Best treatments for warts

Introduction

Warts are such a common skin concern that most people will develop at least one wart in their lifetime. While warts are usually harmless, they can be embarrassing and sometimes even painful. In this guide, we'll cover everything you need to know about warts, including types and causes, effective home remedies, medical treatments, prevention strategies, and when to seek professional help. 1

Understanding Warts: Types and Causes

Warts are small, rough growths that appear on the skin when it becomes infected with certain strains of the human papillomavirus (HPV). There are over 100 different types of HPV, and each type grows in a specific area of the body. 2,3 The most common types of warts include:

• Common Warts (Verruca Vulgaris): These rough, dome-shaped growths usually grow on the hands, fingers, knees, or elbows. They may have black dots (clotted blood vessels) and can be skin-colored, white, pink, or tan.
• Plantar Warts (Verruca Plantaris): These warts develop on the soles of the feet, often on pressure points like the heels or balls of the feet. They can be painful and may grow inward because of the pressure from walking.
• Flat Warts (Verruca Plana): These small, smooth warts are usually flesh-colored and generally grow in clusters on the face, neck, hands, wrists, elbows, or knees. They are more common in children and teens.
• Genital Warts (Condylomata Acuminata): These soft, flesh-colored bumps appear on or around the genitals and anus. They are spread through sexual contact and can cause itching, burning, or discomfort. 4,5,6,7

Warts develop when HPV enters the skin through small cuts, often in areas that are exposed to friction or moisture. The virus triggers a growth of keratin, a tough protein that makes up the top layer of skin, causing the rough, hard texture of warts. 8,9

Certain factors can increase your risk of developing warts, including:

• A weakened immune system from illness, medication, or stress
• Biting your nails or picking at hangnails, where HPV can get in easily
• Walking barefoot in public areas like locker rooms, showers, or pool decks
• Sharing personal items like towels, razors, or nail clippers with someone who has warts 10,11,12,13

While most warts are harmless and will eventually go away on their own, some types of HPV can cause more serious health problems. Certain strains of HPV that cause genital warts can increase your risk of cervical, anal, and oral cancers. Warts that are left untreated can spread to other parts of the body or to other people through direct contact. 14,15

Effective Home Remedies for Warts

If you have a wart, you may want to try an over-the-counter treatment or home remedy before seeking professional help. While home remedies may not work for everyone, some people find them helpful for managing minor warts. Here are a few popular options:

• Salicylic acid: This softens and dissolves the infected skin cells, allowing the wart to slowly peel off. You can find salicylic acid in various forms, including liquids, gels, and adhesive pads. To use, soak the wart in warm water for 10-15 minutes, then gently file away the softened skin with a pumice stone or emery board. Apply the salicylic acid product as directed, and cover the wart with a bandage. Repeat this process daily until the wart is gone, which can take several weeks.
• Duct tape occlusion: This unconventional method involves covering the wart with a small piece of duct tape for several days at a time. The theory is that without oxygen and moisture, the wart will eventually die and fall off. Cut a piece of duct tape slightly larger than the wart, apply it firmly, and leave it in place for 6 days. Then, remove the tape, soak the wart in warm water, and gently scrape away any loose skin with a pumice stone or emery board. Leave the wart uncovered overnight, then reapply a new piece of duct tape in the morning. Continue this cycle until the wart is gone.
• Apple cider vinegar: The acetic acid in apple cider vinegar may help destroy the infected skin cells and help heal the area. Soak a cotton ball in undiluted apple cider vinegar and apply it directly to the wart. Cover the cotton ball with a bandage or tape and leave it in place overnight. In the morning, remove the bandage and wash the area with warm water and mild soap. Repeat this process daily until the wart is gone.
• Garlic: Garlic contains compounds like allicin and ajoene that have antiviral and antimicrobial properties. Crush a fresh clove and apply the pulp directly to the affected area. Cover with a bandage and leave it on overnight. Wash the area in the morning and repeat the process daily until the wart is gone. Garlic can cause irritation or burns in some people, so be careful when using it on sensitive skin. 16,17,18,19,20

While home remedies can be a convenient and inexpensive way to treat minor warts, they are not always effective and may take a long time to work. Some home remedies can cause skin irritation, allergic reactions, or other side effects. If your wart is painful, growing quickly, spreading, or not responding to home treatment after a few weeks, reach out to a healthcare provider for professional advice and treatment.

