Is That A Wart? The Difference Between Warts & Other Skin Growths

Warts are common skin growths caused by human papillomavirus (HPV), a virus that triggers cell growth leading to an unwanted thickening and hardening of skin. Warts are most common on the hands and feet of children and teens, but they can appear at any age on any part of the body. While some warts will go away on their own without treatment, many patients wish to get them removed if they are located in a visible place, or if they become itchy or painful.

As with any skin issue, the first step in addressing warts is to properly identify them. Here’s how to differentiate warts from other common skin growths.

Diagnosing Warts

There are several types of warts. This can make it hard to differentiate warts from other skin growths. Identifying a wart depends on what it looks like, how it feels, and where it is located.

Because warts are generally contagious, identifying your wart can help keep it from spreading to other parts of your body, or to other people. Wart identification will also help you choose the best treatment. To know with certainty what type of wart you have, see your dermatologist.

Common Types of Warts

Many people associate HPV with sexually transmitted diseases, but there are more than 100 strains of HPV. Just a few of them are sexually transmitted. Some warts are transmitted by touch, or by contacting the virus on locker room floors and other public spaces.

Not everyone exposed to HPV will develop warts. Those with compromised or underdeveloped immune systems, such as children and teens, are most vulnerable. Common types of warts include the following:

Common Wart: 

Verruca Vulgaris, or the common wart, is a small, hard bump on the skin. Generally, no bigger than the eraser on a pencil, the common wart has a rough surface and may also be speckled with tiny black dots. They are generally not painful or itchy.

Common warts are most likely found on the hands, feet and elbows. In some people, they clear up on their own within a few years. They are contagious and are spread via touch.

Flat Warts:

Verruca Plana, or flat warts, do not protrude from the skin. The smooth, flat warts tend to form in clusters. Groups of up to 100 can sometimes cover large areas. Like common warts, they may be speckled with small black dots.

Flat warts tend to appear on the face, on the backs of the hands and arms, or on the legs. Like common warts, they are contagious and spread via touch.

Genital Warts:     

Genital warts, Condyloma Acuminata, cannot always be seen. These skin-colored bumps or cauliflower-shaped warts develop on the genitals or anus. They are a symptom of sexually transmitted HPV and are contagious.

The HPV vaccine protects against genital warts. A few types of genital warts can cause cervical cancer in women.   Women who have been exposed to hpv/genital warts should get regular pap smears.

Plantar Warts:

Instead of growing outward like common warts, plantar warts (Verruca Plantaris) grow inward. They are commonly located on the heels or the balls of the feet and can be quite painful and difficult to remove.

Plantar warts are often mistaken for corns or calluses. If you see small black dots on the surface, it’s likely a wart.

Mosaic Warts:

Mosaic warts are a type of plantar wart that grows in clusters. Like plantar warts, mosaic warts may be painful, causing significant discomfort when standing or walking. They often reoccur, even after removal, which makes treatment challenging.

Filiform Warts:

Filiform warts appear as long, slim projections and often look like small clusters of brushes. These fast-growing warts typically appear on the face around eyelids or lips, but they can also spread to other parts of the body.

Filiform warts are not painful or harmful, but because they appear on the face, they can be embarrassing. Visiting a healthcare provider for removal helps limit scarring.

Wart Treatment Options

Some warts clear on their own and don’t require treatment. However, it is possible to remove warts if they are causing discomfort. Because there is no cure for HPV, warts can reoccur even after treatment.

Which treatment is best for you will depend upon your age, the type of wart you have, its size and thickness, and where on your body it is located. The most common wart treatment options include the following:

Chemical Removal: Exfoliating chemicals such as salicylic acid can be applied topically to dissolve warts. There are both over-the-counter and prescription strength options available.

Cantharidin: Also known as ‘blister beetle juice,’ cantharidin is a topical that causes warts to blister, harden and then peel off. This treatment is most often prescribed for small children.

Cryosurgery: This treatment, also known as cryotherapy, uses liquid nitrogen to freeze warts, which then eventually fall off. If you have dark skin, cryosurgery may leave a light spot behind.

Injections: Medications designed to stimulate the immune system can be injected directly into the wart. These medications help the body fight HPV, leading to the wart’s eventual disappearance.

Laser Therapy: A Pulsed Dye Laser can help remove warts that don’t respond to traditional treatment. Special care must be taken to reduce the risk of inhaling vaporized HPV particles.

Surgery: Typically considered a treatment of last resort, warts can be removed via surgical excision. Curettage treatment shaves or scrapes off warts with a small, sharp tool. Electrosurgery burns warts with an electrically charged needle. It is important to note that both methods can potentially leave a scar.

If you have a new or non-healing lesion, please see your dermatologist for evaluation.

Jonathan Bielfield, DO, FAOCD is a board-certified dermatologist experienced in medical, surgical, and cosmetic dermatology. Dr. Bielfield completed his dermatology residency through Rocky Vista University in Colorado Springs, Colorado. A significant portion of his residency was spent training at the University of Colorado. Dr. Bielfield enjoys helping patients look and feel their best by providing personalized care plans tailored to each patient's individual needs.