The Bottom Line

Warts are harmless skin bumps caused by the human papillomavirus (HPV). They affect about 10–20% of the population and are most common in children and teens. Most warts go away on their own within 1–2 years, but treatment can speed things up. Salicylic acid and cryotherapy (freezing) are the most effective first-line options, clearing warts in up to 70–90% of cases.

What Are Warts (Verruca Vulgaris)?

Warts are small, rough skin growths caused by infection with the human papillomavirus (HPV). More than 100 types of HPV exist. The ones that cause common skin warts—the type that grows on your hands, feet, knees, and elbows—are mainly HPV types 1, 2, 4, and 27. The virus gets into your skin through tiny cuts or scrapes, then causes skin cells to multiply too fast, creating the raised, rough bump you see.

Warts are very common. They affect roughly 10–20% of the general population and as many as 15–33% of children and teenagers. About half of all warts will clear up on their own within two years as your immune system fights off the virus. However, many people choose treatment because warts can be uncomfortable or bothersome.

Signs and Symptoms

Common warts look like small, dome-shaped bumps with a rough, cauliflower-like surface. They range from 2 to 10 millimeters (about the size of a pencil eraser or smaller). Here are the main types:

  • Common warts: Rough, raised bumps most often found on the hands, fingers, elbows, and knees.
  • Plantar warts: Warts on the bottom of the foot, especially on weight-bearing areas like the heel or ball of the foot. These grow inward and can be painful when you walk. A telltale sign is tiny black dots inside the wart—these are small blood vessels that have clotted.
  • Flat warts: Small, flat-topped, skin-colored bumps that often appear on the face or arms.
  • Filiform warts: Long, finger-like projections, often on the face or neck.
  • Periungual warts: Warts that grow around the fingernails or toenails and can disrupt nail growth.

Most warts are painless unless they are on a pressure point (like the bottom of the foot) or bumped or traumatized.

What Causes Warts?

HPV spreads through direct skin-to-skin contact or by touching contaminated surfaces. The virus enters your skin through a small cut or abrasion. You can also spread warts from one part of your own body to another (called autoinoculation). Some people are more likely to get warts, including:

  • Children and teenagers (peak age 12–16 years)
  • People with weakened immune systems—such as those with HIV or those taking immunosuppressive medications—who develop warts at 10–15 times the usual rate
  • People with diabetes
  • Athletes in contact sports who have frequent skin-to-skin contact
  • People who bite their nails or pick at their skin

Treatment Options

Warts often resolve on their own, but treatment can clear them faster and reduce the chance of spreading. Here are the most common approaches:

  • Salicylic acid (first-line): Available over the counter as a liquid, gel, or pad. Applied daily to the wart after softening in warm water. Breaks down the wart tissue layer by layer. With consistent use for 12 weeks, salicylic acid clears about 70% of warts. Trim loose tissue weekly with a pumice stone or nail file for best results.
  • Cryotherapy (freezing): Your dermatologist applies liquid nitrogen to freeze the wart. Each session takes about 10–30 seconds. Most people need 3–6 sessions every 2–4 weeks. Cryotherapy clears 70–90% of common warts. Plantar warts may need more aggressive treatment due to thick skin. It is mildly painful and causes a blister that helps clear the wart.
  • Curettage and cauterization: The wart is scraped off under local anesthesia and the base is cauterized (burned) to prevent regrowth. Effective for stubborn warts.
  • Laser treatment: CO2 or erbium laser removes wart tissue layer by layer. Used for warts that have not responded to other treatments.
  • Imiquimod cream: A prescription cream that activates your immune system to fight the HPV virus. Used 3 times per week. Particularly helpful if you have a weakened immune system.
  • Watchful waiting: If your wart is small and not bothering you, your dermatologist may recommend waiting to see if it resolves on its own, especially in children.

Even with successful treatment, warts can come back in 10–30% of cases because HPV may remain in nearby skin cells. Combining treatments (for example, cryotherapy followed by salicylic acid at home) can improve results.

When to See a Dermatologist

  • Your wart is painful, bleeds, or rapidly changes in appearance
  • The wart has not improved after 12 weeks of over-the-counter treatment
  • You have warts on your face, genitals, or around your nails
  • You have many warts or they are spreading quickly
  • You have diabetes or a weakened immune system
  • You are not sure whether the growth is a wart or something else

Frequently Asked Questions

Are warts contagious?

Yes. Warts spread through direct contact with the HPV virus—touching a wart or contaminated surfaces. You can also spread them from one area of your own skin to another. Covering warts during sports or shared activities, washing your hands, and avoiding direct contact reduces transmission risk.

Will a wart go away without treatment?

Yes—about 50% of warts resolve on their own within two years as your immune system clears the virus. In children, the rate of spontaneous resolution is even higher. However, this can take time, and warts may spread in the meantime. Treatment speeds up resolution.

Can warts come back after treatment?

Yes. Recurrence rates are 10–30% depending on the treatment used and how strong your immune system is. This happens because HPV can remain dormant in surrounding skin cells. Completing your full course of treatment and following your dermatologist's aftercare instructions helps reduce the chance of recurrence.

Do plantar warts need special treatment?

Plantar warts are on the weight-bearing areas of the foot, which means they grow inward and can be quite painful. They usually need more aggressive cryotherapy (longer freeze times, more sessions) or combination treatment. Cushioned insoles can ease pain while you are undergoing treatment.

References

  1. Kwok CS, et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2012;9:CD001781.
  2. Sterling JC, et al. Guidelines for the management of cutaneous warts. Br J Dermatol. 2014;171(4):696-712.
  3. Wiley DJ, et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis. 2002;35(Suppl 2):S210-S224.
  4. Lipke MM. An armamentarium of wart treatments. Clin Med Res. 2006;4(4):273-293.

Trusted Resources

Always consult a board-certified dermatologist for diagnosis and personalized treatment recommendations.