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Health condition · Clinically reviewed

Common warts, HPV skin lesions, salicylic acid, cryotherapy and when to escalate.

Most warts clear on their own within two years. A stepped ladder - topical treatment, cryotherapy, then specialist options - handles the rest.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, BAD and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK dermatology practice including salicylic acid, cryotherapy and immunotherapy options.

Key facts

Common warts at a glance.

The essentials, in plain English - what causes them, the main types and how they are treated in the UK today.

  • What it is

    A benign HPV (human papillomavirus) infection of the skin, most often caused by cutaneous types 1, 2, 4, 27 and 57.

  • Not genital warts

    Common cutaneous warts are a different family from genital warts (HPV 6 and 11) covered in our genital warts guide.

  • Very common

    Up to 30% of school-age children have warts at some point. Immunocompromised patients are more susceptible and often develop persistent lesions.

  • Often self-limiting

    Around 50 to 70% of warts clear spontaneously within two years, even without any treatment.

  • Transmission

    Spread by direct skin contact, shared towels or shoes, swimming pools and communal shower floors.

  • First-line treatment

    Topical salicylic acid, cryotherapy with liquid nitrogen, or watchful waiting - guided by site, symptoms and patient preference.

Why this guide matters

A stepped plan, not a shelf of products.

Common warts are common, usually harmless and often self-limiting. Three ideas shape everything else on this page.

  • Doing nothing is a valid option

    Up to 70% of warts clear within two years. Painless lesions in children can often be left alone with reassurance.

  • Salicylic acid and cryotherapy first

    Both are effective, safe and available in primary care. Which one comes first is largely down to patient preference.

  • Persistent or atypical - see a specialist

    Refractory warts, painful periungual disease and any lesion that looks unusual deserve dermatology review.

How the diagnosis is made

From first lesion to a clear plan.

The steps a UK GP or dermatologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Skin examination

    A structured look at the lesion - site, morphology, tenderness and any nail involvement usually settles the diagnosis clinically.

  2. 02

    Assessing

    Identify the wart type

    Common, plantar (verruca), flat, filiform, periungual or mosaic - each has typical features and preferred treatment.

  3. 03

    Assessing

    Symptom and impact review

    Pain (especially plantar and periungual), spread, cosmetic concern and effect on activities such as walking or sport.

  4. 04

    Confirming

    Dermoscopy when uncertain

    Thrombosed capillaries appear as tiny black dots - a helpful feature that distinguishes warts from corns and calluses.

  5. 05

    Confirming

    Biopsy for atypical lesions

    Reserved for persistent, rapidly growing, ulcerated, bleeding or otherwise unusual lesions to exclude skin cancer.

  6. 06

    Preparing

    Consider immune screening

    Extensive, refractory or unusually young-adult onset warts may prompt HIV testing or review of other immunosuppression.

  7. 07

    Preparing

    Agree a treatment ladder

    A stepped plan - no treatment, topical, cryotherapy, then specialist options - tailored to site, severity and preference.

Typical timeline: a first visit to an agreed treatment plan in a single appointment.

Symptoms

What warts actually look like.

Six recognisable patterns, plus the features that suggest a lesion is something more serious and needs specialist review.

  • Common warts

    Rough, hyperkeratotic papules on the hands, fingers and knees - the classic and most familiar pattern.

  • Plantar warts (verrucas)

    On the sole of the foot, flattened by pressure and often tender, sometimes with tiny black dots from thrombosed capillaries.

  • Flat warts

    Smooth, small, skin-coloured or brown papules, often on the face or backs of the hands - can appear in clusters.

  • Filiform warts

    Thread-like or finger-like projections, typically on the face, eyelids or neck.

  • Periungual and subungual warts

    Around or under the fingernails and toenails - painful and sometimes causing nail dystrophy.

  • Mosaic warts

    Clusters of small warts that merge into a plaque, most often on the soles of the feet.

  • Cosmetic concern and spread

    Even painless warts often prompt treatment because they spread to other sites or family members.

  • Red flag - persistent or atypical lesion

    A wart that keeps growing, ulcerates, bleeds or looks unusual in an adult needs a biopsy to exclude skin cancer.

Treatment

How warts are treated in the UK.

A stepped ladder from watchful waiting and topical treatment through cryotherapy to specialist immunotherapy, laser and surgery.

  • No treatment (watchful waiting)

    A reasonable choice for painless warts, given that most clear within two years. Avoid picking and cover with a waterproof plaster.

  • Topical salicylic acid

    First-line over-the-counter treatment (Cuplex, Duofilm, Bazuka, Salactol, Occlusal, 12 to 50%). Soak, pare and apply daily for weeks to months.

  • Cryotherapy

    Liquid nitrogen applied every two to three weeks over several sessions, usually in general practice or dermatology.

