Topic Overview
Is this topic for you?
This topic has information about warts on any part of
the body except the genitals. For information about warts on the genitals, see
the topic
Genital Warts.
What are warts, and what causes them?
A wart is a
skin growth caused by some types of the virus called the
human papillomavirus (HPV). HPV infects the top layer of skin, usually entering the
body in an area of broken skin. The virus causes the top layer of skin to grow
rapidly, forming a wart. Most warts go away on their own within months or
years.
Warts can grow anywhere on the body, and there are different kinds. For example, common warts grow most often on the hands, but they can grow anywhere. Plantar warts grow on the soles of the feet.
How are warts spread?
Warts are easily spread by
direct contact with a human papillomavirus. You can infect yourself again by
touching the wart and then another part of your body. You can infect another
person by sharing towels, razors, or other personal items. After you've had contact with
HPV, it can take many months of slow growth beneath the skin before you
notice a wart.
It is unlikely that you will get a wart every time
you come in contact with HPV. Some people are more likely to get warts than
others.
What are the symptoms?
Warts come in a wide range
of shapes and sizes. A wart may be a bump with a rough surface, or it may be
flat and smooth. Tiny blood vessels grow into the core of the wart to supply it
with blood. In both common and plantar warts, these blood vessels may look like
dark dots in the wart's center.
Warts are usually painless. But a wart
that grows in a spot where you put pressure, such as on a finger or on the
bottom of the foot, can be painful.
How are warts diagnosed?
A doctor usually can tell
if a skin growth is a wart just by looking at it. Your doctor may take a sample
of the wart and look at it under a microscope (a skin biopsy). This may be done if it isn't clear that the
growth is a wart. It may also be done if a skin growth is darker than the skin
surrounding it, is an irregular patch on the skin, bleeds, or is large and
fast-growing.
How are they treated?
Most warts don't need
treatment. But if you have warts that are painful or spreading, or if you are
bothered by the way they look, your treatment choices include:
- Using a home treatment such as salicylic acid
or duct tape. You can get these without a prescription.
-
Putting a stronger medicine on the wart, or getting a shot of medicine in
it.
- Freezing the wart (cryotherapy).
- Removing the
wart with surgery (electrosurgery, curettage, laser surgery).
Wart treatment doesn't always work. Even after a wart
shrinks or goes away, warts may come back or spread to other parts of the body.
This is because most treatments destroy the wart but don't kill the virus that
causes the wart.
Frequently Asked Questions
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Learning about warts and plantar warts:
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Being diagnosed:
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Getting treatment:
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Living with warts:
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Cause
A
wart develops when a
human papillomavirus infects the outer layer of
skin and causes the skin cells to grow rapidly. The virus can then spread from
an existing wart to other areas of the body, causing more warts. Various types
of this virus thrive in warm, damp environments such as showers, locker room
floors, and swimming pool areas.
You are most likely to develop a
wart where you have broken skin, such as a cut, a hangnail, a closely bitten nail,
or a scrape. Plantar warts are common to swimmers whose feet are not only damp
and softened but are also scratched and broken by rough pool surfaces. Common
warts are often seen among those who handle meat, chicken, and fish.
How are warts spread?
Warts are easily spread by
direct contact with a human papillomavirus. You can reinfect yourself by
touching the wart and then another part of your body. You can infect others by
sharing towels, razors, or other personal items. After exposure to a human
papillomavirus, it can take many months of slow growth beneath the skin
before you notice a wart.
It is unlikely
that you will develop a wart every time you are exposed to a human
papillomavirus. Some people are more likely to develop warts than others.
Symptoms
Warts occur in
a variety of shapes and sizes. A wart may appear as a bump with a rough
surface, or it may be flat and smooth. Tiny blood vessels (capillaries) grow into the core of the wart to supply it with blood. In both common and plantar warts, these capillaries may appear as dark dots (seeds) in the wart's center.
- Common warts usually appear singly or
in groups on the hands, although they may grow on any part of the body. They
usually are rough, gray-brown, dome-shaped growths.
- Plantar warts can develop on any part of the foot. As the callus and wart get larger, walking can become painful, much like walking with
a pebble in your shoe. When pressure from standing or walking
pushes a plantar wart beneath the skin's surface, a layer of thick, tough skin
similar to a
callus develops over it. Sometimes dark specks are
visible beneath the surface of the wart.
- Flat warts are usually found on the face, arms, or
legs. They are small (usually smaller than the eraser on the end of a pencil). There are usually several in one area. They have flat tops and can be pink,
light brown, or light yellow. Flat warts are often spread by
shaving.