Medical Treatments for Persistent Warts

If your wart is stubborn, painful, or in the way of your daily life, your healthcare provider may recommend one or more of the following medical treatments:

• Cryotherapy: During this in-office procedure, your healthcare provider will use liquid nitrogen to freeze the wart. The extreme cold destroys the infected skin cells, causing the wart to blister and fall off within a few days. Cryotherapy may be mildly painful and can cause temporary swelling, blistering, and skin discoloration. Multiple treatments are often necessary to fully remove the wart.
• Electrosurgery and Curettage: During this procedure, the provider uses a small electric needle to burn off the wart tissue, then scrapes away any remaining debris with a sharp, spoon-shaped tool called a curette. They then cauterize the wound to prevent bleeding and promote healing. This treatment may need local anesthesia and can cause temporary pain, swelling, and scarring.
• Laser Treatment: Your provider may recommend laser therapy for deep or resistant warts. An intense beam of light destroys the blood vessels that supply the wart, causing it to die and fall off. Laser treatment can be painful and may need multiple sessions. Potential side effects include blistering, scarring, and changes in skin color.
• Immunotherapy: This approach stimulates your immune system to fight off the HPV infection that causes warts. Your healthcare provider may inject the wart with a substance like candida antigen or apply a topical medication like imiquimod, which triggers an inflammatory response. Immunotherapy can be effective for stubborn warts but may cause flu-like symptoms, redness, swelling, and itching at the treatment site.
• Topical Medications: Your healthcare provider may prescribe a stronger version of salicylic acid or other topical medications like trichloroacetic acid, podophyllin, or 5-fluorouracil to help dissolve the wart tissue. These medications may cause skin irritation, burning, or discoloration and should be used as directed. 21,22,23,24,25

In some cases, your healthcare provider may recommend a combination of treatments. For example, they may use cryotherapy to freeze the wart, then have you apply a topical medication at home to continue the healing process.

Preventing the Spread of Warts

Because warts are caused by a contagious virus, it's important to prevent spreading them to other parts of your body or to other people. Here are some simple strategies to help stop warts from spreading:

• Wash your hands regularly: Frequent handwashing with soap and water can help remove HPV particles from your skin.
• Don't pick or scratch your warts: Picking at your warts can cause them to bleed or spread to other areas of your skin. If you must touch your warts, wash your hands thoroughly after.
• Cover your warts: Covering your warts with a bandage or piece of tape can help prevent them from spreading through direct contact. Change the covering daily and wash your hands after changing it.
• Don't share personal items: Avoid sharing towels, razors, nail clippers, or other personal hygiene items with others, as HPV particles can spread through these things.
• Wear shoes in public areas: To protect your feet from plantar warts, always wear sandals or flip-flops when walking in locker rooms, showers, or pool decks.
• Keep your skin moisturized: Dry, cracked skin is more susceptible to HPV infection. Use a gentle, fragrance-free moisturizer to keep your skin hydrated and soft.
• Don't shave over your warts: Shaving can nick the skin and spread HPV to other areas. If you must shave near a wart, use a separate, disposable razor and avoid shaving directly over the wart itself.
• Use protection: For those who are sexually active, using protection can help defend against genital warts.
• Consider the HPV vaccine: The HPV vaccine (Gardasil 9) can help protect against the strains of HPV that cause most genital warts and HPV-related cancers. The vaccine is recommended for boys and girls ages 11-12, with catch-up vaccination for older teens and young adults. 32,33,34,35,36,37,38,39

By following these preventive measures, you can help reduce your risk of developing new warts or spreading them to others. However, it's not always possible to avoid exposure to HPV. If you do develop a wart, don't panic—most warts are harmless and can be effectively treated.

When To Seek Professional Help for Warts

While many warts will eventually go away on their own, some may stick around, spread, or cause discomfort. Here are some signs that it's time to seek professional help for your wart:

• Your wart is painful or interferes with daily activities
• Your wart is spreading or multiplying
• Your wart is on your face or genitals
• Your wart looks unusual (unusual border) or changes in appearance (bleeding or oozing)
• You have a weakened immune system
• Your wart is not responding to home treatment after a few weeks 40,41,42,43,44,45

If you're unsure whether your wart needs medical attention, it's always better to consult a healthcare provider. Dermatologists can help treat it appropriately.

