Common wart
HPV growing in the top layer of skin A human papillomavirus infects skin cells and makes them multiply. Common warts on the hands are usually caused by HPV types 2 and 4.
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Common Wart vs Plantar Wart
A common wart is a raised, rough lump, usually on a hand or a finger. It sits up above the skin, and it rarely hurts. A plantar wart is the same kind of virus on the sole of the foot. Body weight presses it flat and inwards, so it looks like a hard callused spot and hurts to stand on. Same family of virus, different place, different shape.
At a glance
| The difference | Common wart | Plantar Warts |
|---|---|---|
| What it is | HPV growing in the top layer of skin | The same virus, on a surface you stand on |
| What it looks like | A raised, rough dome | A flat, hard, callused spot |
| Does it hurt | Usually not | Often, when you stand |
| What it does over time | Clears, often after months or years | Slower, and it spreads on the foot |
| Treatment | Salicylic acid, then freezing | The same, but stronger and longer |
Plantar Warts
Side by side
The differences that matter
What it is
Common wart
HPV growing in the top layer of skin
A human papillomavirus infects skin cells and makes them multiply. Common warts on the hands are usually caused by HPV types 2 and 4.
Plantar Warts
The same virus, on a surface you stand on
The same family, most often HPV type 1 on the sole. The virus behaves the same way. The pressure of walking is what changes the result.
How it works, illustrated
Plantar Warts
The skin on the sole is the thickest on the body. It takes your weight all day and stays sealed.
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The same HPV, picked up on wet shared floors. Skin softened by a pool, a shower or sweaty shoes lets it through a break too small to notice.
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Anywhere else a wart grows outward. Here your weight presses it flat, so it grows down into the sole under a thick callus - which is why it hurts to stand on and looks like a callus with black dots in it.
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As with any wart, the virus sits above the blood supply. Treatment works by wearing the callus down and irritating the skin enough to draw the immune system to it.
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What it looks like
Common wart
A raised, rough dome
A firm bump that stands proud of the skin, grey-brown, with a cauliflower surface and a thickened rim.
Plantar Warts
A flat, hard, callused spot
Level with the skin or slightly sunken, with a ring of thick pale skin around a rougher centre. Both usually show tiny dark dots, which are clotted blood vessels.
More photographs
Plantar Warts
Across skin tones
Plantar Warts
Plantar warts on light skin
On light skin a plantar wart usually reads as a thick yellow-tan lump pressed into the sole, with a thin pink ring around it. Tiny black dots sit in the middle. Those dots are clotted blood vessels, and they are the clearest sign that this is a wart and not a callus.
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Plantar warts on medium skin
On medium skin the wart is tan to gray and the pink ring around it is fainter, so color is less help. The steadier clue is the surface. The fine skin lines of the sole run right through a callus, but stop at the edge of a wart. Squeezing a wart from the sides also tends to hurt more than pressing straight down on it.
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Plantar warts on brown skin
On brown skin the wart is often close to the color of the sole around it, and the redness at its edge is hard to see. That is why plantar warts here are frequently treated as a callus or a corn for months before the diagnosis is corrected. Paring the top layer down in clinic reveals the black dots and the broken skin lines, and it is worth asking for.
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Plantar warts on deep skin
On deep skin the black dots are the hardest to pick out, so the wart is judged by feel and by the interrupted skin lines rather than by color. Treatment matters here too. Freezing works by blistering the skin, and injured skin on deeper skin tones often heals with a pale ring or a dark mark that outlasts the wart by a year. Daily salicylic acid with regular filing is the slower route that avoids that.
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Size
Common wart
A pinhead to a pea
It thickens over weeks. A ring of smaller warts can appear around a larger one.
Plantar Warts
A few millimetres to a coin
Several can merge into one broad patch on the sole. That flat, tiled version is called a mosaic wart.
Does it hurt
Common wart
Usually not
Most hand warts are noticed by sight. One beside a fingernail can be sore, because the skin there is tight.
Plantar Warts
Often, when you stand
It feels like a small stone in your shoe. Squeezing it from the sides usually hurts more than pressing straight down.
Where it shows up
Common wart
Hands, fingers and knees
Backs of the hands, around the nails, and on the knees. Nail biting explains the ring of warts many people get around one finger.
Plantar Warts
Soles, heels and the ball of the foot
It can appear on parts of the sole that take no weight at all, because it is an infection rather than a pressure problem.
Where it appears
Plantar Warts
The soles, at the pressure points
They sit on the sole, and mostly on the parts that take weight — the ball of the foot and the heel. Pressure pushes them inward instead of letting them stand up, which is why they feel like a stone in the shoe and hurt when you squeeze the sides.
What it does over time
Common wart
Clears, often after months or years
The immune system recognises the virus eventually. Children usually clear warts faster than adults do.
Plantar Warts
Slower, and it spreads on the foot
The same wart can sit for years, and the warm damp inside a shoe helps it seed new spots nearby.
Treatment
Common wart
Salicylic acid, then freezing
Salicylic acid daily, with gentle filing between applications. Liquid nitrogen freezing in a clinic is the usual next step, every one to two weeks.
Plantar Warts
The same, but stronger and longer
The skin on the sole is far thicker, so treatment uses higher-strength salicylic acid, more soaking and filing, and more visits.
Plantar Warts
Salicylic Acid
The best-evidenced treatment you can buy, and for the sole it is used at foot strength, far higher than the acne version. The order matters: soak the foot, file the surface, apply, cover. Applied to an unfiled callus it never reaches the infected skin, which is the usual reason it seems not to work. Twelve weeks of nightly use is a fair trial.
