Warts
Warts are firm, rough growths caused by a common virus that infects the top layer of skin. They are harmless and most of them clear on their own, but they spread easily and they are slow to treat.
Key facts
Warts at a glance.
Typical signs
Rough bumps with black dots
Common locations
Hands, fingers, feet
Expected course
Often clear over 1–2 years
Treatment options
Observation, salicylic acid or freezing
What is it?
Top things to know about Warts
- They are caused by HPV. Cutaneous warts are benign growths caused by certain types of human papillomavirus.
- They spread by contact. Warts can pass through direct contact or from one area of skin to another.
- Many clear on their own. Many resolve naturally, especially in children.
- Diagnosis is usually visual. Clinicians look for the rough surface and small capillary dots; uncertain growths may be biopsied.
What it looks like
What Warts looks like
Warts are small growths caused by the human papillomavirus. Common warts are firm, rough, raised bumps, usually on the fingers, hands, knees and elbows. They often have tiny black dots, which are clotted blood vessels. Warts are not cancerous and often go away on their own over months to years, but they can spread to other parts of the body or to other people.
Warts are named by their shape and where they grow.
Common warts
Rough bumps on hands and fingers.
Plantar warts
Flat, painful warts on the soles.
Flat warts
Small, smooth, flat-topped bumps.
Filiform warts
Long, thread-like growths on the face.
Where it shows up
Common warts often affect the hands and fingers. Warts on the soles are called plantar warts.
Hands and wrists
Hand, finger or wrist locations.
Feet
The soles are not visible in this view.
On different skin tones
Warts on different skin tones
Warts look similar across skin tones, though on brown and Black skin they are often darker than the surrounding skin. Flat warts on darker skin can be confused with other small dark bumps. Freezing treatment can leave light or dark spots in darker skin, so gentler methods are sometimes chosen.
What happens in Warts?
Human papillomavirus enters through small skin breaks and stimulates local surface-cell growth. The thickened tissue forms a rough bump that may contain visible dark capillary dots.
- A rough bump forms: Small capillaries may look like dark dots.
- Infected cells multiply: Local skin growth becomes thicker.
- HPV enters tiny skin breaks: The virus reaches cells in the epidermis.
Causes and triggers
What causes Warts
Causes
Why it happens
Warts are caused by the human papillomavirus infecting the top layer of skin. The virus makes skin cells grow faster, forming a rough bump.
Risk factors
Raise the odds
- Children and teens
- Weakened immunity
- Nail biting
Triggers
Passes it on
- Skin-to-skin contact (Well established)
- Cuts, scrapes and hangnails (Strong link)
- Picking or biting warts (Strong link)
- Shared towels or razors (Possible)
When it usually starts
When it usually starts
Warts
Common in children and teenagers; adults can also develop them.
Daily care
Daily care for Warts
Covering the wart
Keeps virus off other spots and holds treatment against the skin.
Keeping hands and feet dry
Change socks during the day, dry between the toes, air your shoes.
Your own kit
Flip-flops in shared showers, own towel, own clippers.
Follow safe filing instructions for wart treatment; avoid injured or high-risk feet
Use only gentle removal of dead surface skin when advised; never cut or file to pain or bleeding. High-risk feet need professional advice.
Cantharidin, applied in clinic
A blistering agent, painless going on, so it suits children.
Immune-based treatments
Imiquimod cream or candida antigen injections for warts that keep returning.
Treating dry skin and eczema properly
Intact, moisturized skin is much harder to enter.
Allow the treatment-specific course and review if it is not helping
The required course varies by treatment and site. Review persistent, painful or uncertain lesions rather than repeatedly damaging the skin.
Review immune-suppressing medicines with the prescriber; do not stop them yourself
Immune suppression can affect infection persistence. Tell the treating clinician and do not stop a prescribed medicine on your own.
Follow safe wart preparation advice; do not file to pain or bleeding
Use only gentle removal of dead surface skin when the product recommends it. Never file to live, painful or bleeding skin. Do not share files; get advice for diabetes, poor circulation or reduced sensation.
Avoid: Picking, biting and pulling at warts
Carries virus to fingers and lips, and leaves broken skin for it.
Avoid: Shaving over a wart
Seeds virus along the whole shaving path.
Avoid: Walking barefoot in shared showers
Warm wet floors are where the virus survives longest.
Avoid: Skin that stays wet for hours
The outer layer softens and stops being a seal.
Avoid: Nail biting and picking at hangnails
The most reliable way to get warts around the nails.
Avoid: Sharing personal tools
Towels, razors, nail clippers, pumice stones and files move the virus.
Avoid: Reusing one file on several warts
It spreads them between your own sites.
Avoid: Stopping treatment too early
Virus stays at the edges a week or two after the surface looks normal.
Avoid: Eczema, dry skin and cracked heels
Broken skin is an open door.
Treatments
Treatments for Warts
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.
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.
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.
Imiquimod
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.
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.
Fluorouracil
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.
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.
