hands or feet should get medical advice before treating warts themselves.

Prevention

• Avoid picking, biting or shaving over warts.
• Keep hands moisturized and cuts covered.
• Do not share towels, nail clippers or emery boards.
• Wash hands after touching warts.
• Wear gloves when handling raw meat for work.

Outlook

Common warts are harmless. Many disappear spontaneously, and most respond to persistent treatment, though recurrence is common because HPV can remain in nearby skin.

Frequently asked questions

What causes common warts?

Common warts are caused by certain types of human papillomavirus (HPV) that infect the top layer of skin through small cuts. They are not related to the HPV types linked to cervical cancer. Children, nail biters and people with weakened immunity are more prone.

How long does it take to get rid of a common wart?

With salicylic acid it often takes 6 to 12 weeks of daily treatment. Cryotherapy usually needs 3 to 6 sessions spaced 2 to 3 weeks apart. Without any treatment, many warts in children disappear within 1 to 2 years.

Is it safe to freeze a wart at home?

Home freezing kits are generally safe if you follow the instructions, but they are less cold and less effective than the liquid nitrogen used in clinics. Do not use them on the face, genitals or near the eyes, or if you have diabetes or poor circulation.

Are common warts contagious?

Yes, mildly. They spread through direct skin contact and shared items such as towels. Picking or biting a wart can spread it to other fingers. Keep warts covered and avoid touching them to reduce spread.