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Warts and verrucas

Published by Bupa's health information team, June 2009.

This factsheet is for people who have warts or verrucas, or who would like information about them.

Warts are a fleshy growth on the skin caused by infection with the human papilloma virus (HPV). Verrucas are warts found on the sole of the foot.

About warts and verrucas
Symptoms of warts and verrucas
Causes of warts and verrucas
Diagnosis of warts and verrucas
Treatment of warts and verrucas
Special considerations
Prevention of warts and verrucas
Questions and answers
Related topics
Further information
Sources

About warts and verrucas

About seven to 10 percent of people are affected by warts. They are most common between the ages of 12 and 16, but you can get them at any age.

Warts usually occur on the hands or feet, but they can affect the face and other parts of the body. They don't usually cause any harm.

Types of wart and verruca

After coming into contact with HPV, it can take anything from one month up to two years for a wart to develop. The following are some examples of different types of wart.

Common wart (verruca vulgaris)

These are firm, raised, pink or skin-coloured lumps with a rough surface that may look like a cauliflower. They are often seen alone or in clumps on your hands, fingers, elbows, knees or feet.

Plane wart (verruca plana)

These warts are small (2 to 4mm wide), smooth, flat-topped or slightly raised. They affect your face, hands, or legs and can occur alone or in their hundreds. They are usually skin-coloured, light brown or greyish, but are sometimes darker.

Filiform wart

These are long, slender growths on your lips, eyelids, face or neck. They can often group together to form a cluster.

Verruca (plantar wart)

Verrucas are small warts (1 to 10mm wide) that occur on the soles of your feet, heels or toes. They can be painful when under pressure. They have a rough surface and small black dots can sometimes be seen under the hard skin. Verrucas can be seen alone or in clusters.

Mosaic wart

These occur when a number of verrucas group together into a cluster.

Periungual/subungual wart

These occur around your nails and are more common if you bite your nails.

Genital warts

Certain types of HPV affect the genital area, causing a form of sexually transmissible wart. Don't try and treat these at home - seek advice from your GP or a genitourinary medicine (GUM) clinic.

Symptoms of warts and verrucas

Most warts don't cause any discomfort, but if you have a verruca or periungual wart you may have some pain around that area.

Genital warts usually have no symptoms, but you may have some itching and women may get vaginal discharge.

These symptoms may be caused by problems other than genital warts or warts and verrucas. You should visit your GP for advice.

Causes of warts and verrucas

There are over 100 different subtypes of HPV that cause warts. Certain types are more likely to cause warts on different parts of your 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.

You tend to get warts more often on areas of skin that are damaged. Scratching your skin and shaving your face or legs may cause the warts to spread. If you wear ill-fitting shoes you may be more likely to get warts on your feet.

If you're a butcher or work in an abattoir you may be more likely to develop warts.

Babies are unlikely to develop warts, but as they become older the risk of developing them increases.

Diagnosis of warts and verrucas

If you're worried about your wart or verruca, visit your GP.

Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history.

Sometimes warts can be confused with other similar skin conditions. If your GP is unsure about whether you have a wart, he or she may refer you to a dermatologist (a doctor specialising in skin conditions). Your GP may also recommend you visit a dermatologist if you have a weakened immune system.

Treatment of warts and verrucas

Most warts don't need to be treated. In children 30 to 50 percent of common warts disappear within six months without any treatment. Sometimes it can take up to two years for warts to disappear, and plane or mosaic warts may take even longer.

You may need treatment for your wart:

if the wart is unsightly
to prevent spreading
if it's painful or itchy

Although warts and verrucas are very common, there isn't much scientific evidence to show which treatments work best. If your wart is very stubborn, you may need to try several different treatments. Treatment for warts can take several weeks or months to be fully effective.

Self-help

Covering a wart with duct tape may get rid of it. Cover it with a piece of duct tape for six days. After six days, remove the duct tape, soak your wart and rub it with an abrasive board or pumice stone. Leave the wart uncovered overnight and apply more tape in the morning. You may need to continue applying the duct tape for two months before the wart disappears.

There is little evidence that this works, but you may want to try it as an alternative treatment.

Medicines

A variety of creams, gels 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 that makes up the wart.

Other products contain chemicals such as formaldehyde (eg Veracur) or glutaraldehyde (eg Glutarol) and work in a similar way.

Over-the-counter freezing systems can now be purchased at a pharmacy. Follow the instructions carefully as this product isn't suitable for everyone (including people with diabetes or poor circulation).

These treatments aren't suitable for using on the face or genital region. If you have warts in these areas, talk to your GP.

The following are some tips for successful treatment.

Salicylic acid and other wart treatments also affect healthy skin, so it's important to protect the surrounding area - use petroleum jelly or a corn plaster - and apply the product with care.
Soak the wart in warm water for five minutes before applying the salicylic acid.
Rub dead skin off once or twice a week with a pumice stone or emery board.
Stop treatment and re-start in a few days if the skin becomes sore.
Cover the wart with a plaster - this may help get rid of the wart.
Persevere - you may need to continue applying salicylic acid for 12 weeks or more before the wart disappears.

If you have diabetes or poor circulation you shouldn't use salicylic acid treatments. If you're pregnant you should seek advice from your GP before using salicylic acid.

Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Seek advice from your GP if over-the-counter treatments, applied for the appropriate length of time, don't work.

If there is any doubt about whether the lump is a wart, you shouldn't treat it yourself and should seek advice from your GP if you're concerned.

Other treatments

Your GP may recommend the following treatments.

Cryotherapy - your GP will freeze the wart by spraying (very cold) liquid nitrogen on to it. It's available at hospital skin clinics and some GP surgeries. You may need up to three sessions with two to three weeks in between. Cryotherapy can cause pain and blistering around the wart, and infection can sometimes occur.
Surgery - your GP will use a curette (small sharp instrument) to scrape the wart away. Surgery often leaves a scar and there is a danger of spreading the wart virus, so cryotherapy is now more common.

There are other treatments available, which include creams and lasers, although these are less commonly used.

Special considerations

If you have a condition that means your immune system is weakened, such as human immunodeficiency virus (HIV) infection or leukaemia, you're more likely to develop warts and they can be harder to treat. Under these circumstances warts have very occasionally developed into skin cancer. If your wart changes shape or colour, you should visit your GP.

Prevention of warts and verrucas

To prevent warts:

avoid direct contact with another person's wart
don't share towels with a person who has warts
don't share shoes or socks with someone who has a verruca
don't scratch or pick at a wart, this may encourage it to spread
wear flip-flops in communal showers

If your child has a verruca, he or she can still take part in swimming and physical education lessons, but he or she shouldn't have bare feet and the verruca should be covered with a plaster.

If you have a hand wart, you should wear gloves if you're using communal equipment (for example, in a gym).