Warts are small rough lumps on the skin. They are caused by a virus (human papillomavirus) which causes a reaction in the skin. Warts:

  • can occur anywhere on the body but most commonly on hands and feet;
  • tend to be round or oval-shaped (although some are long and thin);
  • range in size from 1mm to over 1cm.
  • are usually firm and raised;
  • have a rough, irregular surface similar to a cauliflower (although some are smooth);
  • can appear on their own or in a group.

Verrucae are warts on the soles of the feet. They are the same as warts on any other part of the body. However, they may look flatter, as they tend to get trodden in. They can also develop on the ends of toes. They are white, often with one or several black dots in the centre and can be painful when on a weight-bearing part of the foot.

Typical appearance of verrucae:

Appearance of verruca

Example appearance of a verruca

Most people develop one or more warts at some time in their lives, usually before the age of 20. They are not usually harmful. Sometimes verrucae are painful if they press on a sensitive part of the foot. Some people find their warts unsightly. Warts at the end of fingers may interfere with fine tasks.

Warts and verrucae are contagious but the risk of passing them on to others is low. When something is called ‘contagious’, it means it can be passed on by touching. You need close skin-to-skin contact to pass the virus on directly. You are more at risk of being infected if your skin is damaged, or if it is wet, macerated and in contact with roughened surfaces, for example, in swimming pools or communal washing areas.

To reduce the chance of passing on 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 or socks.

You can also transfer the wart virus to other areas of your body. For example, warts may spread round the nails, lips and surrounding skin if you bite warts on your fingers, or nearby nails, or if you suck fingers with warts on. If you have a poor immune system you may develop lots of warts which are difficult to clear, for example, if you have AIDS or are on chemotherapy, etc.

To reduce the chance of warts spreading to other areas of your body:

  • Don’t scratch warts or pick them;
  • Don’t bite nails or suck fingers that have warts;
  • If you have a verruca, change your socks or tights daily.

There is no need to treat warts if they are not causing you any problems. Half the number of children with warts will find they have disappeared within a year without any treatment. Two thirds will have gone within two years. The chance that a wart will go quickly is greatest in children and young people. Sometimes warts last longer, particularly in adults. On balance it is usually only worth treating a wart or verruca if it is troublesome, for example, if it is painful or you find it ugly and conspicuous.

Treatment options

Two effective treatments are Salicylic acid and Cryotherapy (freezing). Essential oils are an alternative treatment that I can offer.

Salicylic acid

There are various lotions, paints and special plasters that contain salicylic acid. This acid burns off the top layer of the wart. You can buy salicylic acid at pharmacies, or your doctor may prescribe one. It usually comes as paint or a gel. Read the instructions in the packet on how to use the brand you buy or are prescribed, or ask your pharmacist for advice. Usually:

  • You need to apply it each day for up to three months. Persevere – if you give up too soon, it will not work;
  • Before applying the salicylic acid, carefully rub off the dead tissue from the top of the wart, with an emery file (or similar);
  • It is best if you soak the wart in water for 5-10 minutes before applying salicylic acid;
  • You should not apply salicylic acid to the face because of the risk of skin irritation which may cause scarring;
  • If you have diabetes or poor circulation, you should use salicylic acid only on the advice of a doctor.


Liquid nitrogen or liquid nitrous oxide is sprayed on the wart or verruca. Liquid nitrogen is very cold and the rapid cycle of freezing and thawing destroys the wart tissue. To clear the wart fully it can take up to 4-6 treatment sessions, sometimes more. Each treatment session is a couple of weeks or so apart. Points to note:

  • This treatment is moderately painful and cannot be used on areas where bone is just under the skin;
  • Sometimes a small blister develops for a day or so on the nearby skin after treatment;
  • There is a slight risk of scarring nearby skin or of damaging underlying tissues such as tendons or nerves;
  • It is not suitable for younger children or for people with poor circulation.

A further option is to combine salicylic acid and cryotherapy: in between the freezing sessions, you apply salicylic acid daily to your wart or verruca. You should not use the salicylic acid until any blistering, scabs or soreness from the cryotherapy have settled.

Essential oils

‘Banish That Blotch’ is a very useful alternative treatment for verrucae. It can be applied by the patient at home, used on its own or in combination with other treatments. It is a blend of Tea Tree, Peppermint and other oils with cleansing, therapeutic properties. Tea Tree oil is effective against all three categories of infectious organisms, bacteria, viruses and fungi; it is also an immuno-stimulant, helping the body’s ability to heal. Peppermint oil has analgesic properties, helping to relieve painful or tender verrucae.

This treatment is ideal for patients where it is not possible to use conventional methods, for patients taking certain medications or for those with delicate, sensitive skin. It can also be used by patients with diabetes.