A wart, also known as a verruca, is a small fleshy bump on the skin or mucous membrane caused by human papillomavirus (HPV). Different types of HPV can cause warts on different parts of the body, including the hands, feet, and genitals.
Warts can be unsightly and grow to a significant size or in clusters. While warts are typically painless, pain can sometimes occur when pressure is placed on them (such as with plantar warts on the underside of a foot).
Warts can be extremely difficult to treat and often recur (return). Even so, there are several options a person can turn to if a home remedy or over-the-counter treatment fails.
This article looks at the various types of warts a person can get, including their appearance and location. It also explains how warts are commonly diagnosed and treated.
Does HPV Always Cause Warts?
General Characteristics of Warts
Warts are small raised bumps on the surface of the skin. Most are flesh-colored, although some come in various shades of white, pink, yellow, or brown.
Some warts contain tiny black dots. These are blood vessels that have grown rapidly and irregularly into a wart and have thrombosed (clotted). This is most often seen when a wart is cut away or reduced by abrasion.
Warts normally emerge from the top layer of skin in cylindrical columns. On thick skin, the columns can fuse and become packed tightly, creating a mosaic-like pattern on the surface.
What Different Warts Look Like
Types of Wart
There are many types of warts with different shapes, sizes, and appearances. They vary not only by their location but also by the type of HPV that caused them.
Common Warts (Verruca Vulgaris)
Per their name, common warts (verruca vulgaris) are the most frequent type affecting three out of every four people sometime in their lives. They are recognized by their raised, rough, pebble-textured surface.
Common warts can occur anywhere on the body but are most often seen:
- On the fingers
- Near the nails
- On the backs of the hands
Those that occur around the fingernails and toenails are referred to as periungual warts, while those that develop under the nails are called subungual warts.
Plantar Warts (Verruca Plantaris)
Plantar warts (verruca plantaris) grow on the weight-bearing surfaces of the bottoms of the feet. They are rough in texture and often resemble calluses. Due to their location, plantar warts can be painful to walk or stand on.
Multiple plantar warts can grow together into a cluster called mosaic warts. These are especially hard to treat as much of the wart will grow beneath the surface of the skin.
What Does a Plantar Wart Look Like?
Flat Warts (Verruca Plana)
Flat warts (verruca plana) are tiny growths of the skin that are smooth and flat or slightly rounded. They are sometimes called plane warts.
Flat warts appear in clusters of a few dozen to a hundred. Their location tends to vary by age and a person's biological sex, such as:
- On the legs of adult females
- In the beard area of adult males
- On the face of children
Filiform Warts (Verruca Filiformis)
Filiform warts (verruca filiformis) are an unusual-looking type of wart, forming long, thread-like, or spiky columns that protrude from the skin.
Filiform warts most often appear on the face, especially:
- Around the eyes
- On or around the nose
- Around the mouth
Genital Warts (Condyloma Acuminata)
Genital warts (condyloma acuminata) can appear on or around your genitals or anus. They can be raised or flat and vary in size. When they form in groups, they may resemble cauliflower.
Genital warts are usually painless, but in some people, they cause itching, burning pain, and bleeding.
While genital warts are technically verrucas, condyloma is the preferred term for any wart on the genitals or anus.
HPV and Cancer
Most genital warts are caused by HPV types 6 and 11. HPV 16 is associated with a high risk of genital cancer.
How to Tell If You Have a Genital Wart
Age Warts (Verruca Seborrhoica)
Age warts (verruca seborrhoica) are rough, raised, and light to dark brown in color. They initially start as yellowish skin discoloration and will develop over time into raised warts.
Age warts often appear from the age of 40 and increase in size and number with age. The condition is generally more common in people with fair skin than with dark skin.
Age warts mainly occur in the following locations:
- On the upper back
- On the forehead
- On the backs of the hands
Because age warts can look similar to skin cancers such as melanoma, it is a good idea to see a dermatologist regularly to have a whole-body examination just to be safe.
Is It a Wart, Mole, or Skin Cancer?
Complications of Warts
Warts don't generally cause complications, but a few problems are possible. Among them:
- If you pick at or cut a wart, it can become infected.
- In people with compromised immune systems, warts can be especially difficult to treat.
- While genital warts are not commonly linked to cancer, such as cervical and anal cancer, they are sexually transmitted—as are other types of HPV that do cause cancer. To prevent the spread of sexually transmitted HPV, use condoms and reduce your number of sex partners.
2:02
Everything You Should Know About Warts
This video has been medically reviewed by Casey Gallagher, MD.
Causes and Risk Factors of Warts
HPV is a group of over 350 viruses that can cause different types of warts and skin lesions. Many HPV infections cause no symptoms and over 90% will clear spontaneously within two years with no long-lasting consequence. Of these, over 40 types are sexually transmitted.
Warts are contagious and can spread by skin-to-skin contact, particularly if there are small tears or abrasions on the skin. It is also possible, but less likely, to get HPV by contact with contaminated objects or surfaces, such as a shared razor or locker room floor.
You may be more likely to get warts if you:
- Are a child or teenager
- Bite your nails or pick at the skin around them
- Are immune-compromised, such as people with HIV or those undergoing chemotherapy
- Have condomless sex with someone who has genital warts
- Have multiple sex partners
How Warts Are Diagnosed
Warts are easy to diagnose. Most people can recognize a wart on their own body, particularly if they have had one before. If you're not sure what it is, your healthcare provider can likely diagnose it just by looking.
Warts on the face or genitals—or those that are changing in color or shape or are bleeding—should be seen by a healthcare provider.
