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Warts and verrucas

Expert reviewer, Stephanie Munn, Consultant Dermatologist
Next review due January 2021

Warts are small, rough lumps or growths on your skin caused by the human papilloma virus (HPV). Most people get one at some point in their lives. You can get them anywhere, but warts are most common on your hands, knees and feet. 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 warts caused by human papilloma virus (HPV). They look different but are all essentially caused the same way.

Common wart

These are firm, round, raised growths with a rough surface, which can look like a very small cauliflower. They are generally skin coloured, but often have tiny black dots on the surface. They’re most commonly found on your hands or knees. They are usually a few millimetres across but can range from the size of a pinpoint to 1cm across.

Verruca (plantar wart)

Verrucas are warts on the soles of your feet. They may have tiny black dots in the centre and can be painful when you put weight on them. They 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)

A plane wart is a round, smooth growth that’s often yellow in colour. They may be flat or slightly raised. You may have one, a few grouped together or even a group of hundreds of these warts. They most commonly appear on your face, neck, the backs of your hands or your legs.

Genital warts

Genital warts are caused by different types of HPV than the other types of wart. They are spread by sexual contact and are the most commonly diagnosed sexually transmitted infection (STI) in the UK. If you have these warts, it’s important to go to a STI clinic for further advice. They are treated differently to 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. For more information see our topic on sexually transmitted infections (STIs).

Symptoms of warts and verrucas

Many people with warts worry about how they 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.

Diagnosis of warts and verrucas

If you're worried about your wart or verruca, speak to your pharmacist. They’ll ask you about your warts – how long you’ve had them and how they affect you. They may also examine your wart. In almost all cases your pharmacist will be able to diagnose warts without any further testing.

If your warts are on your face, are very numerous or don’t go away with simple treatments, you may need to see your GP. They will probably refer you to a dermatologist or specialist skin clinic. Your GP will also probably refer you for specialist treatment if you have lowered immunity because of a medical condition or medicines you are taking. You may have lowered immunity if you have:

  • lymphoma
  • had an organ transplant
  • had cancer treatment such as a stem cell transplant

Treatment of warts and 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 cases up 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.

You may want to have warts treated if they become painful, unsightly or don’t go away. There are many different types of treatment for warts, but none of them work completely and doctors still aren’t sure which works best. It’s not unusual for a wart or verruca to come back after treatment.

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 that you can buy at pharmacies. Many of these contain an ingredient called salicylic acid. This is a chemical that helps to soften the hard outer layer of your wart or verruca. Don’t use it on your face or on large areas because of the risk of irritation and scarring. You should also see your doctor before using it if you are diabetic and prone to ulcers, or have loss of feeling in affected fingers and toes.

Always carefully follow the instructions that come with your wart and verruca treatment. Try to get as little as possible on the surrounding area as it can cause irritation to your healthy skin. You can protect the skin around the wart with petroleum jelly or soft paraffin. Avoid getting it 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 it with a plaster or some duct tape. You may need to do this treatment daily for up to three months.

If your GP refers you to a dermatologist or specialist skin clinic, they may offer you other medicines to treat your warts. Your doctor will discuss with you the best options for your circumstances.

Cryotherapy

Cryotherapy is the process of freezing your wart using liquid nitrogen. Cryotherapy can be done by a GP, but depending on where you live, it’s often not funded by the NHS anymore. 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, but they 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.

Your doctor may recommend repeating the cryotherapy every two to three weeks for up to six treatments. It sometimes leads to blistering or scarring of your skin. It isn’t often recommended for children because it can be painful.

If you have poor circulation or numbness in your fingers or toes, cryotherapy isn’t recommended. Cryotherapy for verrucas hasn’t been shown to work any better than salicylic acid treatment.

Surgery

In some circumstances your doctor might suggest surgical removal of your wart or verruca. All surgical procedures leave scars. As with cryotherapy, this may only be available as a private treatment.

Your doctor may remove your wart by scraping it away using an instrument called a curette. Or they may use laser treatment, which destroys your wart and the blood vessels that supply it. These procedures are done under local anaesthetic.

In about three out of 10 cases the wart or verruca comes back after it’s been removed. To try and prevent this your doctor may recommend a combination of surgery and other treatments.

Causes of warts and verrucas

Warts and verrucas are caused by the human papilloma virus (HPV). There are over 150 different types of HPV but most warts are caused by only a few specific types. The virus infects cells in your skin, causing it to thicken and coarsen.

Warts and verrucas can spread from person to person by direct skin contact. They can also spread 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, for example because you have had an organ or stem cell transplant.

Prevention of warts and verrucas

Warts and verrucas are usually caused by direct skin contact or contact with surfaces contaminated with the human papilloma virus (HPV).

It’s hard to completely avoid coming into contact with HPV. Taking the following precautions may help to prevent warts and verrucas.

  • Try not to touch other people’s warts or verrucas.
  • 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 use nail files or pumice stones on your wart or verruca, don’t use these 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 warts and these can, occasionally, be mistaken for other skin conditions. 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.

    There are many types of warts and verrucas caused by different types of the human papilloma virus (HPV). They can appear anywhere on your skin and tend to have a characteristic appearance.

    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 your feet. Verrucas can sometimes be mistaken for corns or calluses but these do not have tiny black dots within them.

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

  • Most warts and verrucas go away by themselves. There are a lot of over-the-counter preparations available to treat warts, but some people who don’t want to use them try other methods.

    Although there isn't much evidence that it works, some people try placing duct tape over their wart to help to get rid of it. Cover your wart with duct tape for six days. Then 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. You may 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’s because it cuts off the supply of oxygen to the wart. Or it may cause irritation and encourage the body’s immune system to kick in and get rid of the wart.

    Following the oxygen theory, some people suggest painting the wart with several coats of nail varnish but there is no evidence that it has any effect.

    If you’re concerned about your wart, speak to your pharmacist.


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Related information

    • Sterling J, Gibbs S, Haque Hussain S, et al. British Association of Dermatologists’ guidelines for the management of cutaneous warts. Br J Dermatol 2014; 171:696–712
    • Warts and verrucae. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated December 2014
    • Nongenital Warts Clinical Presentation. Medscape. emedicine.medscape.com, last updated April 2017
    • Kwok C, Gibbs S, Bennett C, et al. Topical treatments for skin warts. Cochrane Library of Systematic Reviews. onlinelibrary.wiley.com, published September 2012
    • Common warts. BMJ Best Practice. bestpractice.bmj.com, last updated November 2017
    • Skin warts. Map of Medicine. International View. London: Map of Medicine; 2016 (Issue 1). app.mapofmedicine.com
    • Verrucae. Patient Plus. patient.info, last updated May 2015
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    • Nongenital Warts Treatment and Management. Medscape. emedicine.medscape.com, last updated April 2017
    • Salicylic acid. NICE British National Formulary. bnf.nice.org.uk, accessed December 2017
    • Warts and calluses. NICE British National Formulary. bnf.nice.org.uk, accessed December 2017
    • Viral warts. Patient Plus. patient.info, last updated May 2015
    • Focht D, Spicer C, Fairchok M. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris. Arch Pediatr Adolesc Med 2002; 156(10):971–74
    • Melanoma - suspected. Map of Medicine. International View. London: Map of Medicine; 2016 (Issue 1). app.mapofmedicine.com

  • Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, January 2018
    Expert reviewer, Stephanie Munn, Consultant Dermatologist
    Next review due January 2021



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