- Filiform warts, a kind of flat wart, can grow around
the mouth, nose, and beard area. The surface of this type of wart has many
flesh-colored, finger-shaped growths.
- Periungual warts are
found under and around the toenails and fingernails. They appear as rough,
irregular bumps.
Warts cover the lines and creases in the skin—this is one
way to tell a wart from other skin conditions, such as skin tags or moles.
What Happens
Human papillomaviruses can live on healthy skin
without causing infection. But when a human papillomavirus enters the body
through small breaks in the skin, it can infect the skin cells beneath the
surface, causing a
wart to grow.
- A wart can take many months to grow before
it becomes visible.
- Warts, particularly
newer ones, are easily spread. They can spread to other parts of the body or to
other people.
- Plantar
warts can be pushed beneath the skin's surface by pressure from standing and
walking. A thickening of the skin slowly forms over most of the wart and looks
and feels like a callus.
- Periungual warts can affect nail
growth.
- It may be hard to get rid of warts after they develop. But
they generally go away on their own within months or years.
- Just before warts disappear on their own, they
may turn black.
What Increases Your Risk
Risk factors for warts include:
- Having an impaired immune system.
- Your age. Warts occur most often
in children and young adults. As you get older, you
may find that you get fewer warts or that your warts go away.
- Walking barefoot on moist surfaces, as in
public showers, locker rooms, and around swimming pool
areas.
- Sharing towels, razors, and other personal items with a
person who has warts.
- Biting your nails or cuticles.
- Wearing closed or
tight shoes that cause sweaty feet.
When To Call a Doctor
See your doctor if:
- You aren't sure if a skin growth is a
wart. If you are older than age 60 and have never had
warts, consider seeing your family doctor or other health professional to check
for skin cancer.
- Nonprescription home treatment isn't successful
after 2 to 3 months.
- Warts are growing or spreading rapidly despite
treatment.
- Signs of bacterial infection develop, including:
- Increased pain, swelling, redness,
tenderness, or heat.
- Red streaks extending from the
area.
- Discharge of pus.
- Fever.
- A plantar wart becomes too painful to walk
on.
- You have
diabetes or
peripheral arterial disease and you need treatment for
a wart on a leg or foot.
- You have warts on your genitals or around
the
anus. For more information, see the topic
Genital Warts.
Watchful waiting
Watchful waiting is a period of time during
which you and your doctor observe your symptoms or condition without using
medical treatment. It is often appropriate treatment for warts, because they
generally go away on their own within months or years. But you may want to consider treating a wart to prevent it
from spreading to other parts of your body or to other people. You can try a
nonprescription wart treatment for 2 to 3 months before deciding to see a
doctor.
Who to see
Warts can be diagnosed
and treated by most health professionals, including:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Warts are
usually diagnosed based only on their appearance.
In rare cases,
more testing is done. If the diagnosis of a skin condition is unclear or if you
are at high risk for having skin cancer, your doctor may take a sample of the
growth and examine it (a
skin biopsy). A biopsy is usually done if a skin
growth is darker than the skin surrounding it, appears as an irregular patch on
the skin, bleeds, or is large and growing rapidly.
Proper
diagnosis of
plantar warts is important. Some wart treatments can
cause scarring.
Treatment Overview
Not all
warts need to be treated. They generally go away on
their own within months or years. This may be
because, with time, your
immune system is able to destroy the
human papillomavirus that causes warts.
You may decide to treat a wart if it is:
- Painful.
- Embarrassing.
- Easily
irritated.
- Growing or spreading to other parts of your body or to
other people.
The goal of wart treatment is to destroy or remove the wart
without creating scar tissue, which can be more painful than the wart itself.
How a wart is treated depends on the type of wart, its location, and its
symptoms. Also important is your willingness to follow a course of treatment that can last for weeks or months.
Wart treatment isn't always
successful. Even after a wart shrinks or disappears, warts may return or spread
to other parts of the body. This is because most treatments only destroy the
wart and don't kill the virus that causes the wart.
For more
information, see:
Warts: Should I Treat Warts?
Treating the warts yourself
Many people don't treat warts unless they are unsightly or painful. You can treat warts yourself with:
For more information, see Home Treatment.
If you have diabetes or peripheral arterial disease, talk to your doctor before you try home treatment for warts.
Treatment by your doctor
Your doctor can treat warts with:
What to think about
It's important to
distinguish a plantar wart from a
callus before choosing a treatment. Wart treatment
applied to a callus may be painful or create scar tissue.
Plantar
warts are often hard to treat because they lie beneath the skin. A doctor
may need to
pare the skin over a wart to help the medicine
penetrate the wart.
