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Warts and verrucas


Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist and Ade Adeniyi, Bupa Clinics GP
Next review due August 2023

Warts and verrucas are small, rough lumps or growths on your skin caused by the human papilloma virus (HPV). Many people get one at some point in their lives. They’re most common in children and young adults. A wart on the sole of your foot is called a verruca.

An image showing warts on a person's finger

Types of warts and verrucas

There are four main types of wart caused by human papilloma virus (HPV). You can get them anywhere, but aside from genital warts, they’re most common on your hands, knees and feet. They look different but are all essentially caused the same way.

Common wart

These are firm, round, raised growths with a rough surface – they can look like a very small cauliflower. They’re normally greyish-white or light brown, and usually a few millimetres across. This type of wart is most commonly found on your hands or knees.

Verruca (plantar wart)

Verrucas are warts on the soles of your feet. They may have tiny black dots in the centre – these are where blood has clotted in tiny blood vessels on the surface of your skin. They may be painful when you put weight on them. Verrucas tend to look quite flat because of the pressure put on them. Sometimes, if you have clusters of verrucas, they can fuse together. These are called mosaic warts.

Plane wart (flat wart)

Plane warts are round, smooth and slightly raised, with a flat top. They can be slightly brown, greyish-yellow or skin-coloured. They’re most common on your face and the backs of your hands or your legs, and you often have a group of these warts.

Genital warts

Genital warts are caused by different types of HPV from the other types of wart. They are a sexually transmitted infection (STI), which means they’re spread by sexual contact. If you have these warts, it’s important to go to a STI clinic for further advice. Genital warts are treated differently from other types of wart. Don’t use over-the-counter wart treatments on genital warts.

Genital warts aren’t covered any further in this Bupa topic.

Symptoms of warts and verrucas

You might worry about how your warts look, especially if they’re on your hands or face. But apart from their appearance, warts and verrucas don’t usually cause any symptoms. You may find them uncomfortable or painful if they’re on your feet or near your nail beds. Sometimes, common warts may crack and bleed.

Warts and verrucas generally go away by themselves. Speak to your pharmacist if they get worse or become painful.

When to seek help for warts and verrucas

You don’t usually need to see a health professional about warts or verrucas. Warts and verrucas are usually harmless and go away by themselves without treatment. In children, about half go away within a year, and about two-thirds disappear within two years. It may take longer for warts and verrucas to clear up for adults – in some people it can take five to 10 years.

Often, leaving warts is the best option, especially for children, as some treatments can be time-consuming, painful and cause side-effects. If you want to try over-the-counter treatments for a wart or verruca, you can ask your pharmacist for advice. For more information, see our section on treatment.

There are some circumstances when you should see your GP. Always see your GP if you have a new growth on your skin and you’re not sure what it is, especially if it’s growing rapidly. Your doctor will usually be able to tell if it’s a wart just by looking at it and examining it. You should also see your GP if you’re worried about a wart, if it’s painful, bleeding or bothering you in any way.

Treatment of warts and verrucas

Most warts and verrucas go away by themselves, and treatments don’t always work. But if your wart or verruca is bothering you, you might decide to give treatment a try.

The most commonly used treatments for warts and verrucas are salicylic acid and cryotherapy (freezing).

Medicines

There are many creams, gels and medicated plasters for treating warts and verrucas. You can buy these over-the-counter at a pharmacy. Many of them contain an ingredient called salicylic acid. This is a chemical that helps to soften the hard, outer layer of your wart or verruca. It has been shown to have a modest beneficial effect in helping to get rid of warts and verrucas.

Don’t use salicylic acid preparations on your face or on large areas because of the risk of irritation and scarring. Check with your pharmacist or doctor before using it if you have diabetes and are prone to ulcers or have nerve damage.

Always carefully follow the instructions that come with your wart and verruca treatment and ask your pharmacist if you need advice. Try to get as little as possible of the treatment on the surrounding area because it can cause irritation to healthy skin. You can protect the skin around the wart with petroleum jelly or soft paraffin. Avoid getting the treatment on broken skin.

Before applying the treatment, soften the wart by soaking it in water and rubbing it with an emery board or pumice stone to remove any excess hard skin. Once the treatment has dried, it may help to cover the wart with a plaster or some duct tape. You may need to use this sort of treatment daily for up to three months.

Cryotherapy

Cryotherapy is the process of freezing your wart using liquid nitrogen so it falls off. Cryotherapy can be done by a GP but, depending on where you live, it’s not usually funded by the NHS. This means it might only be available as a private treatment.

You can buy over-the-counter cryotherapy preparations at your pharmacist that contain other gases. However, these don’t usually work as well because they can’t freeze at temperatures as low as liquid nitrogen.

When you have cryotherapy, your doctor applies the liquid nitrogen to your wart using either a spray or a cotton bud. It takes between five and 30 seconds to freeze your wart depending on the technique used and the size and location of the wart. You may need to repeat the treatment every two to three weeks, up to six times. It sometimes leads to blistering or scarring of your skin and can be painful, so isn’t often recommended for younger children.

There’s some evidence that cryotherapy may help to remove warts and verrucas, but it hasn’t been shown to work any better than salicylic acid treatment.