Conclusion

Warts are a common skin condition that can be bothersome and even painful. By understanding the different types of warts, their causes, and the available treatment options, you can take steps to manage these pesky growths and keep your skin healthy.

While many warts will eventually go away on their own, others may need treatment to prevent them from spreading or causing discomfort.

If you have a wart that is painful, rapidly spreading, or not responding to home treatments, consult a dermatologist or healthcare provider. They can provide a proper diagnosis, rule out any more serious conditions, and recommend a treatment plan.

Citations:

<1>Vlahovic TC, Khan MT. The human papillomavirus and its role in plantar warts: a comprehensive review of diagnosis and management.</1>

<2>TeensHealth. Warts.</2>

<3>American Academy of Dermatology Association. Warts.</3>

<4>AskMayoExpert. Human papillomavirus (HPV) vaccination. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.</4>

<5>AskMayoExpert. Anogenital warts. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.</5>

<6>Human papillomavirus (HPV) and cervical cancer. World Health Organization. https://www.who.int/en/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer.</6>

<7>Warts. American Academy of Dermatology. https://www.aad.org/public/diseases/contagious-skin-diseases/warts. Accessed Feb. 20, 2019.</7>

<8>Human Papilloma Virus (HPV) - Harvard Health.</8>

<9>Chen X, et al. (2016). Characteristics of human papillomaviruses infection in men with genital warts in Shanghai. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288230/</9>

<10>Human papillomavirus (HPV) vaccines. (2021). https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet</10>

<11>Nikmanesh, N., Hosseini, S. Z., Mirbagheri, F., Asadsangabi, K., Fattahi, M. R., Safarpour, A. R., ... & Nikmanesh, Y. (2023). Knowledge on Human Papillomavirus Infections, Cancer Biology, Immune Interactions, Vaccination Coverage and Common Treatments: A Comprehensive Review. Frontiers in Oncology, 13.</11>

<12>Wang, M., Liang, H., Yan, Y., Bian, R., Huang, W., Zhang, X., & Nie, J. (2023). Distribution of HPV types among women with HPV-related diseases and exploration of lineages and variants of HPV 52 and 58 among HPV-infected patients in China: A systematic literature review. Frontiers in Oncology, 13.</12>

<13>Achdiat, P. A., Yesufardi, R., Rowawi, R., Dharmadji, H. P., Puspitosari, D., Usman, H. A., & Maharani, R. H. (2022). A Review and Case Study of Genital and Extragenital Human Papillomavirus Type 6 and 11 Infections in Men Who Have Sex with Men Accompanied by Human Immunodeficiency Virus Infection. Dermatology and Therapy, 12(12), 2749-2759.</13>

<14>Wolf, J., Kist, L. F., Pereira, S. B., Quessada, M. A., Petek, H., Pille, A., ... & Nasi, L. A. (2023). Human papillomavirus infection: Epidemiology, biology, host interactions, cancer development, prevention, and therapeutics. Frontiers in Oncology, 13.</14>

<15>InformedHealth.org. (2020). Overview: Warts. National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279586/</15>

<16>National Cancer Institute. (2021). Human papillomavirus (HPV) vaccines. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet</16>

<17>Healthline. (2022). 16 Home Remedies for Warts You Can Try Today. https://www.healthline.com/health/home-remedies-for-warts</17>

<18>Medical News Today. (2022). 4 home remedies for warts: Do they work, and are they safe? https://www.medicalnewstoday.com/articles/home-remedies-for-warts</18>

<19>Harvard Health Publishing. (2022). How to get rid of warts: Medical and natural remedies. https://www.health.harvard.edu/diseases-and-conditions/how-to-get-rid-of-warts</19>

<20>WebMD. (2022). Warts: Treatments and Home Remedies. https://www.webmd.com/skin-problems-and-treatments/warts-treatments-home-remedies</20>

<21>PharmEasy Blog. (2021). Easy Home Remedies for Wart Removal. https://pharmeasy.in/blog/home-remedies-for-wart-removal/</21>

<22>Mayo Clinic. (2022). Common warts - Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/common-warts/diagnosis-treatment/drc-20371131</22>

<23>Healthline. (2022). 7 Home Remedies for Genital Warts. https://www.healthline.com/health/std/genital-warts-home-remedies</23>