Before treating your warts, think about:
- The potential for scarring. Scarring is the most important thing
to think about when choosing a wart treatment. Scarring from treatment may be
permanent and can be as painful as the wart itself. The bottom of the foot is
especially sensitive, a consideration in the case of plantar warts. And scarring changes the way your skin looks. Treatments that are less likely to leave a scar
include salicylic acid, cryotherapy, and laser surgery.
- The cost. Home treatment
is often as effective as treatment by a doctor. And it costs less. For example, nonprescription salicylic acid
is as effective as or more effective than other treatments, with minimal risk
and pain.1 But home
treatment may take longer. Less expensive home treatments include tape
occlusion and nonprescription salicylic acid.
- Your ability to tolerate pain. Quicker but more painful methods
include some topical medicines (such as cantharidin) and cryotherapy.
- Your risk of infection. Treatment can sometimes cause infection. If you have an
impaired immune system or a condition such as
diabetes or
peripheral arterial disease, discuss your increased
risk of infection with your doctor. You may need to take special
precautions.
- Your history of recurrent warts. If
you have a history of warts that come back, you may want to talk with your doctor about more aggressive
treatment methods.
- The location and number of warts. Large areas covered by warts may be better treated with
salicylic acid than with more painful, potentially scarring
methods.
- Your age. Painful treatments, such as
cryotherapy, may not be appropriate for young children. If you are older than
age 60 and have never had warts, you may want to see a doctor to check any skin
growths for skin cancer.
- The time needed for treatment. Topical (putting medicine on the wart) treatment is often
slower than surgical treatment. Some treatment methods, such as immunotherapy
applied by a health professional, require repeated office visits. In such
cases, the expense and inconvenience may outweigh the benefits of
treatment.
Prevention
The main way to prevent
warts is to avoid contact with the
human papillomavirus (HPV) that causes warts. If you
are exposed to this virus, you may or may not get warts, depending on how
susceptible you are to the virus.
Tips on avoiding the human papillomavirus
- Avoid touching warts on yourself or
others.
- Don't share razors, towels, socks, or shoes with another
person. Someone with no visible warts can still be carrying the
virus.
- Avoid walking barefoot on warm, moist surfaces where the
wart virus may be alive. Wear shower shoes when using public showers, locker
rooms, or pool areas.
- Keep your feet dry. If your feet sweat
heavily, wear socks that absorb moisture or wick it away from the
skin.
- Avoid irritating the soles of your feet. Warts grow more
easily if your skin has been injured or broken in some way.
Tips on preventing warts from spreading
- Keep warts covered with a bandage or athletic
tape.
- Don't bite your nails or cuticles, as this may spread warts
from one finger to another.
Home Treatment
Home treatment is often the first
treatment used for
warts. When done properly, home treatment is usually
less painful than surgical treatment.
Home treatment
includes:
- Salicylic acid, which is currently considered the most
desirable wart treatment, based on its effectiveness and safety. The treatment takes 2 to 3 months. Salicylic
acid formulas include Compound W and Occlusal. Learn how to use salicylic acid.
- Tape occlusion (duct tape), in which you use duct tape
to cover the wart for a period of time. This treatment takes 1 to 2
months.
- Nonprescription cryotherapy. Although cryotherapy can be
performed in your doctor's office, a type of this treatment for common warts on
the hands and feet can be done at home. You spray a combination of two
chemicals into a foam applicator and then hold the applicator to the wart for a
few seconds. This treatment shouldn't be used for children younger than 4 or
by pregnant or breast-feeding women.
If you are uncertain that a skin growth is a wart, or if
you have
diabetes,
peripheral arterial disease, or other major illnesses
that may affect your treatment, it is best to see a health professional.
Reducing plantar wart pain
You can reduce plantar
wart pain by:
- Wearing comfortable shoes and socks. Avoid
high heels or shoes that increase pressure on your foot.
- Padding
the wart with doughnut-shaped felt or a
moleskin patch that can be purchased at drugstores.
Place the pad around the plantar wart so that it relieves pressure on the wart.
Also, consider placing pads or cushions in your shoes to make walking more
comfortable.
- Using nonprescription medicines, such as aspirin,
ibuprofen (such as Advil), or acetaminophen (such as Tylenol) to help relieve
pain. Do not give aspirin to anyone younger than 20,
because of the risk of
Reye syndrome.
What to think about
Salicylic acid treatments are
often effective. They aren't very painful, aren't very expensive, and usually don't cause scarring. Salicylic acid is a good treatment for children because it
isn't very painful. For treatment to be successful, salicylic acid must be
applied on a regular basis, usually for a number of months.