Specialist treatments

Sometimes, your GP may need to refer you to a dermatologist or specialist skin clinic for treatment. This may be because:

  • you have warts on your face
  • further tests are needed to confirm your diagnosis
  • large areas of your skin are affected
  • your warts are bothering you, and they haven’t gone away with salicylic acid or cryotherapy
  • you have lowered immunity because of a medical condition or medicines you are taking

Your doctor may suggest various different procedures for removing your wart. These can include scraping it away using an instrument called a curette, and laser treatment. Laser treatment destroys your wart and the blood vessels that supply it. These procedures are both done under local anaesthesia, but they can be painful and leave a scar. In about three out of 10 cases the wart or verruca comes back after it’s been removed using these procedures. To try and prevent this, your doctor may recommend combining these with other treatments.

A dermatologist can also prescribe stronger medications that you may either take by mouth or apply to your skin.

Causes of warts and verrucas

Warts and verrucas are caused by infection of your skin with the human papilloma virus (HPV). They can spread from person to person by direct skin contact or by contact with floors or surfaces contaminated with the virus. Although warts are contagious, it’s thought that the risk of catching them is fairly low. You’re more likely to get infected if your skin is damaged or wet, so infection can be linked to swimming pools and communal showers. You can also infect yourself. If you scratch a wart or verruca, the viral particles may spread to other areas of your skin.

You’re more likely to develop warts and verrucas if you have a weakened immune system. This might be because you have a medical condition or are taking medicines that suppress your immune system.

If you have a wart or verruca, taking the following precautions may help to prevent spreading it to other people.

  • Don't share your towels, shoes or socks.
  • Wear flip-flops in communal showers.
  • Cover your wart or verruca with a waterproof plaster when you go swimming.
  • Don't scratch or pick your wart or verruca as it’s more likely to spread.
  • If you have warts on your fingers, don’t bite your nails or suck your fingers.
  • If you use nail files or pumice stones on your wart or verruca, don’t share these or use on other areas of your skin.

Remember – there’s no reason why you can’t continue to take part in activities, such as sports or swimming, if you have a wart or verruca. But do follow all the advice above, to avoid passing the virus onto other people.

Frequently asked questions

  • There are many different types of wart. They can appear anywhere on your skin and tend to have a characteristic appearance. However, they can sometimes look similar to other skin conditions.

    • Common warts are firm, raised growths with a rough surface, which might look like a very small cauliflower. You can get a common wart anywhere, but they are most often found on hands and knees. Warts can look similar to many other skin conditions, including moles and a viral skin infection called molluscum contagiosum.
    • Verrucas, also known as plantar warts, are usually found on the soles of your feet. Verrucas can sometimes be mistaken for corns or calluses. Warts are benign (non-cancerous). But some types of skin cancer can also look similar to warts. If your wart or verruca (or any other skin lesion) is painful, itches, bleeds or gets larger rapidly, see your GP to get it checked.

    Warts and verrucas usually have tiny black dots inside them, which can help to tell them apart from other skin conditions. You might be able to see these on the surface of your wart or verruca. If necessary, your GP may be able to scrape away the surface to look for these dots.

    If you're worried about your wart or verruca or any other recent changes in your skin, speak to your GP.

  • Some people recommend placing duct tape over their wart or verruca as a method to help to get rid of it. There’s not enough evidence to support using this technique, but some people find it works and it might be something you want to give a try.

    The method usually recommended is as follows.

    • Cover your wart or verruca with duct tape for six days.
    • On the seventh day remove the tape, soak the wart in water and rub with an emery board or pumice stone to scrape off the dead skin.
    • Keep the wart uncovered overnight and re-apply fresh duct tape the next day.

    It’s suggested that you would need to continue this cycle of treatment for up to two months before the wart disappears.

    There is no clear explanation as to why this might work. Some people think it might cut off the supply of oxygen to the wart. Others think it may cause irritation and encourage the body’s immune system to kick in and get rid of the wart.

    There’s no harm in trying this approach, but you may find it difficult to keep the duct tape on for this long. If you’re concerned about your wart, speak to your pharmacist or GP.



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Related information

    • Warts and verrucae. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2020
    • Common warts. BMJ Best Practice. bestpractice.bmj.com, last revised May 2020
    • Plantar warts (verrucas). British Association of Dermatologists. www.bad.org.uk, updated November 2018
    • Sterling JC, Gibbs S, Hussain SSH, et al. British Association of Dermatologists’ guidelines for the management of cutaneous warts 2014. Br J Dermatol 2014; 171(4): 696–712. doi:10.1111/bjd.13310
    • Viral warts, excluding verrucae. Patient. patient.info, last edited 8 May 2015
    • Verrucae. Patient. patient.info, last edited 8 May 2015
    • Dermatology. Oxford handbook of general practice. Oxford Medicine Online. oxfordmedicine.com, published online April 2014
    • Anogenital warts. Patient. patient.info, last edited 29 June 2015
    • Conditions for which over-the-counter items should not routinely be prescribed in primary care: Guidance for CCGs. NHS England, 29 March 2018. www.england.nhs.uk
    • Warts and calluses. NICE British National Formulary. bnf.nice.org.uk, last updated 3 June 2020
    • Kwok CS, Gibbs S, Bennett C, et al. Topical treatments for cutaneous warts. Cochrane Database of Systematic Reviews 2012, Issue 9. doi:10.1002/14651858.CD001781.pub3
    • Salicylic acid. NICE British National Formulary. bnf.nice.org.uk, last updated 3 June 2020

  • Reviewed by Pippa Coulter, Freelance Health Editor, August 2020
    Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist and Ade Adeniyi, Bupa Clinics GP
    Next review due August 2023

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