Warts are small growths on the skin caused by a viral infection in the skin's top layer. They can happen anywhere on the body, but typically appear on the hands and feet. Warts are usually harmless and painless, but they can be disfiguring and embarrassing, and occasionally they hurt or itch. Warts may become painful if they are located in areas of repeated friction or pressure. The following are different types of warts:
Warts commonly occur in children and young adults, but they may appear at any age. Genital warts are contagious, while common, flat, and plantar warts are less likely to spread from person to person. However, plantar warts may be spread from moist surfaces in communal swimming areas. All warts can spread from one part of the body to another. Some warts will disappear without treatment, although it can take up to 2 years. Whether treated or not, warts that disappear often reappear.
Warts are caused by various strains of a common virus in humans, the human papillomavirus (HPV). They are more likely to occur if the skin has been broken or damaged in some way. The following factors increase your risk of developing warts:
Most warts can be diagnosed by location and appearance. Your health care provider may want to cut into a wart to verify that it is not a corn, callus, or other growth. Your provider is unlikely to order laboratory tests, however, you may receive a sonogram to confirm plantar wart diagnosis. If you have genital warts, your provider will check inside your anus and (in women) vagina.
In most cases, the best treatment is no treatment at all because most warts will disappear over time without any intervention. Studies show that one half of cutaneous warts resolve spontaneously within one year, and about two-thirds within two years. Some research shows 70% of warts clear within 3 months without any treatment. For warts that are painful or unsightly, medical treatments include drug therapy (application of salicylic acid), cryosurgery with liquid nitrogen ("freezing" the wart to destroy tissue), electrosurgery (burning), lasers, and cutting out the wart.
Other potential treatments include bleomycin (an anticancer drug that is injected into the wart), interferon (a treatment to boost the body's immune reaction to the wart), and other forms of immunotherapy. Preliminary research suggests that immune stimulants like Propiorium bacterium parvum may help the body produce antibodies and destroy warts. Preliminary studies suggest injections of vitamin D3 into the base of plantar warts resolves the issue in 80% of patients. There is even some anecdotal evidence that applying duct tape and leaving it in place for 6 days, can help treat common warts. Simply repeat the process every 6 days, leaving the wart uncovered for 12 hours before covering it for another 6 days until the wart resolves. Unless your wart is causing significant problems, you should avoid treatments that have risks or could result in scarring.
Common, flat, and plantar warts
Nonprescription preparations using salicylic acid are available over the counter. Special cushions are available to relieve pressure and pain from plantar warts. Your doctor may prescribe medications in some instances.
In most cases, if you are healthy and not pregnant, your health care provider will either apply podophyllin weekly or prescribe a podofilox for you to apply. A vaccine is now available to protect women against contracting the HPV virus responsible for genital warts. The vaccine is 90% to 100% effective in protecting against HPV.
Nutritional and herbal support may enhance immune function and minimize recurrence of HPV, the virus that causes warts. Work with a knowledgeable physician to find the therapies or supplements that are right for you. Natural supplements may interact with a variety of medications. Always inform all of your providers about any supplements or therapies you are using.
These nutritional tips may help reduce symptoms:
You may address nutritional deficiencies with the following supplements:
Herbs may help strengthen and tone the body's systems. As with any therapy, you should work with your provider to diagnose your problem before starting treatment. Some herbs may have side effects or interact with certain medications you are taking, so you should speak with your provider before starting any herbal therapy. You may use herbs as dried extracts (capsules, powders, and teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. (5 grams) herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. You may use tinctures alone or in combination as noted.
Topical applications may also be effective for treating warts. Stop any topical application if irritation develops in the surrounding skin. For plantar, flat, and common warts use the following applications:
To maximize benefit, place 2 to 4 drops of tincture of thuja or tea tree oil (Melaleuca alternifolia) on the wart before covering with peel or garlic. DO NOT use tea tree oil internally. This application may need to be repeated nightly for up to 3 weeks. The wart will turn black as it begins to die. Use only commercially-prepared products that are formulated for this type of use. Avoid contact with eyes, mouth, or nose. Never use internally. If you are pregnant or nursing, speak to your doctor before using these topical remedies.
For external genital warts, paint the warts with vitamin A or beta-carotene once or twice daily. Add 3 to 4 drops each of thuja, echinacea, and lomatium for best results. Use only commercially-prepared products that are formulated for this type of use. Avoid contact with eyes, nose, or mouth. Never use internally. DO NOT use vaginal treatments if you are pregnant, unless specifically directed to do so by your doctor.
