ConditionSkin, hair & nails
Viral Warts
Viral warts are small, rough, benign skin growths caused by the human papillomavirus (HPV), which infects the top layer of skin through tiny cuts. They are infectious, spreading by direct contact or via damp surfaces such as shower floors, and they are most common in children and teenagers. Common warts appear on the hands, plantar warts on the soles and flat warts on the face and legs. Most go away on their own within 1 to 2 years. Salicylic acid and freezing speed clearance. Genital warts need medical care.
Also called: Warts, verrucae, verruca vulgaris (common warts), plantar warts (verrucas), flat warts
At a glance
- What they are
- Benign skin growths caused by HPV infection of the skin's outer layer.
- Types
- Common, plantar, flat, filiform, periungual (around nails) and genital warts.
- How they spread
- Skin contact, shared towels and razors, and damp floors in pools and showers.
- Course
- About two-thirds disappear without treatment within 2 years in children.
- Treatment
- Salicylic acid, freezing (cryotherapy), duct tape, and for stubborn warts, prescription creams, laser or surgery.
When to get help
See a doctor within a day or two
- A growth that bleeds, grows quickly, ulcerates or changes color (needs checking for skin cancer)
- Warts with signs of infection: spreading redness, pus, warmth or fever
Book a routine appointment
- Genital or anal warts
- Warts on the face, or many warts spreading quickly
- Warts in someone with diabetes, poor circulation or a weakened immune system (do not self-treat feet)
- Painful plantar warts that make walking difficult
- Warts that have not responded to 12 weeks of home treatment
- A growth in an adult that you are unsure is a wart
Usually safe to manage at home
- A typical common wart on the hand or a small plantar wart in an otherwise healthy person
What causes warts
There are more than 150 types of HPV. Different types prefer different body sites. The virus enters through small breaks in the skin and makes skin cells multiply, forming a thickened bump. Warts can take weeks to months to appear after exposure.
Most skin warts are caused by low-risk HPV types that do not cause cancer. Some genital HPV types are linked to cervical, anal, penile and throat cancers, which is why genital warts and HPV vaccination are handled differently. See human papillomavirus.
Types of warts
| Type | Where | What they look like |
|---|---|---|
| Common warts | Hands, fingers, knees | Rough, raised, cauliflower-like, often with tiny black dots (clotted blood vessels) |
| Plantar warts (verrucas) | Soles of the feet | Flat, hard, pushed inward by walking, painful to squeeze, interrupt skin lines |
| Flat warts | Face, hands, legs | Small, smooth, flat-topped, often many, spread by shaving |
| Filiform warts | Face, around mouth and nose | Thin, thread-like projections |
| Periungual warts | Around and under nails | Rough, can distort the nail |
| Genital warts | Genitals, anus | Soft, skin-colored, sometimes clustered. Sexually transmitted |
Symptoms
- a rough, grainy, raised bump
- tiny black dots inside
- breaks in the normal skin lines
- pain when walking (plantar warts) or with pressure
- occasional itching or bleeding if picked
Warts are usually painless unless on a pressure point.
Warts vs lookalikes
- corns and calluses: on pressure points, skin lines run through them, painful with direct pressure rather than squeezing. See corn
- molluscum contagiosum: smooth, pearly, dome-shaped bumps with a central dimple
- seborrheic keratoses: waxy, stuck-on growths in older adults
- skin cancers: squamous cell carcinoma can resemble a wart, especially in older adults and people with weakened immunity
How warts spread
- direct skin-to-skin contact
- touching surfaces such as shower floors, pool decks and gym mats
- sharing towels, razors or shoes
- picking, biting or shaving over warts, which spreads them to new areas
- sexual contact for genital warts
Risk is higher with damp or broken skin, nail biting and a weakened immune system.
Treatment
Many warts go away without treatment as the immune system recognizes the virus. Treatment is worthwhile if warts are painful, spreading or bothersome.
At home
- salicylic acid (gels, liquids or plasters): soak the wart in warm water, file dead skin with an emery board or pumice stone (not used elsewhere), apply daily, and continue for up to 12 weeks. Avoid on the face and genitals
- over-the-counter freezing kits: less cold than clinic cryotherapy, with variable results
- duct tape occlusion: evidence is mixed, but some people find it helpful
People with diabetes or poor circulation should not self-treat warts on the feet.
In the clinic
- cryotherapy with liquid nitrogen every 2 to 3 weeks, often combined with salicylic acid
- cantharidin, a blistering agent applied by a clinician
- prescription creams such as imiquimod or 5-fluorouracil
- immunotherapy with injected antigens
- laser treatment, curettage or electrosurgery for stubborn warts, with a risk of scarring
- genital warts: imiquimod, podophyllotoxin, sinecatechins, cryotherapy or surgery
Recurrence is common with all treatments, because the virus can remain in surrounding skin.
Prevention
- do not pick, bite or scratch warts
- wear flip-flops in public showers and pool areas
- keep feet dry and change socks daily
- do not share towels, razors or shoes
- cover warts when swimming or doing sports
- wash hands after touching warts
- HPV vaccine prevents most genital warts and HPV-related cancers. It is recommended at ages 11 to 12, and can be given from 9 up to 26, and for some adults up to 45
Frequently asked questions
What causes viral warts?
Warts are caused by the human papillomavirus (HPV), which infects the outer layer of skin through small cuts or breaks. Different HPV types cause different kinds of warts, such as common warts on the hands and plantar warts on the feet.
Are warts contagious?
Yes. Warts spread through direct skin contact and from surfaces such as shower floors and pool decks. They can also spread to other parts of your own body by picking or shaving. Covering warts and avoiding sharing towels reduce spread.
How long do warts last?
Many warts go away on their own within months to 2 years, especially in children. In adults they may last longer. Treatment can speed up clearance, although warts sometimes come back.
What is the best treatment for warts?
Salicylic acid applied daily for up to 12 weeks and freezing with liquid nitrogen are the most common effective treatments. Stubborn warts may need prescription creams, laser or other procedures. Genital warts need treatment from a doctor.
What are the symptoms of infectious viral warts?
Warts appear as rough, raised or flat bumps, often with tiny black dots inside. Plantar warts on the soles can be painful when walking. Most warts are otherwise symptomless, but they can itch, bleed if picked, and spread to nearby skin.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Warts, diagnosis and treatment
- MedlinePlus: Warts
- NHS: Warts and verrucas
- CDC: Genital HPV infection
- British Association of Dermatologists: Viral warts patient information