  • Duct tape occlusion

    Evidence is limited but the technique is harmless and often used alongside salicylic acid or alone.

  • Immunotherapy

    Intralesional Candida antigen or MMR (measles, mumps, rubella), topical imiquimod, intralesional 5-fluorouracil or bleomycin - specialist-led.

  • Cantharidin

    A topical blistering agent applied in specialist clinics for resistant warts, particularly in children.

  • Laser, electrocautery, curettage

    CO2 laser, pulsed dye laser (PDL), electrocautery or curettage for refractory or specialist dermatology cases.

  • HPV vaccination

    Gardasil 9 covers the main oncogenic and genital wart types and is offered routinely to UK adolescents (boys and girls aged 12 to 13).

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or dermatologist knows your skin and history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE CKS. Warts and verrucae: management.

  • British Association of Dermatologists (BAD). Patient information leaflet on warts and verrucae.

  • DermNet NZ. Viral warts - clinical features and treatment.

  • UK Health Security Agency. HPV vaccination programme guidance.

Red flags

When a wart needs urgent attention.

Most warts are harmless and manageable in primary care. These are the situations where a specialist opinion or biopsy is needed.

  • Persistent adult-onset warts

    New, widespread or refractory warts in an adult can be a marker of HIV or other immunosuppression - deserves a targeted assessment.

  • Rapid growth or ulceration

    A lesion that grows quickly, ulcerates or bleeds may not be a wart at all - biopsy to exclude squamous cell carcinoma or Bowen’s disease.

  • Atypical pigmentation

    An unusual pigmented lesion mimicking a wart should raise concern for amelanotic melanoma and needs specialist review.

  • Verrucous carcinoma

    A slow-growing, warty plaque that keeps enlarging despite treatment can be verrucous carcinoma - a biopsy is essential.

  • Facial or genital lesions

    Warts on the face need cautious treatment to avoid scarring. Genital warts are a separate diagnosis - see our genital warts guide.

  • Painful periungual disease

    Warts around or under the nail can damage the nail matrix and need earlier specialist input.

  • Immunocompromised patient

    Transplant recipients, people on immunosuppressants and those with HIV need more aggressive management and lower thresholds for specialist review.

  • Diabetes and peripheral vascular disease

    Foot lesions in these groups need careful assessment before cryotherapy or paring to avoid ulceration.

  • Pregnancy

    Some treatments (imiquimod, 5-fluorouracil, salicylic acid on large areas) are best avoided - always confirm with a clinician.

Living with it

A treatable condition, with a clear ladder.

Four things that make the biggest difference day to day - a bit of patience with treatment, sensible hygiene, not picking, and knowing when to escalate.

A quiet reminder

Consistency beats intensity, every time.

Small, steady habits kept up for weeks do more than a heroic weekend of picking and paring that stops after three days.

  1. 01 Patience

    Give treatment time

    Salicylic acid and cryotherapy work slowly - expect weeks to months, not days. Consistency matters more than intensity.

  2. 02 Hygiene

    Contain the spread

    Cover warts with a waterproof plaster in pools and changing rooms, avoid sharing towels or shoes, and wear footwear in communal showers.

  3. 03 Habits

    Don’t pick

    Picking or biting warts spreads virus to other fingers and to the lips. Cover them and use a dedicated file kept only for that wart.

  4. 04 Escalate

    When to ask for help

    Painful, spreading or refractory warts - and any atypical lesion - deserve a GP or dermatology review rather than another over-the-counter attempt.

Frequently asked

Everything we get asked about common warts.

Quick answers on causes, self-treatment, cryotherapy and when to see a specialist.

  • What causes common warts?

    They are caused by human papillomavirus (HPV) infection of the skin, most often cutaneous types 1, 2, 4, 27 and 57. These are different from the HPV types (mainly 6 and 11) that cause genital warts.

  • Will my wart go away on its own?

    Often, yes. Around 50 to 70% of warts clear spontaneously within two years as the immune system recognises and clears the virus. Watchful waiting is a reasonable choice for painless lesions.

  • What is the difference between a wart and a verruca?

    A verruca is simply a wart on the sole of the foot, flattened by pressure. It is often tender when walking and may show tiny black dots from thrombosed blood vessels.

  • How do I use salicylic acid treatment at home?

    Soak the wart in warm water, gently pare the surface with an emery board kept only for that wart, then apply the salicylic acid (12 to 50%) once daily. Cover with a plaster. Expect to continue for many weeks.

  • Does cryotherapy hurt and does it work?

    Liquid nitrogen stings briefly and can blister the skin. Sessions are usually repeated every two to three weeks. Cure rates are similar to salicylic acid - both are reasonable first-line options.

  • When should I see a specialist?

    If warts are painful, spreading, resistant to first-line treatment, on the face or around the nails, or if you have a weakened immune system. Any lesion that looks atypical deserves review to exclude skin cancer.

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