Candida Antigen Injection
Candida antigen injection. A tiny amount of yeast protein injected into one wart, to wake the immune system up in that spot. What makes it useful here is that untreated warts elsewhere on the body often clear at the same time, so it suits someone with many warts rather than one. It is repeated every few weeks, and it can cause a day or two of aching or flu-like feeling.
Bleomycin Injection
Bleomycin injection. Injected directly into warts that have resisted everything else, particularly thick ones on the soles and around the nails. Clearance rates are good. It is painful enough that the area is numbed first, it can leave a permanent nail change if used at the nail fold, and it is not used in pregnancy, so it sits late in the order for a reason.
Cryotherapy
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.
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.
Paring
Paring in clinic. The top dead layer is shaved off with a blade. It does not hurt, because that layer has no nerve supply, and it does two jobs at once: it confirms the diagnosis by exposing the tiny clotted vessels a callus does not have, and it lets acid or liquid nitrogen reach live infected skin. It is done alongside another treatment, never as the whole treatment.
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.
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.
Outlook
What to expect with Warts
Warts are self-limiting — they end on their own eventually. In children, roughly two thirds clear within two years without treatment. Adults are slower, and warts present for several years are least likely to go quietly.
- 1
While it is active · Often months of no change
A wart can stay unchanged for months, and while it is active it seeds new ones nearby — in a ring around the original, or in a line along a shaving path or a scratch.
- 2
When it turns · A few weeks
Once the immune system identifies the virus the wart clears over a few weeks, and several often go at once. That is why a wart can vanish after a treatment that should not have worked.
- 3
Signs it is clearing · What to look for
The bump flattens, the rough surface softens, the black dots disappear, and the fine lines of the skin start running across it again. If the surface is smooth but the lines still stop at the edge, virus is still there — keep treating another week or two.
- 4
After it clears · Long term
Immunity to that strain lasts, so new warts elsewhere are a different strain or a fresh exposure. In people on immune-suppressing medicine, warts recur far more often and are managed rather than cured.
Complications
Complications to know about
Spreading to new spots
An untreated wart seeds others nearby, so one bump becomes a ring of small ones around it, or a line of them along a scratch or a shaving path. Picking, biting and filing several warts with the same file are the usual ways it happens. Covering the wart, keeping your own file and treating early keep the number down.
Color change after treatment
Freezing, and any treatment that blisters or burns, works by injuring the skin, and injured skin can heal a different color. A pale ring around the treated spot can last a year or more and is sometimes permanent, and a dark mark can outlast the wart by months. Both are far more likely on deeper skin tones, which is why gentler treatment and a small test spot are often the better trade.
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.
When to get help
When to get help
When to seek care
Seek assessment for an uncertain, painful, bleeding or changing growth, or persistent warts with weakened immunity. Genital lesions need separate assessment.
Lookalikes
What else could it be?
Seborrheic Keratosis
Seborrheic keratoses often look waxy and stuck on. Warts are more likely to have tiny dark dots and commonly appear on the hands or feet.
Squamous Cell Carcinoma
A growth that keeps enlarging, bleeding or crusting needs checking for squamous cell cancer. Ordinary warts more often occur in groups, especially in younger people.
Questions
Questions you might be asking.
How did I catch this?
Almost nobody can say. The virus lives on warm wet surfaces and passes by skin contact and shared objects, and there is usually a gap of one to six months between catching it and seeing the wart. It is not a sign of poor hygiene.
Will it go away if I just ignore it?
Probably, eventually. About two thirds of warts in children clear within two years without treatment, and adults are slower. Treating is worth it because warts spread to other spots and other people meanwhile, and older ones are harder to clear.
Why is my wart coming back after freezing?
Freezing removes infected skin but does not reach every infected cell, and it does not teach the immune system to recognize the virus. That is why it takes several sessions two to four weeks apart, and why a wart can regrow from the edge. Regrowth is normal, not treatment failure.
Are warts contagious to my family?
Yes, though not dramatically. The virus passes on shared towels, bath mats, razors, nail clippers and files, and through contact with broken skin. Keeping the wart covered, keeping your own towel and clippers, and wearing something on your feet in shared bathrooms covers most of the risk.
Is a wart on my hand the same as a genital wart?
Related viruses, but not the same strains, and they do not usually move between those sites. Genital warts are assessed and treated differently, so do not manage them with hand-wart products.
Can I cut it off myself?
No. A wart has no root to remove, so cutting reaches live skin without reaching all the virus, and you are left with a scar plus a wart growing back around it. It also risks infection and, on the foot, a wound that heals slowly. Paring is done in clinic with a sterile blade.
Sources
Sources and further reading
Related
Keep exploring.
Seborrheic Keratosis
Cantharidin
Cryotherapy
Salicylic Acid
Squamous Cell Carcinoma
Electrodesiccation and Curettage
Tretinoin
V-Beam
Squamous Cell Carcinoma vs Warts
Warts vs Seborrheic Keratosis
Actinic Keratosis vs Warts