Two well designed trials evaluating the use of homeopathy in the treatment of common and plantar warts found that the remedies were no more effective than placebo in reducing the number of warts. Despite the lack of evidence from these two trials, professional homeopaths might recommend one of the following treatments for warts based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account your constitutional type, including your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
In one study of 40 people, hypnosis resolved more warts than either topical salicylic acid, or a placebo (dummy treatment). In a study of localized topical treatment, 86% of the treated warts cleared compared to 41% of placebo-treated warts.
Even with treatment, some warts may return. Genital warts are more likely to return because there is no cure for the virus that causes them, and because warts are more difficult to control in a moist environment.
Acupuncture may help stimulate your immune system.
DO NOT use podophyllin if you are pregnant.
Agius E, Mooney JM, Bezzina AC, Yu RC. Dermojet delivery of bleomycin for the treatment of recurrent plantar warts. J Dermatolog Treat. 2006;17(2):112-116.
Akhavan S, Mohammadi SR, Modarres Gillani M, Mousavi AS, Shirazi M. Efficacy of combination therapy of oral zinc sulfate with imiquimod, podophyllin or cyrotherapy in the treatment of vulvar warts. J Obstet Gynaecol Res. 2014;40(10):2110-2113.
Aktas H, Ergin C, Demir B, Ekiz O. Intralesional vitamin D injection may be an effective treatment option for warts. J Cutan Med Surg. 2016;20(2):118-122.
Bruggink SC, Gussekloo J, de Koning MN, et al. HPV type in plantar warts influences natural course and treatment responses: secondary analysis of a randomised controlled trial. J Clin Virol. 2013;57(3):227-232.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.
Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm. 2004;54(3):243-250.
Das M, Sur P, Gomes A, Vedasiromoni JR, Ganguly DK. Inhibition of tumor growth and inflammation by consumption of tea. Phytother Res. 2002;16 Suppl 1:S40-4.
Ferri FF, ed. Ferri's Clinical Advisor 2017. 1st ed. Philadelphia, PA: Elsevier; 2017.
Habif TP, ed. Clinical Dermatology. 56h ed. Philadelphia, PA: Elsevier; 2016.
Heggers JP, Cottingham J, Gussman J, et al. The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II. Mechanism of action and in vitro toxicity. J Altern Complement Med. 2002;8(3):333-340.
Heitzman ME, Neto CC, Winiarz E, Vaisberg AJ, Hammond GB. Ethnobotany, phytochemistry and pharmacology of Uncaria (Rubiaceae). Phytochemistry. 2005;66(1):5-29.
Kacar N, Tash L, Korkmaz S, Ergin S, Erdogan BS. Cantharidin-podophyltoxin-salicylic acid versus cryotherapy in the treatment of plantar warts: a randomized prospective study. J Eur Acad Dermatol Venereol. 2012;26(7):889-893.
Keogh-Brown MR, Fordham RJ, Thomas KS, et al. To freeze or not to freeze: a cost-effectiveness analysis of wart treatment. Br J Dermatol. 2007;156(4):687-692.
Lichtenstein AH, Russell RM. Essential nutrients: food or supplements? Where should the emphasis be? JAMA. 2005;294(3):351-358.
Meltzer SM, Monk BJ, Tewari KS. Green tea catechins for treatment of external genital warts. Am J Obstet Gynecol. 2009;200(3):233.
Mulhem E, Pinelis S. Treatment of nongenital cutaneous warts. Am Fam Physician. 2011;84(3):288-293.
Nasser N. Treatment of common warts with the immune stimulant Propionium bacterium parvum. An Bras Dermatol. 2012;87(4):585-589.
Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-247.
Scnitzler P, Schon K, Reichling J. Antiviral activity of Australian tea tree oil and eucalyptus oil against herpes simplex virus in cell culture. Pharmazie. 2001;56(4):343-347.
Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.
Suh DW, Lew BL, Sim WY. Investigations of the efficacy of diphenylcyclopropenone immunotherapy for the treatment of warts. Int J Dermatol. 2014;53(12):e567-e571.
Thomas KS, Keogh-Brown MR, Chalmers JR, et al. Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model. Health Technol Assess. 2006;10(25):iii, ix-87.
Wortsman X, Sazunic I, Jemec GB. Sonography of plantar warts: role in diagnosis and treatment. J Ultrasound Med. 2009;28(6):787-793.
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2022 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.