There are many myths and misconceptions about warts. We’ve probably all heard that one about getting them from touching a frog or toad. While you probably shouldn’t touch these amphibians for other reasons (some have toxins in their skin), warts, like many rashes in children, are caused by a virus (human papillomavirus).

Who it affects

Warts most commonly develop in children and young adults. One out of every 10 people will be affected by these stubborn bumps at some point in their life. Most warts occur on the hands, fingers, elbows, and bottom of the feet. People who bite their nails or pick at their hangnails are at greater risk for warts. Numerous, widespread warts could be an indication that someone has a weakened immune system.

Contracting warts

Warts spread from person-to-person in two ways. Firstly, through direct contact of the wart with broken skin. Secondly, through indirect contact of an object that touched the wart with broken skin. Examples include touching locker room equipment, pool floors, and shower surfaces.

There is a long delay between contact and the first appearance of a wart. This can be anywhere between 1 to 6 months. Prevention of warts is important. Practice good hand-washing, wear protective footwear in public spaces, and be careful during sports activities where there is skin-to-skin contact.

How to diagnose warts

Warts are usually easy to spot by looking at the skin (and, unfortunately, kids are sometimes bullied for this reason). Warts are rough, skin-colored bumps that appear anywhere on the skin, but most often develop on easily scraped areas like the hands and feet. Sometimes scratching of the wart leads to a straight line of new warts near the original area. People may notice tiny blackish-red dots in the center of their warts, which is the blood supply to these growths.

Treatment for warts

Warts often go away without any treatment, particularly in children. Studies show that about 60 percent of warts disappear on their own within two years. For this reason, watchful waiting is a reasonable option, especially in young children where treatment can be both traumatic and poorly tolerated.

Wart treatment is often very humbling because there is no single perfect treatment and usually any treatment will take months to be successful. The main reason to treat a wart is if it is painful. If treatment is desired, the best place to start is with a nightly home treatment, such as this simple four-step regimen:

  1. Soak the affected area in hot (but not scalding) water for 10 minutes each night.
  2. Immediately following the soak, use a nail file or pumice stone to carefully and gently file the warts (only use this for treating warts and not on normal skin since this could spread warts).
  3. After filing, place an over-the-counter wart solution or pad over the warts (these usually contain salicylic acid, the strongest available is 40 percent).
  4. Cover the solution or pad with regular duct tape and leave it on at least overnight. Repeat this nightly for at least 4-6 weeks and expect the wart skin to turn white and peel with treatment. If the surrounding skin becomes too irritated, cover these areas with petroleum jelly.

You may consider in-office treatments if warts fail to respond to home treatments. Freezing with liquid nitrogen is effective, but more painful and usually only older individuals can tolerate it. Other in-office treatments include shots of a yeast extract that may stimulate the immune system to fight the warts, a prescription strength wart cream such as fluorouracil 5%, and, rarely, laser treatment. With these limited treatment options, it becomes easier to see why our ancestors might have blamed those toads!

Keith Morley, MD, is the Director of Pediatric Dermatology at the University of Vermont Medical Center and assistant professor at the Larner College of Medicine at UVM. 

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