Warts

Warts and verrucas are small, rough lumps on your skin, which are caused by the human papillomavirus (HPV). This virus is spread through skin-to-skin contact or by touching surfaces contaminated with HPV.

Warts are common; most people have a wart at some point in their lives. They are usually harmless, although they can cause discomfort and look unsightly.

Warts can affect you at any age, although they’re more likely to appear when you’re a teenager or young adult. Around one in 10 people of all ages are estimated to have warts at any one time, rising to one in three in children or young people.

Warts can appear almost anywhere on your skin. However, warts on hands and warts on feet (verrucas) are most likely.

Warts often go away naturally. However, this can take months or years. If needed, they can usually be treated with over-the-counter or prescribed medications. Warts can also be removed by freezing (cryotherapy) or, occasionally, with minor surgery.

Warts are usually painless but can sometimes be itchy or bleed. In some cases, warts at the end of fingers can make it harder to complete fine tasks. Warts can also look unsightly.

There are several different types of warts.

Common warts

• Skin coloured, firm, raised and rough
• Small – a common wart can be anything from a pinpoint to a centimetre in diameter
• Usually on hands or knees

Plane warts

• Can develop in clusters
• Common in young children
• Round, smooth, flat and with a yellowish tinge
• Usually found on the face, neck, legs or the backs of your hands

Filiform warts

• Can develop on the neck or face
• Long and slender, finger-shaped

Verrucas

• Can be painful — often described as the sensation of standing on a needle
• Have tiny black dots under the hard skin
• Found on feet

Mosaic warts

• Clusters of warts spread over an area of skin
• Commonly found on hands or feet

Warts are contagious — they can be passed on to others through touch. However, the risk of passing on your warts is low as close skin-to-skin contact is needed. 

Your risk of being infected with warts is higher if your skin is damaged or if it is wet, softened from prolonged exposure to water and touching rough surfaces eg in communal washing areas and swimming pools.

Warts can spread from one part of your body to another eg warts on your fingers can spread to your lips and surrounding skin and around your nails if you bite or suck the affected fingers. 

If you have a weakened immune system eg due to AIDS or chemotherapy, you may develop lots of warts that don't easily disappear.

Although warts tend to disappear, this can take time — sometimes several years.

Talk to a pharmacist, who’ll provide advice on how to get rid of warts. They can also explain what causes warts and ways to prevent warts from spreading. They may recommend creams, plasters or sprays to help get rid of your warts — these can take up to three months to work. Side effects include irritated skin and these treatments may not work. You should never use these treatments on your face.

If you have a wart that’s causing you pain, embarrassment or discomfort, and over-the-counter medications aren’t helping, see your GP.

You should also see your GP if you have a wart that:

• Bleeds without being scratched or knocked
• Keeps recurring
• Is in your genital area — genital warts need specialist treatment
• Is spreading or growing
• Is very large or painful
• Looks different

You should also see your GP if you have a growth on your skin that you are worried about. 

Your GP will examine the wart and surrounding skin. They’ll explain how to remove warts and may prescribe wart-removing medication or refer you for cryotherapy. Very occasionally, your GP will refer you to a dermatologist, a consultant specialising in skin conditions.

If you have a wart, you are more likely to pass it onto others if your skin is damaged or wet. After infection, it can take months for warts to appear. 

To reduce your risk of developing warts, or spreading warts to others or other parts of your body, you should:

• Cover your wart with a plaster when swimming
• Not bite or suck fingers that have warts on them
• Not scratch or pick your warts
• Not share flannels or towels 
• Not touch other people's warts 
• Wash your hands after touching your warts

If you shave, you should take extra care, as HPV can spread through small cuts.

If you have a verruca, you should also: 

• Change your socks every day
• Not share socks and shoes 
• Not walk barefoot in public spaces

Warts can disappear on their own and if they are not causing you problems, such as pain, discomfort or embarrassment, they do not need treatment. In children, warts disappear in a year without treatment in half of all cases and in two-thirds of all cases in two years. Warts can last for several years, especially in adults where they can last for 5–10 years.

Treatment can make warts disappear faster but may take a while to work and can cause discomfort or irritation. Verrucas are most often treated as they can make walking painful. 

Your GP may prescribe medication containing salicylic acid to burn your wart away or refer you for cryotherapy. 

Salicylic acid

If you have diabetes or poor blood circulation, only use salicylic acid if your doctor has recommended it. Make sure you store your salicylic acid away from open fire or flames as it is flammable. 

Salicylic acid is usually applied as a gel or paint. Make sure you follow the specific instructions provided with your medication or ask your pharmacist for advice. Usually, you need to apply it every day for up to three months for it to make your wart completely disappear, although you may see some improvement after two weeks.

Before applying it, rub off any dead tissue from the top of your wart with an emery board. Next, soak your wart in water for 5–10 minutes and then apply the salicylic acid.

Salicylic acid can irritate the skin and may cause scarring. It is therefore important that you never apply salicylic acid to your face and try to avoid getting it on the skin next to your wart. You can apply a ring of petroleum jelly around your wart or place a plaster with a hole in it over your wart, which only exposes the wart. 

If the skin surrounding your wart does become irritated, stop applying the salicylic acid until the irritation settles — this usually takes a few days. You can then re-start the treatment. 

In rare cases, salicylic acid can cause a skin allergy, where the skin surrounding your wart becomes itchy and red. If this occurs, stop the treatment and see your GP for further advice on treatment. 

Cryotherapy

Cryotherapy freezes warts away by spraying liquid nitrogen on them, which is very cold. Up to 4–6 sessions of cryotherapy, several weeks apart, may be needed for the wart to drop off — usually a few weeks after your last session. The repeated freezing and thawing of the wart eventually destroys the tissue, although the results vary. 

Cryotherapy is not suitable for young people or those with poor blood circulation. Side effects include: 

• Blistering of skin near the wart
• Pain during treatment
• Scarring — this is a small risk

In some cases, your GP may suggest combining salicylic acid medication and cryotherapy.

Other treatments

Your GP may also recommend:

• Creams that are used to treat skin cancers
• Creams that stop the skin cells of your wart multiplying
• Swift microwave therapy — a new treatment developed in the UK that uses a probe to deliver microwave energy, which is precisely targeted to heat and destroy the wart; the benefits of this treatment are that it: 
• Causes little inflammation of the tissue
• Does not need to be carried out under a local anaesthetic
• Has a high success rate
• Takes a few seconds
• Usually only needs 1–3 sessions
• Virucidal creams — creams that aim to kill the virus

If medication and/or cryotherapy fails to remove your wart, your GP or consultant may suggest minor surgery. This involves having your wart lasered off, scraped away (curettage) or treated with light therapy (photodynamic therapy).