Warts
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Wart vs Splinter
A wart is a growth made by a virus in your own skin. It builds up slowly over weeks, and the tiny dark dots inside it are what people mistake for a splinter. A splinter is a piece of wood, glass or metal stuck under the skin. It arrived in one moment, it hurt straight away, and there is a mark where it went in. When it appeared usually settles the question.
At a glance
| The difference | Warts | Splinter |
|---|---|---|
| What it is | Your own skin, growing too fast | Something from outside, stuck inside |
| What it looks like | Rough bump with dark pinpoints | A dark line or sliver under the skin |
| Does it hurt | Only under pressure | Yes, from the first day |
| What it does over time | Thickens, then slowly clears | Comes out, or the skin pushes it out |
Splinter
Something from outside, stuck inside A fragment of wood, glass, metal or thorn has pushed through the surface and stayed. The redness around it is your body reacting to an object that should not be there.
Side by side
The differences that matter
What it is
Warts
Your own skin, growing too fast
A human papillomavirus, or HPV, infects the top layer of skin. It makes those cells multiply, and the thickened bump is the result. Nothing foreign is in there.
Splinter
Something from outside, stuck inside
A fragment of wood, glass, metal or thorn has pushed through the surface and stayed. The redness around it is your body reacting to an object that should not be there.
How it works, illustrated
Warts
The outer layer sheds and replaces itself steadily. Small nicks and scrapes close over before anything can get in.
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HPV needs a way through - a cut, a hangnail, a shaving nick, or skin softened by water. It reaches the dividing cells at the bottom of the outer layer and settles there.
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The virus makes those cells divide faster than they should. They pile up into the rough, raised bump, with tiny clotted vessels showing as black dots.
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HPV hides in the outer layer, where there is little blood supply and few immune cells patrolling. That is why warts last months or years, and why they eventually clear on their own once the immune system finds them.
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How it started
Warts
Slowly, over weeks
Most people cannot say when it began. It was a small rough patch, then a lump, then a bigger lump.
Splinter
In one second
There is almost always a moment: a deck, a splintered handle, a broken glass, a barefoot step in the garden.
What it looks like
Warts
Rough bump with dark pinpoints
Dry, grainy and slightly raised, with a thickened rim. The black or dark red specks inside are small clotted blood vessels.
Splinter
A dark line or sliver under the skin
A straight, narrow shape rather than a round one. Often you can see one end of it, or a small dark entry point in the skin.
More photographs
Warts
Across skin tones
Warts
Warts on light skin
On light skin a wart usually shows a pink or reddish tinge and a thin red ring around the base, and the tiny black dots inside it stand out clearly against pale, thickened skin. That contrast is why warts are often recognized early here. Freezing leaves a pale mark less often than on deeper tones, though it still blisters and stings.
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Warts on medium skin
On medium skin a wart is usually the same color as the skin around it or slightly gray, and the ring of redness is fainter. The reliable clue is texture rather than color: a firm, rough, thickened bump with the fine skin lines stopping at its edge instead of running across it. Freezing here can leave a mark, so a small test spot first is reasonable.
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Warts on brown skin
On brown skin a wart often reads as gray or brown rather than pink, so it is more often taken for a callus, a corn or a mole and treatment tends to start later than it should. Run a finger over it: a wart is firm and rough, and the fine skin lines stop at its edge. Because injured skin here commonly heals a different color, slower options like daily salicylic acid, filing and paring in clinic are usually the better first move.
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Warts on deep skin tones
On deep skin tones the redness dermatologists look for is effectively invisible, so warts are recognized late and are the most likely to be dismissed as hard skin. The trade-off around treatment also shifts: freezing and anything that blisters can leave a pale ring or a dark mark that outlasts the wart by a year. Test one small wart before treating a group, keep freezing shorter, and add a daily sunscreen on any treated area of the face, hands or arms.
