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Warts and verrucasThis factsheet is written for people who get warts or verrucas. A wart is a fleshy growth on the skin caused by infection with the human papilloma virus (HPV). Verruca is another name for wart but is usually used to refer to warts found on the soles of the feet. Treatment for warts can take several weeks or months to be fully effective.
Warts are commonAbout one in 10 children and young adults in the UK are thought to be affected by warts. They're most common between the ages of 12 and 16, but you can get them at any age. Warts usually occur on the hands and feet, but they can affect the face and other parts of the body. Although they can be unsightly and embarrassing for people who have them, the common type of wart generally causes no harm. People taking steroid tablets, or with conditions that suppress the immune system (such as HIV infection) are more likely to develop many warts. HPVThere are over 100 different subtypes of the human papilloma virus (HPV) responsible for warts. Certain types are more likely to cause warts on different parts of the body. The virus is spread by direct skin contact or by touching moist surfaces, such as floors in swimming pools and changing rooms, which have been in contact with a person who has warts. Warts occur more commonly on areas of skin that are likely to be damaged, such as fingers, elbows, knees and the face. Nail-biting in children and shaving of the face or legs, and ill-fitting shoes in adults have all been blamed for making warts more likely. Children who have never come into contact with HPV have no immunity to it and so are more prone to developing warts. Some people seem to be more susceptible to warts than others - so not everyone in the same family necessarily gets them. Wart typesAfter coming into contact with HPV, it can take anything from one month up to two years for a wart to develop. Below are some examples of different types of wart. Common wart (verruca vulgaris). A firm, raised, pink or skin coloured lump with a rough surface that may look like a cauliflower. Often seen alone or in clumps on the hands, fingers, elbows, knees or feet. They are usually smaller than a centimetre in diameter. Plane wart (verruca plana). Small (1 - 5mm) smooth, flat topped or slightly raised. They affect face, hands, or legs and are usually skin coloured, light brown or greyish, but are sometimes pigmented. Can occur alone or in their hundreds. Filiform wart. Long, slender growths on lips, eyelids, face or neck. Plantar wart. Commonly known as verrucas, these occur on the soles of feet. They can be painful when under pressure. Small black dots can be seen on the surface under the callous. Mosaic warts. These occur when a number of plantar warts group together into a cluster. Genital wartsCertain types of HPV affect the genital area, causing a form of sexually transmissible wart (condylomata acuminata). Don't try and treat these at home, seek advice from your GP or a genitourinary medicine (GUM) clinic. In October 2006, a vaccine against the strains of HPV that cause genital warts was released in Europe. It's hoped that this will lead to a dramatic reduction in the incidence of HPV and genital warts. This will help reduce the incidence of cervical cancer, which is related to HPV infection. For more information, please see the separate BUPA health factsheet, sexually transmitted infections. TreatmentMost warts don't need to be treated. In children, between 30 and 50 percent of verrucas disappear within six months, although they may last longer in adults. One study found that two thirds of warts disappear on their own within two years. However, treatment may be needed:
Although warts and verrucas are very common, there isn't much scientific evidence to show which treatments work best. For stubborn warts, several different approaches might need to be tried. Over-the-counter remediesA variety of creams, gels, paints and medicated plasters for treating warts are available from pharmacies. Most of these contain salicylic acid as their active ingredient. Examples include the brands Compound W and Bazuka. Salicylic acid works by destroying the thickened skin which makes up the wart. This can then be rubbed off with an abrasive board or pumice stone. Other products contain chemicals such as formaldehyde (eg Veracur) or glutaraldehyde (eg Glutarol) and work in a similar way. Below are some tips for successful treatment.
These treatments should not be used by people with diabetes or people with poor circulation, and may not be successful with very large warts. Silver nitrate pencilThis over-the-counter treatment burns away warts. You apply it daily, but it should only be used three times for a wart, and six times for a verruca. Duct tapeSome evidence suggests that covering a wart with duct tape may get rid of it. The tape needs to be used on the wart for several weeks before it can have an effect. Remove the duct tape at night and then rub it with an abrasive board or pumice stone. Apply more tape in the morning. CryotherapyOver-the-counter freezing systems can now be purchased at a pharmacy. Follow the instructions carefully as the product is not suitable for everyone (including pregnant women and people with diabetes). More aggressive freezing treatments can be given by a doctor (see When to see a doctor). These treatments aren't suitable for using on the face or genital region. If you have warts in these regions, talk to your GP. When to see a doctorSeek advice from your GP if over-the-counter treatments, applied for the appropriate length of time, don't work. If there's any doubt about whether the lump is a simple wart, you shouldn't treat it yourself. Seek advice from your GP about any lump or bump that bleeds, is painful, becomes crusty, oozes discharge, looks dark in colour or changes shape or size. Don't treat this kind of lump at home. Below are some treatments available on prescription.
Issues to considerIs treatment necessary? Warts tend to disappear without treatment. One research study showed that 93 percent of British school children who had warts when they were 11 were clear of them by the age of 16. Cost - chemical-based wart cures can be bought relatively cheaply (currently about £3 to £6). Cryotherapy and other treatments are available on the NHS, but there may be a long wait. Privately, costs vary according to the number of warts and the type of treatment. Pain - chemical wart applications cause some soreness, but they are not as painful as cryotherapy, which can cause discomfort for a few days after treatment. Scarring - surgery is the most likely treatment to cause scarring, and creams and liquids the least. Cryotherapy usually causes temporary blistering rather than scarring. Prevention
Children and swimmingThere's no national policy that bans children with a verruca from games and swimming. Many doctors feel it is more important that children learn to swim and enjoy physical activity than it is to prevent verrucas spreading. However, it seems sensible advice that games are not done in bare feet and that verrucas are covered with a plaster. People with hand warts should wear gloves if they are using communal equipment (for example, in a gym). Further information
Sources
Reviewed by Dr James Quekett, Bsc.MB Ch.B MRCGP DRCOG DFFP, partner/principal general practitioner at Rowcroft Medical Centre. Published by BUPA's health information team, healthinfo@bupa.com, March 2007.
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