Warts are usually harmless but may be unsightly. Warts on the feet (verrucas) are sometimes painful. Warts usually clear in time without treatment. As verrucas do not respond well to liquid nitrogen, we do not treat them in the surgery. We advise you to try over the counter treatments. Your Pharmacist will be able to advise you about available preparations for verrucas and warts.

Treatment with liquid nitrogen is painful and we do not offer this to children under 10 years of age.

What are warts and verrucas?

Warts are small rough lumps on the skin. They are caused by a virus (human papilloma virus) which causes a reaction in the skin. Warts can occur anywhere on the body but occur most commonly on hands and feet. They range in size from 1 mm to over 1 cm. Sometimes several occur in the same area of skin. The shape and size of warts vary, and they are sometimes classed by how they look. For example: ‘common warts’, ‘plane (flat) warts’, ‘filiform (finger-like) warts’, mosaic warts’, etc.

Verrucas are warts that occur on the soles of the feet. They are the same as warts on any other part of the body but may look flatter and broader as they tend to get ‘trodden in’.

Note: anal and genital warts are different. Leaflets are available at the surgery.

Who gets warts and verrucas and are they harmful?

Most people develop warts at some time in their life, usually before the age of 20. About 1 in 10 people in the UK have warts at any one time. They are not usually harmful. Sometimes verrucas are painful if they press on a sensitive part of the foot. Some people find their warts unsightly. Warts at the end of fingers may interfere with fine tasks.

Are warts contagious?

Yes, but the risk of passing them on to others is low. You need close skin-to-skin contact. You are more at risk of being infected if your skin is damaged, or it is wet and macerated, and in contact with roughened surfaces. For example, in swimming pools and communal washing areas.

You can also spread the wart virus to other areas of your body. For example, warts may spread round the nails, lips, and surrounding skin if you bite warts on your fingers, or nearby nails, or if you suck fingers with warts on. If you have a poor immune system you may develop lots of warts which are difficult to clear. (For example, if you have AIDS, if you take chemotherapy, etc.)

To treat or not to treat?

There is no need to treat warts if they are not causing you any problems. Without treatment, most warts will go after 6 – 12 months, and leave no scar. This is particularly true in children and young adults. Sometimes they last longer. In particular, warts in older people are sometimes more persistent and may last for several years.

Treatment can often clear warts more quickly. But treatments are time consuming and some can be painful. Parents often want treatment for their children but children are often not bothered by warts. Simply waiting for them to go is often the best thing to do.

What are the treatment options?

Salicylic acid

There are various lotions, paints, and special plasters which contain salicylic acid. You can buy these at pharmacies, or your doctor may prescribe one.

Read the instructions in the packet on how to use the brand you buy or are prescribed, or ask your pharmacist for advice. Usually:

• You need to apply each day for up to 3 months. This ‘acid burns’ off the top layer.
• Every few days rub off the dead tissue from the top of the wart with emery paper (or similar). Gradually the wart is ‘burnt off’ and ‘rubbed away’.
• It is best if you soak the wart in water for 5-10 minutes before applying acid.
• You should not apply acid to the face because of the risk of skin irritation which may cause scarring.
• If you have diabetes or poor circulation, you should use salicylic acid only on the advice of a doctor.

If you put the acid on correctly each day you have a good chance of clearing the warts within 3 months. Tips for success include:

• Try not to get the acid on the skin next to the wart as it may become irritated. You can protect the nearby skin by putting some Vaseline on the normal skin beforehand, or by putting on a plaster with a hole in it which just exposes the wart for treatment.
• If the surrounding skin does become sore, stop the treatment for a few days until it settles. Then re-start treatment. There is also a small risk that you may get a skin allergy to the treatment. If this occurs, the surrounding skin becomes red and itchy.
• It may take 2 weeks or more before you notice any improvement. It usually takes up to 3 months of daily applications for warts to go completely.
• Treatment may work better if you put a plaster on the wart after applying the acid.
• Acid lotions and paints are flammable. Keep them away from open fires and flames.

Freezing treatment

Freezing warts with liquid nitrogen is a popular treatment. Many GPs and practice nurses are skilled at this. Liquid nitrogen is sprayed on, or applied to, the wart. Liquid nitrogen is very cold and the freezing and thawing destroys the wart tissue. To clear the wart fully it usually needs 3 – 5 treatments, a couple of weeks or so apart. The chance of clearing a wart with freezing treatment is about the same as acid treatment. However, it is quicker.

Freezing treatment can be painful. Sometimes a small blister develops for a day or so on the nearby skin after treatment. Also, there is a slight risk of scarring the nearby skin or nail, or damaging underlying tissues such as tendons or nerves. It is not suitable for younger children or for people with poor circulation.

Other treatment options

• Tape – A recent study suggested that if you cover a wart with strong adhesive tape (duct tape was used in the study) there is a good chance that it will clear away within a month or two. It may be worth a try as it is painless. However, further studies are needed to clarify the role of this treatment.
• A chiropodist can pare or rub down a verruca which is painful. This is often sufficient to ease any pain, even though part of the verrucas may still remain.

What about swimming?

A child with warts or verrucas should go swimming as normal. However, some swimming pools and schools have their own regulations. If they insist that a verrucas is covered you can cover it with special socks or plasters which you can buy from pharmacies.