Viral Warts: Understanding HPV Infection and Effective Removal Options

Most people think warts are just a nuisance - ugly bumps on the skin that won’t go away. But they’re not just cosmetic. Viral warts are caused by HPV, the human papillomavirus, and they’re far more common than you might think. In Australia, up to 24% of children and 5% of adults have them. Kids pick them up at school, adults get them from shared gym equipment or even barefoot walks in public showers. And while many warts disappear on their own - 60 to 70% within two years - most people don’t want to wait. They hurt. They spread. They embarrass.

What Causes Viral Warts?

Not all warts are the same. They’re caused by different strains of HPV, and each strain tends to show up in a specific spot. HPV is a family of over 100 viruses, and each one has a preferred target. For example:

• Common warts (verruca vulgaris) usually show up on fingers, hands, or knees. They’re rough, raised, and often have tiny black dots - those are clotted blood vessels. HPV types 1, 2, and 4 are the usual suspects.
• Flat warts are smoother, smaller, and show up in clusters on the face, arms, or legs. They’re more common in kids and teens, and HPV types 3 and 10 cause them.
• Plantar warts grow on the soles of your feet. They’re often mistaken for calluses, but they hurt when you walk. HPV types 1, 2, 4, 60, and 63 are behind these. They grow inward because of pressure from walking, which makes them harder to treat.

HPV enters through tiny cuts or breaks in the skin. You don’t need to have a big wound - even a small scrape from a shoe or a hangnail can be enough. Once inside, the virus tricks skin cells into multiplying faster than normal, forming the wart. It’s not dangerous, but it’s contagious. You can spread it to other parts of your body or to other people through direct contact or shared towels, socks, or shower floors.

Why Don’t Warts Just Go Away?

Your immune system can handle HPV - eventually. That’s why so many warts vanish without treatment. But the process is slow. Some people wait months or even years. And while your body fights, the wart can spread. The virus hides in the deeper layers of the skin, where immune cells have a harder time finding it. That’s why some warts stick around for years, especially in people with weakened immune systems or those who keep reinfecting themselves by scratching or shaving over them.

It’s not about being ‘dirty’ or ‘weak.’ It’s about biology. Some people’s immune systems just respond slower to HPV. That’s why two siblings might both touch the same towel, but only one gets warts.

Topical Treatments: What Actually Works?

If you’re trying to treat a wart at home, you’ve probably seen dozens of products on the shelf. But not all of them work. The two most proven options are salicylic acid and trichloroacetic acid.

Salicylic acid is the gold standard for over-the-counter treatment. You can buy it in pads, liquids, or gels with concentrations between 17% and 40%. It works by slowly peeling away the infected skin. The key? Consistency. You need to apply it every day, soak the wart in warm water for 10 minutes first, then gently file away the dead skin with an emery board or pumice stone. Don’t share the file - it can spread the virus. Studies show an 84% success rate for plantar warts when used correctly over 6 to 12 weeks.

Trichloroacetic acid (TCA) is stronger and usually applied by a doctor. It burns the wart tissue on contact. Dermatologists often scrape the surface first to help the acid penetrate deeper. It’s especially useful for warts on thick skin, like the soles of feet or palms. Side effects include pain, burning, and sometimes dark spots on the skin. Scarring is rare if done properly.

Other acids - like glycolic, citric, or pyruvic - are sold online or in naturopathic stores, but there’s almost no solid evidence they work better than salicylic acid. Zinc creams and duct tape? Some people swear by them, but large studies haven’t proven they’re more effective than placebo.

In-Office Treatments: When Home Care Isn’t Enough

If warts don’t budge after 12 weeks of home treatment, it’s time to see a dermatologist. The two most common professional treatments are cryotherapy and electrosurgery.

Cryotherapy uses liquid nitrogen to freeze the wart. It’s quick, widely available, and covered by most insurance plans. The doctor sprays it on for 10 to 20 seconds, freezing the tissue about 2-3mm beyond the visible edge. You’ll feel a sharp sting, then a burning sensation. The wart turns white, then blisters. It falls off in 1-2 weeks. Most people need 3 to 6 sessions, spaced 2 to 3 weeks apart. If you wait longer than 4 weeks between treatments, success drops from 75% to 40%. That’s a huge difference.