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Soaking and filing
Not an optional extra. Ten minutes in warm water softens the callus, then a file or pumice takes the dead surface down until the skin looks live again. It relieves the pain by itself, because the pain comes from the hard pad. Use a file kept only for that foot, and never share it.
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A padded ring or offloading insole
A felt ring around the wart, or an insole that shifts weight off it, makes walking comfortable while the treatment works. It does nothing to the virus. It is worth using early, because it stops the limping that causes aching in the knee and hip.
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Home freezing kits
The sprays sold in pharmacies do not get as cold as the liquid nitrogen used in clinic, and on the sole they usually cannot get through the callus at all. They are more useful on hands than on feet. If you try one, file the surface down first and do not use it on a foot with reduced feeling.
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Duct tape
Covering the wart with tape between treatments is cheap and harmless, and the trials of it are mixed at best. It keeps the surface soft and stops picking, which may be most of the benefit. Reasonable to add, especially for a child, but not a replacement for acid and filing.
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Cryotherapy (Liquid Nitrogen)
Freezing in clinic, repeated every two to three weeks. Over several months the results are broadly similar to salicylic acid used properly, so it is one reasonable option rather than the top of a ladder. On the sole it is more painful than elsewhere, walking is sore for a day or two, and it works far better if the callus is pared first.
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Cantharidin
A blistering liquid painted on in clinic and washed off a few hours later, which lifts the wart away from the skin beneath. It is painless to apply, which makes it a common choice for children. The blister that follows can be sore to walk on for a few days, and on the thick skin of the sole it often needs repeating.
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Nd:YAG Laser
A laser that heats the blood vessels feeding the wart and cuts off its supply, used for foot warts that have failed simpler treatments. It reaches deeper than freezing does. It is done with local anesthetic, it is sore for several days afterwards, and it usually takes more than one session.
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Electrodesiccation and Curettage
Burning and scraping the wart out under local anesthetic. It clears the visible wart in one go, which is why people ask for it. On the sole it leaves a wound that takes weeks to heal and can leave a scar you then walk on, and the wart can still return, so it is a late option rather than an early one.
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Surgical Excision
Cutting a plantar wart out is generally avoided. There is no root to remove, so surgery takes healthy tissue with it, and it leaves a scar on a weight-bearing surface that can hurt more than the wart did. Recurrence around the scar is common. It is used for a growth that needs sending to the laboratory, not to get rid of an ordinary wart.
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Cimetidine tablets
A stomach medicine that also nudges the immune system, sometimes tried in children with many warts because it is easy to take and well tolerated. Controlled trials have not shown it beats a dummy tablet. It is a reasonable add-on if you want to try something painless, not a treatment to rely on.
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5-fluorouracil cream
A chemotherapy cream used at low strength, applied under tape to a wart that has not responded to salicylic acid. It kills the rapidly dividing infected cells. It stings, it needs the callus filed down to work, and it is avoided in pregnancy.
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Imiquimod cream
This one works by asking the immune system to notice the infection rather than by destroying the wart, which is the step the foot is stuck on. Most of its evidence is in warts elsewhere, and on the thick skin of the sole it is usually combined with filing or with salicylic acid. Expect redness and soreness while it is working.
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Urea 40% cream
Not a wart treatment. It dissolves hard callus, so it is used under a dressing to thin the pad over a wart that is too thick to file comfortably, and to treat the cracked heels that let the virus in. It makes the other treatments reach further.
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When it needs a doctor
Common wart
Bleeding, changing, or on the face
Worth a visit if it bleeds without being knocked, changes colour or shape, keeps spreading, or you want a facial one treated without a mark.
Plantar Warts
Painful walking, or no change in weeks
Worth a visit if it hurts enough to change how you walk, if it has not shifted after several weeks, or if you have diabetes, neuropathy or poor circulation.
What treatment actually asks of you
Plantar Warts
A plantar wart takes longer than a hand wart, so plan for months. The acid has to get through a much thicker layer of skin before it reaches the wart at all.
Related topic illustrations
Plantar Warts
Walking differently to avoid it
A wart under a weight-bearing area hurts with every step, and people quietly shift their weight to the side of the foot to keep off it. Months of walking that way causes aching in the other foot, the knee and the hip. Thinning the callus, or a padded ring that takes the weight off, usually fixes the walking long before the wart is gone.
Common questions
Questions Patients Ask
Are common warts and plantar warts the same thing?
They are the same family of virus behaving the same way in two different places. The usual HPV types differ slightly, and the pressure of walking is what makes the foot version look flat and hurt.
Why does my plantar wart hurt but my hand wart does not?
A hand wart grows outwards into open air. A plantar wart is pressed inwards by your body weight with every step, so it presses on the tissue underneath.
Can a plantar wart spread to my hands?
Yes, though it is not common. The virus moves on contact, so picking at a foot wart and then touching broken skin elsewhere can carry it.
Is a verruca the same as a plantar wart?
Yes. Verruca is the everyday British word for a wart on the sole of the foot. The medical name is verruca plantaris.
How long does treatment take?
Plan on weeks to months for a hand wart and longer for a foot wart. The skin on the sole is much thicker, so the acid takes longer to reach the wart at all.
Do I need to keep my feet covered at the pool?
Wearing something on your feet in pools, changing rooms and shared showers lowers the chance of picking up or passing on the virus. Damp shared floors are the classic place it spreads.