Warts

Causes

 All warts can spread from one part of your body to another. Warts may be spread from person to person but this is uncommon.

Symptoms

Most warts are raised with a rough surface. They may be round or oval.

• The spot where the wart is may be lighter or darker than the other skin. Rarely, warts are black.
• Some warts have smooth or flat surfaces.
• Some warts may cause pain.

Different types of warts include:  

• Common warts - often appear on the hands, but can grow anywhere. Flat warts are generally found on the face and forehead. They are common in children. They are less common in teens, and rare in adults.
• Genital warts(condyloma) - usually found on the genitals, in the pubic area, and in the area between the thighs. They can also appear inside the vagina and anal canal.
• Plantar warts - found on the soles of the feet. They can be very painful. Many of them on the foot may cause problems walking or running.
• Subungual and periungual warts - appear under and around the fingernails or toenails.  

Exams and Tests

Your health care provider will look at your skin to diagnose warts.

You may have a skin biopsy to confirm the wart is not another type of growth such as skin cancer.

Treatment

You can get treatment if you do not like how the wart looks or if it is painful.

Do NOT attempt to remove a wart yourself by burning, cutting, tearing, picking, or any other method.

MEDICINES

Over-the-counter medicines are available to remove warts.

Do NOT use over-the-counter wart medications on your face or genitals. Warts in these areas need to be treated by a health care provider. 

To use wart-removal medicine:

• File the wart with a nail file or emery board when your skin is damp (for example, after a shower or bath). This helps remove dead tissue. Do not use the same emery board on your nails.
• Put the medicine on the wart every day for several weeks or months. Follow the instructions on the label.
• Cover the wart with a bandage to prevent it from spreading. 

OTHER TREATMENTS

Special foot cushions can help ease the pain due to plantar warts. You can buy these at drug stores without a prescription. Use socks. Wear shoes with plenty of room. Avoid high heels.

Your doctor or nurse may need to trim away thick skin or callus that form over warts on your foot or around nails.

Your health care provider may recommend the following treatments if your warts do not go away:

• Stronger (prescription) medications, such as podophyllin or salicylic acid
• A blistering solution 
• Freezing the wart (cryotherapy) to remove it
• Burning the wart (electrocautery) to remove it
• Laser treatment for difficult to remove warts
• Immunotherapy, which gives you a shot of a substance that causes an allergic reaction and helps the wart go away
• Skin medicine called imiquimod 

Genital warts are treated in a different way than most other warts.

A new medicine called veregen may be used on genital warts as well as other warts.

Outlook (Prognosis)

Most often, warts are harmless growths that go away on their own within 2 years. Warts around and under your nails are harder to cure than warts in other places. Warts can come back after treatment even if they appear to go away. Minor scars can form after warts are removed. 

When to Contact a Medical Professional

Call your health care provider if:

• You have signs of infection (red streaking, pus, discharge, or fever) or bleeding.
• You have a lot of bleeding from the wart or bleeding does not stop when you apply light pressure.
• The wart does not respond to self-care and you want it removed.
• The wart causes pain.
• You have anal or genital warts.
• You have diabetes or a weakened immune system (for example, HIV) and have developed warts.
• There is any change in the color or appearance of the wart.

Prevention

• Avoid direct contact with a wart on another person's skin. Wash your hands carefully after touching a wart.
• Wear socks or shoes to prevent getting plantar warts.
• Wash the nail file that you use to file your wart so that you don't spread the virus to other parts of the body.
• Ask your health care provider about vaccines used to prevent some types or strains of viruses that cause genital warts.

Alternative Names

Plane juvenile warts; Periungual warts; Subungual warts; Plantar warts; Verruca; Verrucae planae juveniles; Filiform warts; Verruca vulgaris

References

Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 12.

Kirnbauer R, Lenz P. Human Papillomaviruses. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.  Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 79.

Update Date: 11/20/2012

Updated by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.