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Does it hurt
Warts
Only under pressure
A wart on the hand is usually painless. A wart on the sole hurts when you stand on it, and it hurts more when squeezed from the sides.
Splinter
Yes, from the first day
Sharp and well localised. Pressing directly over it reproduces the pain exactly, and it does not settle while the object is still there.
Where it shows up
Warts
Hands, fingers and soles
Backs of the hands, around the nails, knees, and the weight-bearing parts of the foot.
Splinter
Fingertips, palms and soles
Wherever skin meets a rough surface. Fingertips from handling wood, soles from walking barefoot, knees from kneeling.
Where it appears
Warts
Fingers, hands, knees and feet
Warts land where skin gets knocked, wet or broken: the fingers, the backs of the hands, around and under the nails, the knees, and the soles and edges of the feet. Biting nails or picking skin spreads them along the finger.
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The face, in a shaving path
Flat warts turn up in groups on the face, often spread in a line along a shaving path. The long, thread-like kind grow around the eyes, the nose and the mouth. They are the same virus, spread by the razor.
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What it does over time
Warts
Thickens, then slowly clears
It grows for weeks to months and can spread to nearby skin. The immune system clears it eventually, often after a year or more.
Splinter
Comes out, or the skin pushes it out
A shallow splinter often works its way to the surface within days. A deep one can stay, and the skin may seal over and form a firm lump around it.
Warts
Salicylic Acid
The first treatment for almost every ordinary hand or foot wart, and the one with the best evidence outside the clinic. It dissolves the infected thickened skin a layer at a time, so it only works if it goes on every single day. Soak the wart for five minutes, file the dead surface off, apply, and cover it. Twelve weeks is a fair trial; ten days is not.
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Soaking and filing
Not a treatment on its own, but the thing that makes salicylic acid work. Filing the dead crust off between doses lets the next dose reach live infected skin instead of sitting on top of it. Use a file or pumice kept only for that wart and thrown away afterwards, because one file used on several warts spreads them between your own sites.
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Home freeze kits
The pharmacy sprays get nowhere near as cold as clinic liquid nitrogen, so they work best on small, new, thin warts on the hands and poorly on thick foot warts. They sting and can blister. On deeper skin tones they carry the same risk of leaving a pale or dark mark as clinic freezing does.
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Duct tape
Covering a wart with tape for a few days at a time, then filing it, is cheap and harmless, and the trials are genuinely mixed on whether the tape itself adds anything. Any benefit is probably from the covering and the filing. It is reasonable alongside salicylic acid and a poor substitute for it.
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Cryotherapy (Liquid Nitrogen)
Liquid nitrogen freezes the infected skin and the injury also draws immune attention to the spot. It needs repeating every two to four weeks, usually three or four times, and a wart regrowing from the edge between sessions is normal rather than failure. Over several months its results are broadly similar to salicylic acid used properly. It stings, it blisters, and on deeper skin tones it can leave a lasting pale or dark mark.
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Cantharidin
A blistering liquid painted on in clinic and washed off a few hours later. It is painless going on, which is why it is a common first choice for children and for warts on the face. The blister that follows lifts the infected skin away over the next few days and can be sore. It usually takes more than one visit.
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Electrodesiccation and Curettage
The wart is numbed, burned with an electric current and scraped away in one visit. It is kept for a single stubborn wart that has failed everything gentler, because it leaves a scar, and a scar on the sole of a foot can hurt more than the wart did. Warts can still regrow at the edge of the scar.
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Pulsed Dye Laser (V-Beam)
The laser targets the small blood vessels feeding the wart rather than the virus itself. It is an option for stubborn warts on the hands and around the nails when freezing has not worked, and it spares the skin around it, which matters on the face. Several sessions are needed, results are inconsistent, and it is not usually covered by insurance.
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Cimetidine
An old stomach-acid tablet that people ask about for multiple stubborn warts, on the idea that it nudges the immune system. The better-controlled trials found it no more effective than a dummy tablet in adults. It is safe and cheap, so it is occasionally still tried in children, but it should not replace treatment that is known to work.
