Warts

Warts are noncancerous growths that develop when certain strains of the human papillomavirus (HPV) infect the skin. The virus enters through tiny cuts or breaks in the skin and triggers rapid growth of cells in the outer layer, known as the epidermis. This overgrowth creates the raised, thickened texture people recognize as a wart. The virus thrives in warm, moist environments and is commonly found in public areas such as locker rooms, swimming pools, and communal showers.

Children and adolescents tend to develop warts more often than adults, partly because their immune systems are still developing and they may have more skin injuries from play or sports. People with eczema or those who bite their nails or pick at their skin may also have an increased risk because the skin barrier is compromised.

Not everyone who comes into contact with HPV will develop a wart. The body’s immune response often clears the virus before a growth forms. In many cases, warts eventually resolve on their own as the immune system recognizes and fights the infection, though this process can take months or even years.

Warts can appear almost anywhere on the body. They often develop on the hands, fingers, and around the nails, but they are also common on the feet, face, arms, and legs. The appearance varies depending on the type and location. Some are rough and raised, while others are flat and smooth. On the soles of the feet, they may grow inward due to pressure from standing and walking.
Several types of warts exist. Common warts usually appear on the hands and fingers and have a rough, grainy surface. Plantar warts develop on the bottom of the feet and may cause discomfort when walking. Flat warts are smaller and smoother and often occur in clusters on the face or legs. Filiform warts are thread-like and typically appear around the mouth, nose, or eyes. Each type has distinctive characteristics, but all are caused by variations of the same virus.

Warts typically present as small, fleshy, rough bumps on the skin. Their color may range from flesh-colored to pink, tan, or slightly darker than the surrounding skin. The surface may feel coarse, and some warts contain tiny black dots. These dots are small, clotted blood vessels and are a common identifying feature.

Most warts are painless, especially those on the hands. However, plantar warts on the feet can be uncomfortable. Because they are pressed inward by body weight, they may feel like stepping on a pebble. Pain can increase with pressure or prolonged standing.

Flat warts are usually not painful but can be noticeable because they often appear in larger numbers. Filiform warts may cause irritation depending on their location, particularly if they catch on clothing or are irritated by shaving.

In some cases, warts spread from one area of the body to another. Scratching, picking, or shaving over a wart can allow the virus to spread to nearby skin. Warts can also spread through direct skin-to-skin contact or by sharing personal items such as towels or razors.

Although warts are benign, changes in size, color, or shape should not be ignored. Some skin cancers and precancerous growths can resemble warts. A lesion that bleeds easily, grows rapidly, ulcerates, or does not respond to typical wart treatments requires professional evaluation.

Diagnosis of warts is usually straightforward. Dr. Patricia Richey performs a thorough skin examination and evaluates the lesion’s size, shape, texture, and location. In most cases, visual inspection is sufficient to identify a wart.

A dermatologist may gently pare down the surface of the lesion to look for the pinpoint black dots that represent clotted blood vessels. This finding helps distinguish a wart from other thickened skin growths such as calluses or corns. On the feet, this step is particularly useful because plantar warts can resemble pressure-related calluses.

Many people attempt over-the-counter treatments before seeking medical care. While some warts respond to these therapies, others persist or recur. Most warts require a combination of in-office and at-home treatments. Medical evaluation is recommended if a wart is painful, spreading, bleeding, changing in appearance, or interfering with daily activities. Evaluation is also important for individuals with diabetes, circulation problems, or weakened immune systems, as self-treatment may increase the risk of complications.

Warts are common and generally not dangerous, but they should not be dismissed without consideration. A professional examination ensures an accurate diagnosis and appropriate management. Careful assessment also provides reassurance when a growth is benign and allows prompt intervention when something more serious is identified.