Introduction
Warts are benign skin growths caused by human papillomavirus (HPV) infection of the epidermis.
They appear as rough raised lesions on hands, feet, face, or genitals depending on viral subtype and contact patterns.
Many warts resolve spontaneously, but persistent or painful lesions respond to topical treatments, cryotherapy, or office procedures.
This page explains common symptoms, how evaluation usually proceeds, treatment options, and when to seek medical care.
Overview
Common warts (verruca vulgaris), plantar warts, flat warts, and genital warts differ in appearance and HPV types. Transmission occurs through direct skin contact or contaminated surfaces.
Treatment choice depends on location, number, patient age, and immune status. Genital warts require evaluation for coexisting STIs.
- HPV-driven epidermal hyperplasia
- Common on hands, feet, and knees in children
- Plantar warts grow inward on weight-bearing skin
- Autoinoculation spreads lesions by scratching
- Cryotherapy and salicylic acid are first-line options
- Genital warts linked to specific oncogenic HPV types
What happens in the body
HPV infects basal keratinocytes after microabrasions, triggering localized proliferation and horny layer thickening.
Viral persistence reflects immune evasion; regression occurs when cell-mediated immunity clears infected cells.
- Viral E6/E7 proteins disrupt normal keratinocyte regulation
- Capillary loops visible as black dots in plantar warts
- Immunosuppression allows larger or treatment-resistant warts
- Oncogenic HPV types integrate in mucosal infections with malignancy risk
Signs and symptoms
Common symptoms and warning signs may include:
- Rough, cauliflower-like papules on skin
- Tender callus-like lesions on soles with pinpoint bleeding when pared
- Flat smooth-topped warts on face or legs
- Clustered mosaic plantar warts
- Genital flesh-colored bumps or plaques
- Occasional itching or pain with pressure on plantar lesions
- Cosmetic concern on visible areas
- Usually no systemic symptoms
Causes and risk factors
Possible causes and contributing factors include:
- Direct contact with HPV-infected skin or fomites
- Walking barefoot in communal showers or pools
- Nail biting and cuticle picking spreading hand warts
- Sexual contact transmitting genital HPV types
- Immunosuppression from medications or HIV
- Atopic dermatitis with skin barrier breakdown
- Shared grooming tools in salons
Diagnosis and evaluation
Evaluation may include:
- Clinical appearance in most cases
- Dermoscopy to distinguish from corns and melanocytic lesions
- Shave biopsy when diagnosis is uncertain or malignancy suspected
- Acetowhite staining for genital lesions in clinic
- Screening for other STIs when genital warts present
- Exclude molluscum contagiosum and seborrheic keratosis
Treatment and management
Treatment and management may involve:
- Over-the-counter salicylic acid preparations with regular debridement
- Cryotherapy with liquid nitrogen in primary or dermatology care
- Cantharidin, imiquimod, or fluorouracil for selected cases
- Electrosurgery or laser for recalcitrant lesions
- HPV vaccination to prevent new genital and some cutaneous HPV disease
- Duct tape occlusion as adjunct in children sometimes
- Treat genital warts during pregnancy with clinician-guided safe options
Prevention, self-care, and lifestyle
Not every condition is fully preventable, but the steps below may lower risk or recurrence:
- HPV vaccination per age-based guidelines
- Wear footwear in locker rooms and avoid sharing razors or towels
- Treat active warts to reduce autoinoculation and transmission
Possible complications
Delay, missed care, or unsafe self-medication can raise the chance of complications in some cases:
- Pain and gait change from large plantar warts
- Spread to multiple sites or mosaic patterns
- Recurrence after treatment common
- Psychosocial distress with genital warts
- Rare malignant transformation of long-standing mucosal HPV lesions
When to see a doctor or seek emergency care
Seek prompt medical advice or emergency care if any of the following apply—it is safer not to wait and see:
- Warts that bleed, grow rapidly, or change color
- Painful plantar warts limiting walking despite home care
- Genital lesions or need for partner evaluation
- Extensive warts in immunosuppressed patients
Living with the condition
Be patient with treatment; several weeks of consistent therapy are often needed. Avoid picking lesions to limit spread and cover plantar warts with clean padding in shoes.
Frequently asked questions
Do warts always need treatment?
Many clear on their own within months to a few years. Treatment is recommended for pain, spread, genital involvement, or cosmetic concern.
Are warts contagious after treatment?
HPV can persist in surrounding skin. Good hygiene and completing treatment reduce but may not eliminate transmission risk immediately.
Important caution
This article is general health education in English. It is not personal medical advice.
Diagnosis and treatment should be guided by a qualified clinician who knows your full history.
Seek urgent care for severe, sudden, or rapidly worsening symptoms.