Warts & Verrucas

A wart is generally a small, rough growth, typically on the hands and feet, that can resemble a cauliflower or a solid blister. Warts are common, and are caused by a viral infection, specifically by the human papillomavirus (HPV) and are contagious when in contact with the skin of another person. It is also possible to get warts from sharing towels or other objects. They typically disappear after a few months but can last for years and can recur. A few papilloma viruses are known to cause cervical cancer.

A range of different types of warts have been identified, varying in shape and the area of the body affected, as well as the type of human papillomavirus involved. These include:

1. Common wart (Verruca vulgaris): a raised wart with roughened surface, most common on hands and knees
2. Flat wart (Verruca plana): a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees
3. Filiform or digitate wart: a thread- or finger-like wart, most common on the face, especially near the eyelids and lips
4. Plantar wart (verruca, Verruca pedis): a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet
5. Mosaic wart: a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet                           5. Genital wart (venereal wart, Condyloma acuminatum, Verruca acuminata):

Treatments that may be prescribed by a medical professional include:

1. Keratolysis, removal of dead surface skin cells usually using salicylic acid, blistering agents, immune system modifiers ("immunomodulators"), or formaldehyde.
2. Cryosurgery, which involves freezing the wart (generally with liquid nitrogen), creating a blister between the wart and epidermal layer, after which the wart and surrounding dead skin falls off by itself.
3. Surgical removal of the wart.

One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75%  compared with 48% for placebo in six placebo-controlled trials including a total of 376 participants. The reviewers also concluded that there was little evidence of a significant benefit of Cryotherapy over placebo or no treatment.

There are several over-the-counter options for common warts and verrucas only. (All other warts must be treated through your General Practitioner)  The most common preparations involve salicylic acid.  Removing a wart or verruca with salicylic acid requires a strict regimen of cleaning the area, applying the acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a wart.

Bazuka gel contains salicylic acid and lactic acid and is suitable for children and adults. Bazuka Extra Strength gel contains salicylic acid in a higher concentration. Both form a coating over the wart or verruca. Salactol paint is a less expensive alternative to Bazuka gel.

Wartner is an over the counter product which freezes the wart or verruca.

Another over-the-counter product that can aid in wart removal is silver nitrate in the form of a caustic pencil. This method generally takes three to six daily treatments to be effective. The instructions must be followed to minimize staining of skin and clothing. (Skin and clothing goes black)

Duct tape occlusion therapy (DTOT) involves placing a piece of duct tape over the wart(s) for six days, followed by soaking the area in water and scraping it with a pumice stone or emery board. Evidence suggests that DTOT is more effective than cryotherapy.

For much more information click Warts & Verrucas or go to NHSDirect at www.nhs.uk 

This page was last updated: Monday 25 September, 2017