A 2023 review of seven studies involving nearly 1,000 patients found cryotherapy and salicylic acid had nearly identical success rates for common warts. Neither was clearly better. But when used together - salicylic acid at home, cryotherapy every few weeks - the cure rate jumped to 78%.

Electrosurgery burns the wart off with a tiny electric needle. It’s faster - often just one or two visits - but it leaves a small scar. It’s usually reserved for stubborn warts that haven’t responded to anything else. Laser treatment, like the VBeam pulse dye laser, targets the blood vessels feeding the wart. It’s effective but expensive and not always covered by insurance. The wart turns purple or black right after treatment and sloughs off in a week or two.

Surgical removal? Dermatologists avoid it. Cutting out warts often leads to more warts growing back around the scar. The virus is still in the surrounding skin.

Immunotherapy: Training Your Body to Fight Back

Sometimes, the problem isn’t the treatment - it’s your immune system. That’s where imiquimod comes in. It’s a cream that wakes up your skin’s immune cells and tells them to attack the HPV-infected tissue. It’s not a quick fix. You apply it three times a week for up to 16 weeks. You’ll see redness, swelling, and itching - that’s the immune system doing its job. But for warts that won’t respond to acid or freezing, imiquimod has a high success rate. One study showed it cleared warts that had resisted cryotherapy and salicylic acid.

It’s not FDA-approved for non-genital warts in Australia, but dermatologists prescribe it off-label all the time. It’s especially useful for flat warts on the face or clusters of warts that keep coming back.

What Doesn’t Work - And Why

There’s a lot of noise out there. Cantharidin? Applied by doctors, it causes blisters. It works, but it’s messy and painful. Silver nitrate? Used for centuries, but studies show it’s no better than salicylic acid. Phenol? Risky - can damage nerves. Formic acid? Too weak. Most of these have been tried, but only a handful have solid data.

The biggest myth? That warts are caused by frogs or toads. They’re not. HPV only infects humans. You can’t catch a wart from touching an animal.

How to Prevent Warts From Spreading

Treating the wart is only half the battle. Stopping it from spreading is just as important. Here’s what actually helps:

• Don’t pick, scratch, or bite warts. You’re spreading the virus to other parts of your skin.
• Use separate towels, socks, and shoes. Wash them in hot water after each use.
• Wear flip-flops in public showers, pools, and locker rooms.
• Don’t share razors or nail clippers - HPV can hide in dead skin.
• Keep your skin moisturized. Dry, cracked skin is more likely to let HPV in.
• Boost your immune system with sleep, stress management, and good nutrition. It’s not a cure, but it helps your body fight faster.

When to See a Doctor

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

• The wart is painful, bleeding, or changing color.
• It’s on your face, genitals, or around the nails.
• You have diabetes or a weakened immune system - you’re at higher risk for complications.
• It hasn’t improved after 12 weeks of home treatment.
• You’re not sure if it’s a wart or something else - melanoma can sometimes look like a wart.

Dermatologists can do a quick visual exam or, if needed, a biopsy to confirm it’s HPV. Don’t guess. Misdiagnosing a skin cancer as a wart can be dangerous.

Realistic Expectations

There’s no magic cure. Every treatment - whether it’s acid, freezing, or cream - takes time. Most require multiple visits or weeks of daily use. Side effects like pain, redness, and scarring are possible. And even after the wart disappears, the virus might still be there. Recurrence rates are around 20-30% within a year.

That’s why patience and consistency matter more than speed. The goal isn’t to zap it in one day. It’s to outlast the virus.

And remember - even if you’ve had warts before, you’re not doomed. Many people clear them permanently after one successful treatment. Others need a few tries. Either way, you’re not alone. Millions of Australians deal with this every year. The key is knowing what works, avoiding the hype, and sticking with a plan.

What Comes Next?

If you’ve tried home treatments and nothing’s working, don’t give up. Talk to a dermatologist. Bring a photo of the wart, note how long it’s been there, and list what you’ve already tried. Most clinics can get results in a few visits. And if you’re still unsure - wait. Some warts vanish on their own. But if they’re hurting you, spreading, or making you self-conscious, there’s no shame in seeking help. You don’t have to live with them.