SymptomSkin, hair & nails
Warts: Types and What to Do
Warts are small, rough skin growths caused by human papillomavirus (HPV) infecting the top layer of skin. They are harmless and common, especially in children and teens, and about two-thirds of warts in children disappear without treatment within 2 years. The type depends on where they grow: common warts on hands, plantar warts on soles, flat warts on the face and legs, and genital warts. Salicylic acid and freezing are the main treatments.
Also called: Verrucae, viral warts, HPV warts, skin warts
At a glance
- What they are
- Benign skin growths caused by HPV.
- Types
- Common (hands), plantar (soles), flat (face, legs), filiform (face) and genital.
- Spread
- Direct skin contact and damp surfaces such as pool decks and showers.
- Course
- Many go away by themselves within 1 to 2 years.
- Treatment
- Salicylic acid, freezing, and prescription or in-office treatments for stubborn warts.
When to get help
See a doctor within a day or two
- A wart-like growth that bleeds easily, grows quickly or is ulcerated, especially in an older adult
- A red, hot, swollen, painful area around a wart after home treatment (possible infection)
Book a routine appointment
- Warts in the genital or anal area
- Warts on the face or around the nails
- Many warts, or warts spreading quickly, especially with a weakened immune system
- A wart on the foot in someone with diabetes or poor circulation
- A wart that is painful, interferes with walking or use of the hand, or has not responded to 12 weeks of home treatment
- Uncertainty whether a growth is a wart
Usually safe to manage at home
- A typical rough, painless wart on a finger, hand or knee in an otherwise healthy person
- A small plantar wart with tiny black dots that is not painful
What causes warts
Warts are caused by human papillomavirus (HPV). There are more than 100 types. Most skin warts are caused by low-risk types such as HPV 1, 2, 4, 27 and 57. Genital warts are mostly HPV 6 and 11. The virus enters through tiny cuts or softened skin and makes skin cells multiply, forming a thickened bump. It can take 2 to 6 months after contact for a wart to appear.
Warts are more common in:
- children and teenagers
- people who bite their nails or pick at hangnails
- people who use communal showers and pools
- people with eczema
- people with weakened immunity, such as transplant recipients or those with HIV
- people who handle raw meat (butcher's warts)
Types of warts
| Type | Where | Appearance |
|---|---|---|
| Common warts | Fingers, hands, knees, elbows | Raised, rough, gray-brown, cauliflower-like, often with tiny black dots |
| Plantar warts (verrucas) | Soles of feet | Flat, hard, painful on pressure, interrupt skin lines, black dots |
| Mosaic warts | Soles of feet | Clusters of small plantar warts |
| Flat warts | Face, backs of hands, shins | Small, smooth, flat-topped, often many, may follow a shaving line |
| Filiform warts | Face, around mouth, nose and eyes | Long, thin, finger-like projections |
| Periungual warts | Around and under fingernails and toenails | Rough, may lift the nail and be painful |
| Genital warts | Genitals, anus, groin | Soft, skin-colored, flat or cauliflower-like |
The black dots are tiny clotted blood vessels. They help tell warts from corns.
Things that look like warts
- Corns and calluses: thickened skin on pressure points of the feet. Skin lines run through them, and there are no black dots. A corn hurts with direct pressure; a plantar wart hurts more when squeezed from the sides.
- Molluscum contagiosum: smooth, pearly bumps with a central dimple.
- Seborrheic keratoses: waxy, stuck-on brown growths in older adults.
- Skin tags: soft, smooth, flesh-colored flaps on a stalk.
- Skin cancers: squamous cell carcinoma can look like a wart, especially on sun-exposed skin in older adults or around the nails. A "wart" that bleeds, grows quickly or does not respond to treatment needs a biopsy.
Are warts contagious?
Yes, but not very. They spread by direct skin-to-skin contact, by sharing towels, razors or shoes, and from damp floors around pools and gyms. You can spread warts to other parts of your own body by picking, biting or shaving over them.
How warts are diagnosed
Most warts are diagnosed by appearance. A doctor may pare the surface to reveal black dots. A biopsy is done if the growth is unusual or not responding to treatment.
How to get rid of warts
Treatment is optional for warts that do not bother you. No treatment works every time, and all take weeks.
Home treatment
- Salicylic acid (gels, liquids or plasters, 17 percent or higher) is the best-studied over-the-counter treatment. Soak the wart in warm water for 5 minutes, file off dead skin with a disposable emery board or pumice stone, apply the acid, and repeat daily for up to 12 weeks. Protect surrounding skin. Do not use on the face or genitals.
- Over-the-counter freezing kits are less cold than clinic liquid nitrogen and work less well.
- Duct tape occlusion has mixed evidence. It is harmless to try.
Treatments from a doctor
- Cryotherapy: liquid nitrogen freezing every 2 to 3 weeks. It causes a blister and can be painful, especially for children.
- Stronger acids and cantharidin.
- Immunotherapy: prescription imiquimod cream (mainly for genital warts), or injecting candida antigen to trigger an immune response.
- Other options: laser, electrosurgery, curettage, bleomycin injections or topical 5-fluorouracil for stubborn warts.
Warts on the face, genitals and around nails should be treated by a doctor. People with diabetes or poor circulation should not treat foot warts themselves.
Preventing warts
- Do not pick or bite warts or nails.
- Wear flip-flops in communal showers and pool areas.
- Keep feet dry and change socks daily.
- Do not share towels, razors or shoes.
- Cover warts with a waterproof plaster when swimming.
- The HPV vaccine protects against the types that cause most genital warts. It does not cover common skin wart types.
Frequently asked questions
What causes warts?
Warts are caused by human papillomavirus infecting the skin through small cuts or softened skin. Different HPV types cause different warts. Some people are more susceptible, including children, people with eczema and people with weakened immune systems.
How long do warts last?
Without treatment, many warts disappear within 1 to 2 years as the immune system recognizes the virus. In adults they can persist longer. Treatment usually takes 6 to 12 weeks of consistent effort and does not guarantee the wart will not return.
Can you cut off a wart at home?
No. Cutting or digging out a wart can cause bleeding, infection and scarring, and can spread the virus. Use salicylic acid and gentle filing, or see a doctor for freezing or other treatments.
Why do warts keep coming back?
HPV can remain in surrounding skin that looks normal, so warts can regrow after treatment. Picking and shaving can spread the virus to new sites. Keep treating a few weeks beyond when the wart seems gone, and avoid touching it.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Warts, signs and symptoms; Warts, diagnosis and treatment
- NHS: Warts and verrucas
- MedlinePlus: Warts
- British Association of Dermatologists: Viral warts patient information
- CDC: Human papillomavirus (HPV)