Common warts

Last reviewed: 21 Apr 2022
Last updated: 20 Dec 2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • lesion growth over weeks to months
  • round, raised papule
  • tiny black dots on surface of lesion
More key diagnostic factors

Other diagnostic factors

  • satellite lesions
  • fingers or nail fold lesions
  • facial lesions
  • fissuring
  • hyperkeratosis
  • greyish-white or light brown colour
  • filiform papule with sharp spikes
Other diagnostic factors

Risk factors

  • water immersion
  • occupations involving handling of meat or fish
  • nail biting
  • age under 35 years
  • immunocompromised
More risk factors

Diagnostic investigations

1st investigations to order

  • no initial test
More 1st investigations to order

Investigations to consider

  • skin biopsy
  • immunoperoxidase stain
  • skin culture
More investigations to consider

Treatment algorithm

ACUTE

common wart: immunocompetent

common wart: immunocompromised

filiform wart

Contributors

Authors

Angela Yen Moore, MD

Director

Arlington Center of Dermatology

Primary Investigator

Arlington Research Center

Arlington

Clinical Assistant Professor

Baylor University Medical Center

Dallas

Clinical Assistant Professor

University of Texas Medical Branch

Galveston

TX

Disclosures

AYM has received funds in the following roles: as an advisory board member for Janssen and LEO Pharma; as a consultant for Allergan, Biofrontera, Bristol-Myers Squibb and Mayne Pharma; as a clinical study investigator for AbbVie, Aclaris, Allergan, Astellas Pharma, Biofrontera, Boehringer Ingelheim, Bristol-Myers Squibb, Dermavant Sciences, Dermira, Eli Lilly and Company, Foamix Pharmaceuticals, Galderma, Incyte, Janssen, Mayne Pharma, Naked Biome, Novartis, Parexel, Pfizer and Verrica Pharmaceuticals; as a coordinating investigator for Allergan; and as a speaker for AbbVie, Aclaris, Allergan and Almirall.

Acknowledgements

Dr Angela Yen Moore would like to gratefully acknowledge Dr Leonid Izikson, the previous contributor to this topic. LI declares that he has no competing interests.

Peer reviewers

Brenda L. Pellicane, MD

Dermatologist

Wayne State University School of Medicine

Department of Dermatology

Detroit

MI

Disclosures

BLP declares that she has no competing interests.

David Cassarino, MD, PhD

Assistant Professor

Department of Pathology and Laboratory Medicine

University of California

Los Angeles

CA

Disclosures

DC declares that he has no competing interests.

Jashin J. Wu, MD

Chief Dermatology Resident

University of California

Irvine

CA

Disclosures

JJW declares that he has no competing interests.

Sam Gibbs, FRCP

Consultant Dermatologist

Dermatology Department

The Great Western Hospital

Swindon

UK

Disclosures

SG declares that he has no competing interests.

  • Common warts images
  • Differentials

    • Flat warts
    • Palmoplantar warts
    • Seborrhoeic keratosis
    More Differentials
  • Guidelines

    • British Association of Dermatologists’ guidelines for the management of cutaneous warts 2014
    • British Association of Dermatologists' guidelines on the efficacy and use of acitretin in dermatology
    More Guidelines
  • Patient leaflets

    Warts (common)

    HPV (human papillomavirus) vaccine

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer