Warts and verrucas

Also called Verrucae, Plantar warts, HPV skin infection

Harmless, caused by a virus, and they go away on their own. Treatment is optional and mostly for comfort.

What it is

Small rough growths caused by human papillomavirus infecting the top layer of skin. A verruca is simply a wart on the sole of the foot, pushed flat by weight.

They are extremely common in children and young people, they are mildly contagious through direct contact and damp floors, and they are harmless.

The most useful fact is that they clear by themselves. Around two thirds of warts in children disappear within two years without any treatment at all. Treatment shortens that a bit and is worth doing when they are painful, spreading or embarrassing, but doing nothing is a legitimate and often sensible choice.

Salicylic acid applied daily, with the surface filed down between applications, is the best-evidenced treatment, and it needs weeks to months of consistent use. Cryotherapy is often no better and hurts.

Two situations need a different approach: warts in anyone immunosuppressed, which are more numerous and harder to treat; and any wart on a diabetic foot, which should be managed by podiatry rather than with over-the-counter acid.

Anything that is growing quickly, bleeding, changing colour or not behaving like a wart in an adult should be examined, because skin cancers are occasionally mistaken for warts.

Signs you might notice

Common warts: firm, raised, rough growths, often on the hands and fingers, sometimes with tiny black dots which are clotted capillaries.

Verrucas: flat, often with a rough surface and black dots, on the sole of the foot, sometimes painful when standing, and often surrounded by hard skin.

Mosaic warts: clusters of small warts merging together.

Not usually itchy or inflamed.

See a GP or podiatrist for: warts on the face or genitals; warts in anyone immunosuppressed; any wart on the foot of somebody with diabetes or poor circulation; a painful, bleeding or rapidly changing lesion; or an adult with a first wart-like lesion that is not clearly a wart.

How it can affect day-to-day life

Children are sometimes excluded from swimming, which is unnecessary. Covering the verruca with a waterproof plaster or a verruca sock is enough, and exclusion does more harm than the wart.

The main reason treatment fails is stopping too soon. Salicylic acid needs daily application and regular filing for up to three months, and most people give up in a fortnight.

Cosmetic and social distress is the real reason most people seek treatment, particularly teenagers with hand warts, and that is a perfectly good reason.

Home remedies including duct tape are popular; the evidence is weak but the harm is nil.

Do not share files, pumice stones or towels, and treat a verruca before it spreads around a household.

Supporting someone well

Consider doing nothing, especially in a young child with a painless wart. Most go by themselves.

If treating, use salicylic acid daily, soak and file the surface first, protect the surrounding skin, and keep going for up to three months.

Cover verrucas in swimming pools and changing rooms rather than avoiding them.

Do not pick or bite warts; that spreads them.

Do not share towels, files or footwear.

Do not use over-the-counter wart treatments on a person with diabetes or poor circulation. Go to podiatry.

Get anything unusual, rapidly growing or bleeding looked at rather than treated as a wart.

Where to get help

A pharmacist for treatments and advice.

A GP practice for facial or genital warts, warts in immunosuppressed people, or an uncertain diagnosis.

Podiatry for verrucas in people with diabetes or poor circulation.

British Association of Dermatologists publish a patient leaflet on warts and verrucas.