Warts are common growths caused by the human papilloma virus (HPV), which infects the top layer of the skin. They often appear as rough and dry bumps, but can be flat. As this is caused by a virus, this is a contagious but common condition affecting many people.
Types of Warts
Common warts: AKA verruca vulgaris. These often present on the fingers and hands as rough bumps. They are more common where skin has been broken (cut, biting), which is an entry point for this widespread virus. Common warts may have black dots or “seeds” (which are actually tiny clotted capillaries).
Plantar warts: are found on the plantar aspect (sole) of the foot. They often grow in clusters. Plantar warts may be flat and sometimes grow inward. They can cause discomfort caused by pressure with activities like walking or running. Similar to common warts, they sometimes also have tiny black dots or “seeds”
Flat warts: Flat warts are most commonly found on face and legs and are often spread with shaving. These warts are generally smaller and smoother than other types of warts. They can be multiple in number and are sometimes hard to see.
Filiform warts: This is the least common type of wart. They can grow quickly. They may look like a small spiky horn or fingerlike projection.
The human papilloma viruses (HPV) which cause warts are very widespread throughout the population. Warts can spread from person to person via direct skin contact and possibly via another surface such as a shared towel, etc. An individual can also spread warts on themself through scratching, shaving, or picking. It is easier for the virus to infect the skin when there is a cut, scratch, or scrape. This may be why warts are relatively common in children, on the fingers (and sometimes mouths) of individuals who bite their nails or pick at hangnails, and on areas that are shaved (beards in men, legs in women). It is often difficult to pinpoint the source of infection with warts as several months may pass between the time of infection and when the wart becomes visible.
Typically, when a viral infection occurs, the body’s immune system recognizes the infection and successfully attacks the source. However, the virus that causes warts is quite good at evading the immune system and warts are very difficult to treat. Sometimes without treatment warts disappear on their own. The decision to treat is therefore based on several factors: symptoms, location, number of lesions, and/or the age of patient. Most treatments irritate or destroy the tissue surrounding the viral infection. However, physical destruction and even surgical removal of a wart is sometimes not enough to eradicate it. Successful treatment also requires that the immune system recognizes the infection in the treatment process. This may require more than one treatment.
OTC Treatment Options
Prep (Soak & Thin)
Dual Action Foot File by Pedifix
Curad Mediplast Corn, Callus & Wart Remover
After soaking in water and before application of one of the above, the wart may be thinned with an emery board, pumice stone or wart file. Be careful not to use these items in uninfected areas as you may transmit the virus and cause as new wart to grow. Do not use in children younger than 2 years, on irritated skin or on moles, birthmarks, genital warts or warts on the face or mucous membranes. Inform your doctor if you are pregnant or breastfeeding.
Compound W Wart Removal System Freeze Off Advanced Treatment
Review package information for detailed instructions carefully before using at-home freeze treatments.
For plantar warts, soak foot with plantar wart for 5 minutes in warm water. Dry thoroughly. File the plantar wart area with a pumice stone or wart file before applying freeze off wart remover. Once the applicator is pressed on the wart, freezing begins within a few seconds. The treated tissue will turn white. This may cause a stinging or aching sensation. Most of this discomfort should resolve quickly, but may linger for a few hours. After the area thaws, the treated site will turn red. A blister may form within the next few days. Sometimes the blister is filled with blood. This should not cause alarm. The treated skin should fall off in about 10-14 days. This may be repeated in 2 weeks if the wart remains.
OTC freeze treatment for warts is not the same treatment as in-office liquid nitrogen cryotherapy performed by a clinician. This OTC treatment uses compressed liquid gas called dimethyl ether in a special applicator to freeze warts.
After application of the freeze treatment, the color of the skin may change, varying from white to red. A blister may form under the wart and an aching/stinging feeling normally will occur for up to a few hours. If the aching, stinging feeling continues until the next day, or if another problem (such as freezing the skin beyond the size of the wart or less of feeling) occurs, contact your doctor. It is normal for the treated area to be sensitive for a few days. Black dots may appear in the center of the treated wart after a few days. Keep the treated area clean. You may swim or shower. Do not pick or scratch the treated area as this may result in infection. Protect blisters, if necessary, with a gauze or sterile adhesive bandage. Do not puncture blisters. Puncturing blisters will be painful and may result in an infection.
Alternative & Complementary Treatments
Alternative OTC Products
Duct tape occlusion therapy and Dual Action Foot File by Pedifix or Trim Nail Care Standard Emery Boards
- Dr. Scholl’s Round Callus Cushions
- Dr. Scholl’s Moleskin Plus Padding Strip
Instructions & Tips
Duct tape occlusion therapy is a method of treating warts with prolonged coverage with duct tape. This is a popular treatment method, although most experts believe that there is insufficient evidence to recommend this treatment.
Duct tape occlusion is performed by placing a piece of standard duct tape on the wart and leaving it in place for six days. If necessary, the tape may be reinforced or replaced. After six days, the tape is removed and the wart is soaked in water and then debrided/thinned/pared with a pumice stone, file or emery board. Dual action foot file is reusable, so disinfect with rubbing alcohol between treatments. The wart is left uncovered and duct tape is reapplied the next morning for another 6 day cycle. This may be repeated for several weeks.
One strategy is to simply address the symptoms that warts cause in hope that the wart will resolve without treatment. In certain circumstances, this is a reasonable option, particularly with plantar warts. Repeated pounding and pressure with hard soled shoes or sandals can make symptoms worse . Wearing comfortable padded shoes and socks can be helpful. Special bandages which are also sometimes used as callus or corn cushions or moleskin may reduce pressure on the wart. Typically, these are applied in a donut formation around the wart.
It is not always necessary to treat warts.
As per the American Academy of Dermatology, “You should see a dermatologist when you have”:
- A suspicion that the growth is not a wart.
- A wart on your face or genitals.
- Many warts.
- Warts that hurt, itch, burn, or bleed.
- A weakened immune system.
Never try to remove any wart on your foot if you have diabetes. If you cut or burn your skin, it could cause lasting damage to the nerves in your feet.
Warts are very difficult to treat, even for doctors. If you do not have success after a few treatments with OTC options, please see your dermatologist for more advanced treatment options noted above.