<24>The Healthy. (2022). 12 Home Remedies for Warts You Can Actually Make Right at Home. https://www.thehealthy.com/skin-health/home-remedies-warts/</24>

<25>WebMD. (2022). Over-The-Counter & Medical Treatments for Common Warts. https://www.webmd.com/skin-problems-and-treatments/understanding-common-warts-treatment</25>

<26>Liu, X., Xi, R., Cheng, L., Wang, Y., Nie, Y., Yan, G., Guo, D., Guo, W., Du, T., Lu, H., Wang, P., Zhu, J., & Li, F. (2023). Effectiveness and mechanism of the Chinese medicine Weiren Xiaoyou formula in improving palmoplantar warts. Phytomedicine, 108, 154443. https://doi.org/10.1016/j.phymed.2023.154443</26>

<27>Xu, Y., Wang, Y., Huang, K., Huang, W., Zhao, S., & Jiang, Z. (2023). Topical antimitotic treatments for plantar warts are more beneficial: A Bayesian network meta-analysis of randomized controlled trials. Journal of the American Academy of Dermatology, 88(3), 532-540. https://doi.org/10.1016/j.jaad.2022.09.025</27>

<28>Kim, M. H. (2022). Plantar warts successfully treated with bee venom: A case report. Integrative Medicine Research, 11(1), 100803. https://doi.org/10.1016/j.imr.2022.100803</28>

<29>Zhang, W., Jin, Z., Gao, T., Fan, L., Wang, W., Zeng, X., & Qin, L. (2022). Topical 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts. Dermatologic Therapy, 35(1), e14958. https://doi.org/10.1111/dth.14958</29>

<30>Cleveland Clinic. (2022). 3 At Home Wart Remedies (That Actually Work!). https://health.clevelandclinic.org/weird-wart-home-remedies-and-what-works</30>

<31>American Academy of Dermatology Association. (2022). Warts: Tips for managing. https://www.aad.org/public/diseases/a-z/warts-self-care</31>

<32>Abdel-Latif, A., Abdel-Wahab, A., Abdel-Aziz, R. T., & Abdel-Aal, A. M. (2020). Silver duct tape occlusion in treatment of plantar warts in adults: is it effective?. Dermatologic Therapy, 33(1), e13342. https://doi.org/10.1111/dth.13342</32>

<33>Mayo Clinic. (n.d.). Common warts - Diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/common-warts/diagnosis-treatment/drc-20371131</33>

<34>American Academy of Dermatology Association. (n.d.). Warts: Diagnosis and treatment. https://www.aad.org/public/diseases/a-z/warts-treatment</34>

<35>Podiatry Care Specialists. (n.d.). When Should I See a Doctor for Foot Warts? https://www.podiatrycarespecialists.com/blog/item/51-when-should-i-see-a-doctor-for-foot-warts</35>

<36>Planned Parenthood Federation of America. (n.d.). Where Can I Get Tested For Genital Warts? | Testing Info. https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/genital-warts/do-i-have-genital-warts</36>

<37>American Academy of Dermatology Association. (n.d.). Genital warts: Diagnosis and treatment. https://www.aad.org/public/diseases/a-z/genital-warts-treatment</37>

<38>Rydberg, A., Ameduri, R., Brown, T., Johnson, J. N., Todd, A., Tollefson, M. M., & Anderson, K. (2023). Prevalence and spectrum of infectious and inflammatory dermatologic conditions occurring in pediatric heart transplant patients on a predominantly mTOR-based immune suppressive regimen: A retrospective chart review. Pediatric Dermatology, 40(2), 235-241. https://doi.org/10.1111/pde.15141</38>

<39>Olguín-García, M. G., Peralta-Pedrero, M. L., Jurado-Santa Cruz, F., Vega-Memije, E., & Morales-Sánchez, M. A. (2023). Low-dose oral isotretinoin in the treatment of recalcitrant facial flat warts: A clinical case and review of literature. Journal of Dermatological Treatment, 34(3), 1-6. https://doi.org/10.1080/09546634.2023.2181524</39>

<40>Cook, M. K., Hagen, E. M., & Feldman, S. R. (2023). Cidofovir in the Management of Non-Genital Warts: A Review. Journal of Drugs in Dermatology, 22(10), 1009-1016. https://doi.org/10.36849/JDD.7258</40>

