Warts and verrucas
Warts and verrucas are caused by a harmless viral infection in the skin called the human papilloma virus (HPV). HPV causes keratin, a hard protein in the top layer of the skin, to grow too much, giving the typical roughened texture of a wart. There are more than 60 different types of viruses known to cause warts; this includes genital warts. They are increasingly common through childhood and adolescence but then their frequency drops drastically again on reaching adulthood. Warts often look different depending on where they are on the body and how thick the skin is, and a wart on the sole of the foot is called a verruca.
What do they look like?
Warts on the hands are found most frequently around the nails and on the fingers and are often shaped like a cauliflower, whereas verrucas are seen most commonly on the ball of the foot as areas of flat, thicker skin with a harder edge around a softer center.
Doctor’s advice
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Are they contagious?
Yes, but the risk of passing them on to others is low - you need close skin-to-skin contact and are more at risk of being infected if your skin is damaged, or if it is wet and macerated, and in contact with roughened surfaces such as found in swimming pools and communal washing areas. If a wart bleeds or breaks up it becomes even more contagious so people with scratches or cuts on the soles of their feet are especially vulnerable here. It can take several months for warts and verrucas to develop after infection.
To reduce the chance of passing warts to others, don’t share towels, when swimming cover any wart or verruca with a waterproof plaster and if you have a verruca wear flip-flops in communal shower rooms and don’t share shoes and socks. If you have a wart, try not to scratch it, don’t bite nails or suck fingers that have warts and change your socks every day if you have a verruca.
Healthwords pharmacists' top tips
Many cases of warts and verrucas require no treatment at all and will go away over time by themselves – if they are not causing any problems this is what is often recommended. Without treatment, about 3 in 10 warts have gone away within 10 weeks, and most warts will have gone away within 1-2 years, and leave no scar. The chance that a wart will go away is greatest in children and young people. However, warts do sometimes last longer, in particular in older people where they can be more persistent and may last for several years.
Treatment can clear warts more quickly but can also be time-consuming and sometimes uncomfortable. The success of any treatment tried depends on the person's age, how many there are, where they are, and what trouble they cause. There are over the counter medicines available from your local pharmacist or your doctor for salicylic acid solutions, and your doctor can also freeze warts and verrucas away with liquid nitrogen - several treatments are usually necessary here before the warts are totally removed.
Salicylic acid treatments come in many different forms such as in a gel, cream or even in a plaster and usually take around three months of use to be effective.
There are many products containing salicylic acid such as Bazuka gel, or others that may be paints or medicated plasters. These products do work very well, however for gels and creams, the typical expected treatment can take between one and three months to get rid of the wart, and allow healthy skin to regrow and heal.
Salicylic products should ideally be used every night. Care must be taken to apply just on the wart, to avoid damaging healthy skin around the wart. You could try protecting the surrounding skin with Vaseline or other similar petroleum jellies, leaving just the wart exposed and ready for treatment. If the wart has lots of hard skin over the top of it, it's helpful to try to file this down with an emery board or pumice stone before treating, to make the acid more effective where it matters.
Cryotherapy (freezing the wart) is done at some doctor practices. Liquid nitrogen is sprayed onto the wart to kill the wart tissue. It's like a freezer-burn and can hurt a bit afterwards. It can take a couple of sessions of freezing for the wart to fully go away, and these sessions are usually done a couple of weeks apart.
For more convenience, there are other products using the freeze method now available as a home kit. A cold liquid is applied with an applicator for around 30 to 40 seconds. They aim to create an inflammatory reaction that will stimulate the body to recognize and destroy the wart virus. More stubborn warts or verrucas can be treated up to 4 times on separate occasions if necessary.
Pharmacist recommended products
Am I fit for work?
You are fit for work if you have a wart.
When should I see my doctor?
You should book a visit with your doctor if:
- You have a wart on your face or genital area
- The wart is large in size (bigger than 1/2 inch), or you have lots of warts
- The wart is painful
- The wart has changed shape or color
- The wart keeps recurring
The doctor will ask you about your medical history and examine the area. They may prescribe a stronger form of salicylic acid treatment or recommend cryotherapy.
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