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Imiquimod cream
A cream that works on the last step of the problem: it makes the local immune system pay attention to the virus. It is used mainly for flat warts on the face and for warts that keep coming back, applied a few nights a week for weeks. It reddens and irritates the skin while it works, and it does poorly on thick foot warts.
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Tretinoin
A retinoid cream used for the flat warts that appear in groups of dozens on the face and the backs of the hands, where acid and freezing would be too harsh over so wide an area. It speeds up the turnover of the infected surface cells. It takes months, and it makes the skin dry and sun-sensitive while it runs.
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5-fluorouracil cream
A chemotherapy cream at a low strength, applied to the wart itself, often under tape. It is used for flat warts and for warts that have not shifted with acid, and it is a common choice in children because it does not hurt going on. It reddens and can crust the treated skin, and it is not used in pregnancy.
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What to do about it
Warts
Salicylic acid and patience
Soak, file the surface gently, apply salicylic acid, cover, repeat daily for weeks. Freezing in a clinic is the usual next step.
Splinter
Remove it, then keep it clean
Clean tweezers and a good light for anything you can see and grip. Pull along the same angle it went in. Then wash the area and cover it.
When it needs a doctor
Warts
Spreading, bleeding or not shifting
Worth a visit if it bleeds without being knocked, changes shape, keeps spreading, or has not budged after several weeks of treatment.
Splinter
Deep, glass, or turning red
Worth a visit if you cannot see or reach it, if it is glass or metal, or if the skin around it becomes red, warm and increasingly sore.
Getting a splinter out
Splinter
Most splinters can be taken out at home. Wash your hands, clean the skin, and use tweezers under a bright light. Grip the end and pull along the line it entered. Yanking sideways snaps it and leaves the deep half behind.
A splinter you cannot see is a different job. Glass, metal and deep wood fragments often need a clinician, who can numb the skin and open it slightly. Wood left in the skin is the type most likely to become inflamed, because it holds moisture and bacteria.
Related topic illustrations
Warts
Warts around and under the nails
Warts that set up in the nail folds are the most stubborn of the group, because the nail shields the virus from creams and from freezing. Left long enough, a wart growing under the nail can lift it or leave a permanent ridge or split in the nail plate. Nail biting and picking at hangnails are how most of them start, and they are the ones most worth taking to a dermatologist early.
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Squamous Cell Carcinoma
The reason a single stubborn growth in an adult should be looked at rather than treated blindly. This skin cancer can be rough and raised enough to pass for a wart. The differences are that it is usually one growth rather than several, it keeps growing rather than sitting still, it often bleeds or crusts and does not heal, and it turns up on sun-exposed skin in older adults. Warts are commoner in children and tend to come in groups.
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Common questions
Questions Patients Ask
Do warts have seeds or roots?
No. The dark specks in a wart are tiny blood vessels that have clotted, not seeds, and warts have no roots. They sit in the top layer of skin only.
Can a splinter cause a wart?
Not directly, but a break in the skin is how the wart virus gets in. A splinter site is one of the small injuries that can let HPV take hold weeks later.
How can I tell if something is still in my foot?
Pain that stays sharp and localised, and does not settle over a few days, points to something still in there. A lump that grew slowly over weeks with no injury behind it points to a wart.
Is it safe to dig at it with a needle?
No. Digging at a wart breaks the skin and can move the virus to nearby skin, and digging blindly for a splinter usually pushes it deeper. Tweezers and a visible end are the only home combination worth trying.
Why does it hurt more when I squeeze the sides?
Warts sit in the skin like a plug, so pinching the skin from the sides presses the whole growth. A splinter and a callus usually hurt more with direct downward pressure.
How long should I treat it before giving up?
Salicylic acid needs several weeks of daily use with filing between applications before you judge it. If nothing has changed after that, it is worth having someone confirm what it is.