Viral Warts: What Causes Them and How to Remove Them for Good

Most people think warts are just a harmless nuisance - a rough bump on the hand or foot that’s ugly but harmless. But viral warts aren’t just skin deep. They’re caused by an infection with the human papillomavirus (HPV), and they can spread, hurt, and stick around for years if not treated properly. In Australia, up to 24% of children and 5% of adults have them. That’s millions of people dealing with something most of us are told to just ignore.

Here’s the truth: warts don’t always go away on their own. Yes, 60-70% of them clear up within two years without treatment, but that’s cold comfort when you’re staring at a painful plantar wart every time you walk, or a cluster of flat warts on your face that make you avoid mirrors. And if you’ve tried scraping, taping, or over-the-counter sticks that didn’t work, you’re not alone. Most treatments require patience, consistency, and sometimes professional help.

What Causes Viral Warts?

Viral warts are caused by specific strains of HPV - not just one, but dozens. Different types of HPV target different parts of the body. For example:

• HPV types 1, 2, and 4 cause common warts - those raised, rough bumps often found on fingers and knuckles.
• HPV types 3 and 10 cause flat warts - small, smooth, and often appearing in rows on the face, arms, or legs.
• HPV types 1, 2, 4, 60, and 63 are behind plantar warts - hard, painful growths on the soles of the feet that feel like you’re stepping on a pebble.

HPV enters through tiny cuts or breaks in the skin. You don’t need to shake hands with someone who has warts to catch it. Walking barefoot in public showers, sharing towels, or even scratching a wart and then touching another part of your body can spread it. That’s why warts often show up in clusters - you’ve accidentally inoculated yourself.

Children are more likely to get warts because their immune systems haven’t built up resistance yet. Adults can still get them, especially if their immune system is stressed or weakened. The virus doesn’t care if you’re clean or healthy - it just needs a way in.

Do Warts Go Away on Their Own?

Yes - sometimes. But waiting isn’t always the best strategy. While 60-70% of warts disappear within two years, that means 30-40% stick around longer. And during that time, they can multiply. One wart can become ten. A plantar wart can make walking painful. A flat wart on your chin can ruin your confidence.

Plus, warts are contagious. You can spread them to others - or to other parts of your own skin. That’s why dermatologists don’t just say, “Wait and see.” They say: “If it’s bothering you, treat it.”

And here’s something most people don’t realize: the immune system is the real hero in wart removal. Even when you use a treatment like salicylic acid or cryotherapy, the final step - the actual disappearance of the wart - happens because your body recognizes the virus and fights it off. Treatments just help trigger that response.

Topical Treatments: Salicylic Acid and More

Salicylic acid is the most studied and widely used treatment for viral warts. It’s in almost every over-the-counter wart remover - patches, liquids, gels. You can buy it at any pharmacy in Australia for under $15.

How it works: salicylic acid slowly peels away layers of the wart. You apply it daily after soaking the area in warm water and gently filing the surface with an emery board or pumice stone. This helps the acid penetrate deeper. Studies show it works in about 84% of plantar warts over 12 weeks.

But here’s the catch: you have to stick with it. Skipping days or not filing the wart reduces effectiveness. Most people give up after two weeks because they don’t see results. But real progress takes 6-12 weeks. If you’re not consistent, you’re wasting your time.

Other topical options include trichloroacetic acid (TCA), which dermatologists apply in-office. It’s stronger than salicylic acid and works by burning off the wart tissue. It’s especially useful for thick warts on the feet or hands. But it’s not for home use - it can burn healthy skin if applied wrong.

Imiquimod cream is another option. It’s not a direct wart killer. Instead, it tricks your immune system into attacking the HPV-infected cells. It’s often used when other treatments fail. You apply it three times a week for up to 16 weeks. Side effects include redness, itching, and flaking - but that’s actually a good sign. It means your immune system is waking up.

Cryotherapy: Freezing Warts Off

Cryotherapy - freezing warts with liquid nitrogen - is one of the most common in-office treatments. It’s quick, doesn’t require anesthesia, and is covered by Medicare in Australia for eligible patients.

