Warts and Verrucas

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Warts are small rough lumps on the skin caused by a virus (human papilloma virus).  They can occur anywhere on the body but commonly on hands and feet. 

Verrucas are warts that occur on the soles of the feet.

Warts are common and are usually not harmful but some people find them unsightly.  Verrucas can be painful.

Warts can be contagious but the risk of passing them on is low, needing close skin to skin contact.  There is more risk if the skin is damaged or wet and macerated (e.g. in swimming pools and communal washing areas).

To reduce the risk of passing the warts to others:

• Don’t share towels
• When swimming, cover any wart or verruca with a waterproof plaster
• If you have a verruca, wear flip-flops in communal shower rooms and don’t share shoes/socks

To reduce the chances of warts spreading to other areas of the body:

• Don’t scratch warts
• Don’t bite nails or suck fingers that have warts
• If you have a verruca, change socks daily

Treatment

There is no need to treat warts if they are not causing you any problems.  Without treatment, about 3 in 10 warts have gone within 10 weeks, and most warts will have gone within 1-2 years and leave no scar (particularly in young people).  Sometimes, warts last longer (particularly in older people), and can be painful.  As children are often not bothered by warts, in most cases, simply waiting for them to go is usually the best thing to do.

Treatment Options

Over the counter treatments from pharmacists include:

• Use of duct tape (see below)
• Salicylic acid (e.g. Bazuka, Cuplex Gel – they cost approximately £4 - £6) – apply as per directions on the box  
• Freezing treatments –approximately £9 - £12 (e.g. Scholl Freeze Wart & Verruca Remover)

Treatments for Warts

Duct Tape is a simple method of treating warts.  You can buy duct tape at a hardware store, or you can use any strong, sticky, waterproof tape.  According to one study (Archives of Paediatric and Adolescent Medicine 2002; 156:971-4) duct tape is as effective as other treatments, such as freezing.

• Cut a piece of tape the same size as the wart and stick it on.
• Leave it for 6 days, and then remove it in the evening.
• After removing the tape, soak the wart in warm water and then gently rub the wart with an emery board.  Leave the tape off overnight and then apply a new piece for another 6 days.
• If the skin under the tape becomes red and soggy, stop using the tape for a few days.
• Continue this routine for 2 months.

In the study, 85% of the warts disappeared with this treatment and most did so within 4 weeks. 

However, a more recent study in the same journal (Archives of Paediatric and Adolescent Medicine 2006; 160:1121-5) gave a much lower success rate of only 16% after treatment with duct tape for 6 weeks.  And another study has suggested that after duct tape treatment, a wart is more likely to reappear (Archives of Dermatology 2007;143:309-13) .

Wart paint for hand and feet warts:  For warts, buy some wart paint from a pharmacy.  Wart paints are not suitable for using on the face (or genital area), or if you are pregnant.  Most contain salicylic acid; some also contain lactic acid.  The acid does not attack the virus, but simply removes some of the warty tissue, so that the body’s natural recovery process has less to do.  Therefore the result is very unpredictable.  In one person, the wart may disappear in days, while an identical-looking wart in a different person may take weeks and weeks, so this treatment does need patience.  Overall, salicylic acid wart paint cures about 75% of warts (British Medical Journal 2002; 235:461-4).

The instructions will tell you to rub the wart with a pumice stone or an emery board before applying the paint.  Do not overdo it – if you rub too hard, you may encourage spread of the virus onto nearby skin.  In fact, this rubbing down needs to be done only twice a week, not every time you apply the paint.
Before applying the paint, soak the wart in warm water for 2 minutes; this will encourage the paint to penetrate the wart.  Then dry it thoroughly using your own towel.
Then apply a tiny drop of the paint to the centre of the wart using a cocktail stick, matchstick or the applicator from the bottle.  Take care to avoid getting the paint onto the skin nearby; you could protect the normal skin with Vaseline.  

Allow the paint to dry and then cover it with a sticking plaster.

If the skin becomes sore, you have probably been rubbing it down too enthusiastically.  Stop the treatment for a few days until the skin recovers.  

Other types of wart paint or gel are worth trying if you have been using the salicylic acid wart paint for 3 months and the wart has not gone.  Ask your pharmacist for Glutaraldehyde (which may stain your skin brown) or Formaldehyde paint or gel.  However, some people are over-sensitive to these substances, so it might be better to ask your doctor for advice.  Redness or itching around the wart may indicate an allergy to the treatment.