If your provider suspects skin cancer or a precancerous growth, they may order a skin biopsy. This is where a small piece of tissue is removed and examined under a microscope. This isn't necessary for most warts.
How Warts Are Treated
Most warts resolve within weeks or months without treatment, although some may take many years to fully clear. However, because warts can be uncomfortable or unsightly, most people opt to remove them.
Many warts can be treated with simple over-the-counter remedies. Those that don't clear up with home treatment may require prescription drugs or in-office therapies.
Home Remedies
A popular home remedy for wart removal is the duct tape method. For this procedure, you would put a piece of duct tape on the wart and leave it for six days. You would then remove the tape, soak the wart in water, and pare it down with an emery board.
If that doesn't get rid of it, you can wait 24 hours and try again. This may need to be repeated several times depending on the size and location of the wart.
Although studies have shown mixed results with the duct tape method, it is considered a safe home remedy for adults and children with few side effects.
Over-the-Counter (OTC) Wart Medications
Salicylic acid is a common and effective over-the-counter (OTC) wart removal treatment. It can be found in several forms, including oils, drops, and infused adhesive pads or strips.
Salicylic acid is applied to a wart and allowed to dry. Some practitioners recommend paring back the wart with a pumice stone or emeryboard before application. Soaking the wart in water before applying the acid and covering the area with a bandage will also aid with the absorption.
Some of the more popular salicylic acid-based wart removers include:
- Compound W
- Dr. Scholl's Clear Away
- DuoFilm
- Wart-Off
Another OTC option is an at-home freeze kit, also known as home cryotherapy. These products use a mixture of propane mixed in dimethyl ether delivered under pressure to freeze and destroy wart tissues. You simply point the precision applicator at the wart and spray.
Options include:
- Skin Clinic Freeze & Clear
- Dr. Scholl Freeze Away
- Compound W Nitro Freeze
At-home wart freeze kits should never be used on the face. They are intended for use only on the feet or hands.
Prescription Wart Medications
When OTC remedies aren't effective, there are topical medications available by prescription that can be applied to warts at home:
- Aldara (imiquimod) is a topical cream that treats non-melanoma skin cancers and anal or genital warts.
- Retin-A (tretinoin) is a topical cream that is particularly effective in treating flat warts.
These products are applied once daily or several times a week per your healthcare provider's instructions. A wart should clear within nine to 12 weeks depending on its severity.
Surgeries and Specialist-Driven Procedures
Larger warts or those that resist treatment may require in-office care by a dermatologist. Some of the treatments are applied topically or injected into a wart to break down tissues. Others directly ablate (remove) tissues with either cold or heat.
Once the tissues have been broken down or reduced, the remaining tissues can be debrided (scraped) or excised (cut out).
Generally speaking, topical therapies and direct ablation methods are pursued before injections. Many injectable wart therapies are still regarded as experimental.
Specialist treatment options include:
- Topical therapies: These include chemical irritants like bleomycin, cantharidin, glutaraldehyde, formalin, and podophyllin or acids like lactic acid and trichloroacetic acid (TCA). Several applications may be needed.
- Cryotherapy: This involves the application of liquid nitrogen, usually with a swab, to freeze and kill a wart. After the wart crusts over and falls away, the underlying skin will usually heal with minimal scarring.
- Electrodesiccation and curettage: This is a procedure in which a wart is burned with an electrical needle or probe. Afterward, the dead tissue is scraped away with a spoon-shaped tool called a curette.
- Intralesional vitamin D injections: Injections with vitamin D3 have been used with varying degrees of success. One study involving 64 people with treatment-resistant warts reported that 90% experienced complete clearance after four treatments.
- Intralesional immunotherapy: This is a newer approach in which an injection of the MMR (mumps, measles, rubella) vaccine or Candida antigen stimulates the immune system to clear the wart. It usually involves five once-monthly injections.
Treatment-resistant warts tend to benefit from a combination of immunotherapy and topical or injected therapies. Doing so nearly doubles the chances of success compared to a single treatment.
Treating and Preventing Genital Warts
Summary
Warts (verrucas) are small raised growths on the skin or mucus membranes caused by a group of viruses known as human papillomavirus (HPV). Many types of warts can appear on different parts of the body, including the hands, feet, face, genitals, or anus.
HPV is contagious. It can be spread by skin-to-skin contact and even by touching objects or surfaces contaminated with HPV. Of the more than 350 types of HPV that can cause warts or lesions, over 40 are sexually transmitted.
Warts can be diagnosed visually. Treatment options include OTC or prescription medications applied to the skin or specialist in-office procedures like cryotherapy or electrodesiccation.
A Word From Verywell
Warts can be unsightly, annoying, and difficult to treat. If you have a wart that simply won't go away, do not hesitate to contact a dermatologist who can offer recommendations on the best and safest ways to remove the type of wart you have.
A dermatologist is a physician specially trained in diseases and disorders of the skin, hair, and nails and should not be confused with a cosmetologist or esthetician who is a non-medical professional licensed to provide cosmetic treatments to the skin, hair, or nails.
What to Expect When Seeing a Dermatologist
Frequently Asked Questions
Can warts go away on their own?
Yes, if you have a healthy immune system, your wart may go away without treatment. However, it can take a long time—up to two years—which may allow the virus to spread and cause more warts both in you and other people.
Can you cut off a wart?
You shouldn't. It won't get rid of the virus, so the wart will most likely come back. Also, cutting it may lead to an infection.
Do warts have roots?
No, warts don't have roots. Warts originate from the top layer of skin, the epidermis. As they grow down into the second layer of skin, the dermis, they can displace the dermis. The underside of a wart is smooth.