The procedure: a dermatologist sprays liquid nitrogen onto the wart for 10-20 seconds. The goal isn’t just to freeze the wart - it’s to freeze the tissue about 2-3mm beyond its edge to make sure you get the root. After treatment, the area blisters, then forms a scab that falls off in 1-2 weeks.

Studies show cryotherapy works about as well as salicylic acid for common warts. One 2023 review of 976 patients found no significant difference in cure rates between the two after 12 weeks. But there’s a big catch: timing matters.

Back in 1976, a major study showed that freezing warts every 2-3 weeks gave a 75% success rate. When treatments were spaced out to every 4 weeks, success dropped to 40%. That’s a huge difference. So if your doctor says, “Come back in a month,” they’re not giving you the best chance of success. Ask for 2-3 week intervals.

Most people need 3-6 sessions. Some warts need more. It’s not a one-and-done fix. And yes - it hurts. The freezing sensation feels like a sharp sting. But most patients tolerate it well. The pain lasts only seconds.

Other Professional Treatments: When Simpler Options Fail

If salicylic acid and cryotherapy haven’t worked after several tries, your dermatologist might suggest stronger options. These aren’t first-line treatments - they’re for stubborn, recurring warts.

• Electrosurgery: A small electric needle burns the wart off. Often combined with curettage (scraping). Leaves a small scar, but works fast.
• Laser treatment: Pulse dye lasers (like VBeam) target the blood vessels feeding the wart. The wart turns purple or black, then falls off. Used mostly for warts that won’t respond to anything else.
• Immunotherapy injections: Some doctors inject Candida antigen or other immune stimulants directly into the wart to trigger a localized immune response. It’s experimental but promising for hard-to-treat cases.

Surgical removal - cutting the wart out - is rarely recommended. Why? Because it often leads to recurrence. The virus is still in the surrounding skin. Cutting it out just leaves a scar and a new spot for the virus to come back.

What Doesn’t Work (And Why)

There are dozens of home remedies floating around: duct tape, apple cider vinegar, garlic, banana peels. Some people swear by them. But the science doesn’t back them up.

Duct tape? One small study showed it might help - but the same study showed placebo (a plain patch) worked just as well. It’s possible the constant pressure and occlusion helped, not the tape itself.

Apple cider vinegar? No controlled studies prove it kills HPV. It can irritate skin and delay real treatment.

And don’t try to cut or burn warts off yourself. You risk infection, scarring, or spreading the virus. Warts are not pimples. They’re viral infections. Treat them like one.

How to Prevent Spreading and Recurrence

Even after the wart is gone, the virus can still be hiding in nearby skin. That’s why warts come back - sometimes months later.

To reduce the chance of spreading or recurrence:

• Don’t pick or scratch warts.
• Wear flip-flops in public showers and pools.
• Don’t share towels, shoes, or nail clippers.
• Keep your feet dry. Moisture helps HPV thrive.
• Wash your hands after touching a wart.
• Use separate emery boards for warts and healthy skin.

And if you have a wart on your foot, change your socks daily. If you have one on your hand, avoid biting your nails. These small habits make a big difference.

When to See a Dermatologist

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

• The wart is painful, bleeding, or changing color.
• You’ve tried over-the-counter treatments for 12 weeks with no result.
• The wart is on your face, genitals, or near your nails.
• You have diabetes or a weakened immune system.
• You’re not sure if it’s a wart - some skin cancers look like warts.

Don’t guess. A dermatologist can tell the difference in seconds with a dermatoscope. Misdiagnosing a melanoma as a wart can be dangerous.

What’s New in Wart Treatment?

Research is moving beyond just freezing and peeling. Scientists are exploring:

• Combination therapy - using salicylic acid and cryotherapy together. One study showed 78% success with the combo, compared to 69% with cryotherapy alone.
• New topical antivirals like cidofovir, which can be applied at home under supervision.
• HPV vaccines - while primarily for genital HPV, some early studies suggest they might help prevent or reduce non-genital warts in high-risk groups.

The big takeaway? Treatment is becoming more personalized. Instead of one-size-fits-all, doctors are starting to consider wart location, patient age, immune status, and treatment history to pick the best option.

But for now, the best tools are still the old ones: salicylic acid, cryotherapy, and patience. The science hasn’t changed much - but our understanding of how to use them has.