<41>Graham, J. G., & Tosti, R. (2023). Finger Necrosis After Cutaneous Wart Intralesional Injection with Candida albicans Antigen: A Case Report. Dermatologic Surgery, 49(3), 365-367. https://doi.org/10.1097/DSS.0000000000003524</41>

<42>Choi, Y. L., Lee, K. J., Kim, W. S., Lee, D. Y., Lee, J. H., Lee, E. S., & Yang, J. M. (2006). Treatment of extensive and recalcitrant viral warts with acitretin. International Journal of Dermatology, 45(4), 480-482. https://doi.org/10.1111/j.1365-4632.2006.02724.x</42>

<43>Centers for Disease Control and Prevention. (2021). Human Papillomavirus (HPV) and Cervical Cancer. https://www.cdc.gov/cancer/hpv/index.htm</43>

<44>World Health Organization. (2022). Human papillomavirus (HPV) and cervical cancer. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer</44>

<45>Mayo Clinic. (2022). HPV infection: Vaccine may prevent most common types. https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596</45>

<46>Kim, M. H. (2023). Plantar warts successfully treated with bee venom: A case report. Dermatologic Therapy, 36(2), e15451. https://doi.org/10.1111/dth.15451</46>

<47>Navarro-Pérez, D., García-Oreja, S., Álvaro-Afonso, F. J., López-Moral, M., García-Madrid, M., & Lázaro-Martínez, J. L. (2023). Cantharidin-Podophyllin-Salicylic Acid Formulation as a First-Line Treatment for Plantar Warts? A Case Report with Multiple Plantar Warts of Human Papillomavirus Biotype 27 and Previous Failed Treatments. Dermatologic Therapy, 36(2), e15455. https://doi.org/10.1111/dth.15455</47>

<48>Ciccarese, G., Parodi, A., & Drago, F. (2023). 5-Fluorouracil 0.5%/salicylic acid 10% solution in the treatment of ano-genital warts. Dermatologic Therapy, 36(2), e15458. https://doi.org/10.1111/dth.15458</48>

<49>Prathibha, J. P., Varghese, N., & Aithal, V. V. (2023). Intralesional Vitamin D3 Versus Bleomycin for Difficult-to-Heal Palmoplantar Warts: A Comparative Study. Dermatologic Therapy, 36(2), e15465. https://doi.org/10.1111/dth.15465</49>

<50>Swaroop, M. R., Sathyanarayana, B. D., Vasudevan, P., Kumari, P., & Raghavendra, J. (2016). Evaluation of efficacy and safety of modified technique of auto wart implantation in the treatment of multiple, recurrent and recalcitrant warts. Indian Journal of Clinical and Experimental Dermatology, 2(2), 27-31.</50>

<51>Ulschmid, C. M., Patel, J., Pan, A. Y., Liegl, M., & Holland, K. E. (2023). Intralesional measles, mumps, and rubella vaccine after failure of intralesional Candida antigen for the treatment of recalcitrant pediatric warts. Pediatric Dermatology, 40(6), 1057-1059. https://doi.org/10.1111/pde.15415</51>

<52>Rutnin, S., Namasondhi, A., Pomsoong, C., Kositkuljorn, C., Anuntrangsee, T., & Thadanipon, K. (2023). Intralesional Measles, Mumps, Rubella Vaccine versus Tuberculin Purified Protein Derivative Injections in the Treatment of Palmoplantar and Periungual Warts: A Double-Blind Randomized Controlled Trial. Dermatology, 239(1), 109-115. https://doi.org/10.1159/000526601</52>

<53>Bunney, M. H., Nolan, M. W., & Williams, D. A. (1976). An assessment of methods of treating viral warts by comparative treatment trials based on a standard design. British Journal of Dermatology, 94(6), 667-679.</53>

<54>Micali, G., Dall'Oglio, F., & Nasca, M. R. (2004). An open label evaluation of the efficacy of imiquimod 5% cream in the treatment of recalcitrant subungual and periungual cutaneous warts. Journal of Dermatological Treatment, 15(1), 46-49.</54>

<55>Focht, D. R., Spicer, C., & Fairchok, M. P. (2002). The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Archives of Pediatrics & Adolescent Medicine, 156(10), 971-974.</55>