Folk remedies, such as rubbing a wart with a bean, may
have an effect on a wart. But such treatment may simply coincide with the
natural disappearance of a wart.
Never cut or burn off a wart
yourself.
Medications
If you decide to treat your warts, both nonprescription and prescription
medicines are available.
For more information, see:
- Warts: Should I Treat Warts?
Nonprescription medicines
Nonprescription
medicines include:
- Salicylic acid, which softens the skin layers that
form a wart so that they can be rubbed off. Salicylic acid formulas include Compound W and Occlusal.
Prescription medicines
Prescription medicines
less commonly used to treat warts include:
- Retinoid cream (Retin-A, Avita). It disrupts the
wart's skin cell growth.
- Cantharidin. (Cantharone, Cantharone
Plus). This medicine causes the skin under the wart to blister, lifting the wart off
the skin. This medicine is injected into the wart at your doctor's
office.
-
Bichloracetic acid (BCA), which kills warts by destroying the
proteins in the cells. It is useful for warts on the palms and on the soles of
the feet. BCA also can destroy normal cells, which is why careful application
is needed. A doctor applies BCA once a week.
Other medicines
Immunotherapy triggers your
immune system to destroy the virus causing the wart.
Because some of the substances used for immunotherapy are expensive, are dangerous,
or require specialized handling, this treatment is usually considered only
after other methods have failed. Immunotherapy options include
contact sensitizers (such as squaric acid dibutyl
ester or SADBE),
imiquimod (Aldara), and interferon. Interferon is an
experimental treatment and is used only for severe and treatment-resistant
warts. Discuss the benefits and side effects of interferon treatment with your
doctor.
Bleomycin injection destroys the skin containing the
wart. But bleomycin isn't often used, because it is painful during and after the injection.
What to think about
Other medicines used for warts include
5-fluorouracil, which is more often used on
genital warts, and cimetidine. Cimetidine can be taken
by mouth (orally) or as an injection.
As with any medicine, talk
to your doctor before using a wart medicine if you are or may be pregnant. Some
wart medicines may cause birth defects.
Surgery
Surgery is an option if home treatment and
treatment at your doctor's office have failed. Surgery for
warts is usually quick and effective. No single
surgical method is more effective than another in removing warts. Generally,
doctors start with the surgical method that is least likely to cause
scarring.
Surgery choices
The most common types of surgical treatment for wart
removal include:
- Electrosurgery and curettage.
Electrosurgery is burning the wart with an electrical current. Curettage is
cutting off the wart with a sharp knife or a small, spoon-shaped tool. The two
procedures are often used together.
- Laser surgery.
Laser surgery burns off the wart with an intense beam of light.
What to think about
A wart may return after surgery,
because surgery removes the wart but doesn't destroy the virus that causes the
wart.
The type of surgery used to remove warts depends on the warts'
type, location, and size. Curettage, electrosurgery, and laser surgery are more
likely than cryotherapy to leave scars, so they are usually reserved for
hard-to-remove or recurring warts. If you have a large area of warts, curettage
may not be an effective treatment.
Some surgical treatments may be
too painful for some children.
Other Treatment
Cryotherapy,
which uses a very cold liquid to freeze a
wart, is the most commonly used procedure that doesn't involve medicine to treat warts. This procedure poses little risk of
scarring but can be painful.
For more information, see:
- Warts: Should I Treat Warts?
Other Places To Get Help
Organization
| American Academy of Dermatology |
| P.O. Box 4014 |
| Schaumburg, IL 60168 |
| Phone: |
1-866-503-SKIN (1-866-503-7546) toll-free
(847) 240-1280 |
| Fax: |
(847) 240-1859 |
| Web Address: |
www.aad.org |
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The American Academy of Dermatology provides information
about the care of skin, hair, and nails. You can locate a dermatologist in your
area by using their "Find a Dermatologist" tool at www.aad.org/find-a-derm.
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References
Citations
- Gibbs S, Harvey I (2006). Topical treatments for
cutaneous warts. Cochrane Database of Systematic Reviews
(3).
Other Works Consulted
- Ahmed I (2010). Viral warts. In MG Lebwohl et al.,
eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 770-775.
Edinburgh: Saunders Elsevier.
- Wolff K, Johnson RA (2009). Human papillomavirus infections. In Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 6th ed., pp. 787-794. New York: McGraw-Hill.
Credits
| By |
Healthwise Staff |
| Primary Medical Reviewer |
Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer |
Alexander H. Murray, MD, FRCPC - Dermatology |
| Last Revised |
April 12, 2012 |
