Warts are generally harmless skin growths. They are very common, affecting around one in five children. Warts can come up anywhere on the skin or mucous membranes (e.g. the mouth, genitals). However, they are most commonly found on the hands, fingers, feet and face.

Warts can spread to other people, usually due to skin-to-skin contact with another person. Picking or scratching may lead to spreading of warts on the same child. Warts can also be spread indirectly through swimming pools or public showers, especially if your child is barefoot and they have scratches or cuts. Wearing thongs is recommended in public pools and showers.

Half of all warts will disappear within two years. They can last longer in adults, or people with immune system problems. If the warts are not causing any problems, there is no need to treat them.

Signs and symptoms of warts

Warts can have many different appearances, from flat, shiny or long stalks to large rough lumps. In some instances, they can be painful, particularly when they are on the feet or under nails.

What causes warts?

Warts are caused by a family of viruses called human papillomavirus (HPV). Once infected with the virus, it may take up to a year or more for the wart to become visible. They then grow very slowly over a period of months to years.

There are many different types of wart virus, and it is possible to become immune to one type, but develop other types of warts. Any immunity is not lifelong.

Genital warts are caused by a different family type of HPV. These are sexually transmitted and can sometimes cause cervical and vulval cancer. Ordinary skin warts do not cause cancer.

Care at home

You don't need to treat your child’s warts, especially if they are not causing any problems. However, if the warts are causing your child embarrassment or pain, there are treatment options. No single treatment is guaranteed to work, and many require a few attempts.

• A good initial approach is to keep the warts covered with a strong, waterproof tape (e.g. duct tape) for 24 hours a day. This is simple and low cost, and may help to prevent spreading of the warts.
• Special wart ointments or wart paints that contain salicylic or lactic acid are available from most pharmacies. Ointments can make warts disappear faster and seem to be more effective in treating warts on the hands, compared to the feet.
• Ointments/paints peel away the layers of infected skin and can take up to three months to work. Before using paints, it is important to prepare the skin by soaking the wart in warm water for 10 minutes, then rubbing it with a pumice stone or nail file. The ointment or paint is then applied to the wart, taking care to avoid the normal surrounding skin. You can use petroleum jelly, such as Vaseline, to protect the skin around the wart. Allow the paint to dry, and then cover the wart with tape or a strong, waterproof sticking plaster.
• Speak to your local pharmacist for advice on suitable wart treatment for your child. Always follow the directions on the packaging for the use of wart treatments, and ask your pharmacist if you have any questions.

When to see a doctor

Make an appointment to see your GP if the warts, or their treatment, cause excessive pain, or if home treatments haven’t worked.

Treatment options available from a GP include:

• liquid nitrogen freezing – a common treatment that is effective, but it can be painful. Of all the studies performed on this topic, liquid nitrogen only seems to be helpful on warts found on the hands.
  
• your GP can refer your child to a skin specialist (paediatric dermatologist or dermatology nurse practitioner).
• the skin specialist can provide treatments that encourage the immune system to recognise and destroy the skin cells that are infected with the wart virus – these are an option if other treatments do not work or if there are many warts.
• surgery to remove warts is not recommended 
  

Key points to remember

• Warts are common, harmless skin growths caused by a virus.
• Warts can spread between people or on the same person.
• Half of all warts will disappear within two years.
• It is not essential to treat the warts, particularly if they are not causing any problems.

For more information

• See your GP or dermatologist.

Developed by The Royal Children's Hospital Dermatology department. We acknowledge the input of RCH consumers and carers.

Reviewed May 2020. 

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.