Warts Explained: How They Develop and Ways to Treat Them

Warts are one of the most common skin conditions people face, yet many individuals still misunderstand what they are and how they develop. These benign, often stubborn growths result from a viral infection and can appear anywhere on the skin. Although warts are usually harmless, they can be bothersome, contagious, and difficult to manage without proper guidance. This article explores what causes warts, how to recognise them, the available treatment options, and steps you can take to prevent their spread.

What Are Warts?

At their core, warts are small, non‑cancerous skin growths triggered by infection with the human papillomavirus (HPV). When the virus enters through tiny breaks in the skin, it triggers cells to multiply rapidly, forming a wart. More than 150 different HPV strains have been identified, and each strain is associated with specific types of warts.

Because HPV is widespread in everyday environments, most people come into contact with it at some point in their lives. While not everyone who encounters the virus develops warts, certain factors, such as a weakened immune system or frequent exposure to communal areas, increase the likelihood of infection.

How Warts Develop and Spread

Understanding how warts develop helps explain why they are so common and why preventing them can be challenging. The HPV virus enters the skin through tiny cuts, scrapes, or weak spots, most commonly on the hands and feet. Once inside, the virus takes time to incubate, often weeks or months, before visible growth appears.

Warts are highly contagious and can spread in several ways:

1. Direct contact with infected skin — touching a wart on someone else can transfer the virus.
2. Indirect contact via objects — towels, razors, nail clippers, and even floors in wet areas can carry HPV.
3. Self-spread (autoinoculation) — touching a wart and then another part of your body can spread the virus further.

Because HPV transmission does not always result in visible warts immediately, someone might unknowingly spread the virus long before any symptoms appear.

Common Types of Warts

Warts vary widely in appearance and behaviour depending on their location and the strain of HPV involved. The most frequently observed types include:

• Common Warts: These warts usually appear on the hands and fingers. They are raised bumps with a rough texture and often display tiny black dots at the surface — a sign of small clotted blood vessels within the wart.
• Plantar Warts: Found on the soles of the feet, plantar warts can be painful, especially when they occur on pressure points like the heel or ball of the foot. The virus enters through microabrasions when individuals walk barefoot in moist environments such as pools or locker rooms.
• Flat Warts: Smaller and smoother than other types, flat warts tend to form clusters and are often seen on the face, legs, or neck. They are especially common in children and young adults.
• Genital Warts: These warts develop in and around the genital and anal areas. They are usually transmitted through sexual contact and may require specialised medical care and counselling.

Recognising Symptoms of Warts

While warts can look quite different depending on their type, they share several characteristic features. Warts may appear as tiny, rough lumps, smooth flat bumps, or cauliflower-like clusters. Their colour can range from flesh-toned to grey, brown, or black. Most warts are painless, but some, especially plantar warts, may cause discomfort, itching, bleeding, or pain when walking or touching.

Diagnosis: How Doctors Confirm Warts

Healthcare professionals usually diagnose warts through careful physical examination. In many cases, their distinctive appearance is enough for a confident diagnosis. However, when warts look unusual, resist treatment, or appear in sensitive areas, doctors may take additional steps for confirmation.  

For instance, a doctor may gently scrape the wart to look for tiny black dots, a telltale sign of wart tissue. In more complex cases, doctors may perform a small skin biopsy to rule out other conditions, such as calluses or skin cancer. Tools like a dermatoscope can also help magnify the surface of the wart for better assessment.

Treatment Options for Warts

The rising global prevalence of HPV-related skin conditions, increasing demand for non-invasive home-based treatments, and continuous improvements in immunotherapy and topical drug delivery systems drive the warts therapeutics market. HPV is extremely common in the U.S., for instance, the U.S. Centers for Disease Control and Prevention (CDC) estimates that about 79 million Americans currently carry HPV, and that about 14 million people acquire new HPV infections each year. This includes strains that can lead to warts and other diseases.

Although many warts disappear naturally within one to two years as the immune system gains control of the virus, most individuals prefer treatment to reduce appearance, discomfort, or spread. Treatment choice depends on wart type, size, location, and patient preference.

• Topical Treatments: Over-the-counter or prescription products containing salicylic acid or similar agents help dissolve the wart layer by layer. Consistent, diligent application is necessary for the best outcomes.
• Cryotherapy (Freezing): This widely used method involves applying liquid nitrogen to the wart to freeze and destroy affected tissue. It may require several sessions and can cause temporary blistering or discomfort.
• Laser Therapy: Laser treatments target wart tissue with intense light energy to destroy it. This option is usually reserved for stubborn or recurrent warts.
• Surgery and Electrosurgery: For larger or resistant warts, surgical removal or electrosurgery (burning the wart) may be considered. These methods are more invasive but often effective for difficult cases.
• Immunotherapy: Immunotherapy aims to stimulate the body’s own defence systems to recognise and fight the HPV infection more effectively. This approach can be helpful, especially for warts that keep returning.

Preventing Warts

Completely preventing warts may not be possible, but you can reduce your risk with a few simple habits:

• Wash your hands regularly and avoid touching someone else’s warts.
• Keep cuts and abrasions clean and covered to block HPV entry.
• Do not share personal items such as towels, razors, or nail tools.
• Wear protective footwear in communal showers and pool areas.
• Avoid biting nails or picking at hangnails, as these actions expose skin to infection.
• Speak to your healthcare provider about HPV vaccination to reduce risk, especially for genital warts.

Conclusion

Warts are common skin growths caused by HPV and can affect people of all ages. While they usually resolve naturally, they can be contagious and, at times, uncomfortable or unsightly. Recognising what causes warts, understanding how they spread, and knowing your treatment options empowers you to take effective action and reduce the impact of these growths on your life. With proper care and professional guidance, doctors can successfully treat most warts and minimize their spread.