Viral Warts: HPV Infection and How to Remove Them

Warts aren’t just annoying-they can be painful, embarrassing, and stubborn. If you’ve ever looked at a rough bump on your hand or foot and wondered, “How did this even happen?”, you’re not alone. Viral warts are caused by the human papillomavirus (HPV), a group of more than 100 different strains. Not all HPV types are the same. Some cause genital warts, others cause warts on your fingers, and some just show up on your soles. The good news? Most go away on their own. The bad news? They can take years to disappear, and in the meantime, they spread.

What Causes Viral Warts?

HPV infects the top layer of your skin, usually through a tiny cut or scratch. You don’t need to be in a locker room or public shower to catch it-just touching a surface someone else with a wart touched can do it. Kids are more likely to get them because their immune systems haven’t learned to fight off these viruses yet. In Australia, up to 24% of children have warts. Adults? About 5% do. That’s millions of people, globally.

There are three main types you’re likely to see:

• Common warts (verruca vulgaris): Rough, raised bumps, often on fingers or hands. Caused by HPV types 1, 2, and 4.
• Plantar warts (verruca plantaris): Found on the soles of your feet. They grow inward because of pressure, so they look like a callus with black dots (tiny blood vessels). Caused by HPV types 1, 2, 4, 60, and 63.
• Flat warts (verruca plana): Smaller, smoother, and often show up in clusters on the face, arms, or legs. Linked to HPV types 3 and 10.

HPV doesn’t care about your age, hygiene, or how often you wash your hands. It just wants a foothold. And once it’s there, your skin starts growing abnormally-creating that bumpy, thickened patch you can’t ignore.

Do Warts Go Away on Their Own?

Yes. About 60 to 70% of viral warts disappear within two years without any treatment. That’s why some doctors suggest waiting it out, especially in kids. But waiting isn’t always practical. Warts hurt when they’re on your feet. They spread to other parts of your body-or to other people. And for many, the look of them is enough to make them want them gone.

Here’s the catch: even if a wart disappears, the virus might still be hiding under your skin. That’s why they come back. And if you keep scratching or picking at them, you can spread them to new spots. That’s called autoinoculation. It’s like planting seeds in your own skin.

Topical Treatments: What Actually Works?

Over-the-counter wart removers are everywhere. Salicylic acid is the most common-and the most studied. It’s in gels, pads, and liquids, with concentrations from 17% to 40%. The science is clear: if you use it right, it works. A 1976 study of over 1,800 patients found an 84% cure rate for plantar warts using daily salicylic acid.

How to use it properly:

1. Soak the wart in warm water for 10 minutes.
2. Gently file away the dead skin with a pumice stone or emery board (use a new one each time-don’t reuse it).
3. Apply the acid directly to the wart, avoiding healthy skin.
4. Leave it on. Repeat daily.

It takes time. Six to twelve weeks. But if you stick with it, you’ll see results. No pain. No needles. Just patience.

Another option is trichloroacetic acid (TCA), sold as Tri-Chlor. This is stronger and usually applied by a dermatologist. It works by burning off the wart tissue. Before application, they’ll file the wart and sometimes prick it to let the acid sink in deeper. It stings. It can leave a scar. But it’s effective for stubborn warts on palms or soles.

Cryotherapy: Freezing Warts Off

Cryotherapy-freezing with liquid nitrogen-is one of the most common in-office treatments. Dermatologists spray it directly onto the wart, freezing it to a depth of 2-3mm beyond the visible edge. The tissue dies, then falls off. It’s quick. It’s done in minutes.

A 2023 review of seven studies with nearly 1,000 patients found cryotherapy and salicylic acid had nearly identical success rates after 12 weeks. No big difference. But here’s the twist: timing matters.

The 1976 Bunney study showed something critical: if you wait too long between treatments, the cure rate drops. At 2-3 week intervals, 75% of hand warts cleared. At 4 weeks? Only 40%. Most people need 3-6 sessions. Each one hurts a little. You’ll feel a burning sensation, then numbness. A blister might form. It’s not fun-but it works.

Home cryotherapy kits exist. They’re weaker than what a doctor uses. Don’t expect miracles. If your wart hasn’t budged after a few tries, see a professional.

Immunotherapy and Other Advanced Options

When the usual methods fail, doctors turn to ways that wake up your immune system. Imiquimod cream (Aldara) is one. It’s not a wart killer-it’s a signal. It tells your body: “Hey, there’s a virus here. Go deal with it.”

It’s used for warts that won’t budge. Studies show it works even after cryotherapy and salicylic acid failed. But it takes weeks. And it causes redness, swelling, and itching. That’s not a side effect-it’s proof it’s working.

Other options include:

• Electrosurgery: A tiny electric needle burns the wart off. Usually done under local anesthetic. Leaves a small scar.
• Laser treatment: Pulse dye lasers (like VBeam) target the blood vessels feeding the wart. It turns purple or black, then sloughs off in 1-2 weeks. Used for stubborn cases, especially on the face.
• Antiviral creams: Cidofovir or acyclovir (Zovirax) are sometimes prescribed off-label. Not FDA-approved for warts, but used when other options run out.

Don’t expect surgery to be the answer. Cutting out a wart doesn’t remove the virus underneath. It often comes back, sometimes worse.

What Doesn’t Work (And Why)

There are dozens of treatments out there. Silver nitrate. Cantharidin. Zinc. Phenol. Formic acid. You’ll find them in alternative health blogs and YouTube videos. But here’s the truth: the Royal Australian College of General Practitioners reviewed 15 different therapies and found solid evidence for only two: salicylic acid and cryotherapy.

The rest? Anecdotes. Small studies. No randomised trials. That doesn’t mean they’re useless-but they’re not proven. And when you’re spending money and time, you want something that actually works.

Also, don’t believe the myth that duct tape suffocates warts. A few small studies suggested it might help, but later, larger reviews found no significant benefit over placebo.

Preventing Spread and Recurrence

Treating the wart is only half the battle. Stopping it from coming back-or spreading-is just as important.

• Don’t pick or scratch. Ever.
• Use separate towels, nail clippers, and pumice stones.
• Wear flip-flops in public showers and pools.
• Don’t share shoes or socks.
• Keep feet dry. Moisture helps HPV thrive.
• Wash hands after touching a wart.

Dr. William Warren Kwan, a dermatologist, says it plainly: “To attenuate transmission, hygienic practices need to be adopted in conjunction with any treatment.” That’s not a suggestion. It’s essential.

When to See a Doctor

You don’t need to rush to a dermatologist for every wart. But you should if:

• It’s painful or bleeding.
• It’s on your face or genitals.
• It’s growing quickly or changing color.
• You have diabetes or a weakened immune system.
• Home treatments haven’t worked after 12 weeks.

Also, if you’re not sure it’s a wart-see a doctor. Skin cancer can sometimes look like a wart. A dermatologist can tell the difference in seconds.

Final Thoughts

Viral warts are common. They’re annoying. And they’re not a sign of poor hygiene. They’re a sign that your skin got infected-and your immune system hasn’t kicked in yet.

Salicylic acid and cryotherapy are your best bets. Both have decades of evidence behind them. Both are affordable. Both require patience. No magic bullet. No overnight fix.

What works for one person might not work for another. That’s why treatment needs to be personal. Location matters. Skin type matters. Pain tolerance matters. And so does persistence.

Warts don’t define you. But how you handle them? That does. Stay consistent. Stay clean. And don’t give up.