HPV and Viral Warts: Causes, Types, and Treatments

With fast-paced modern lifestyle, people often neglect skin health. Some may notice small, raised bumps on their skin that are painless and non-itchy but unsightly, leading to concerns about serious illness. In fact, these are probably “viral warts”! So, what exactly are viral warts? Who is at high risk? What are the methods for wart removal? This article will comprehensively answer your questions about viral warts. 

HPV Causes Viral Warts 

Viral warts are caused by the Human Papillomavirus (HPV). There are over 150 different genotypes of HPV. Certain strains of HPV invade through tiny breaks in the skin, stimulating abnormal growth of keratinocytes, which thickens and hardens the outer skin layer, eventually forming warts. Moist, soft skin or wounds are more susceptible to wart infection. 

Are Viral Warts Contagious? 

Viral warts are mainly spread through direct or indirect contact. 

• Direct contact: Skin-to-skin contact, sexual contact, or infection through broken skin. 

• Indirect contact: Sharing towels, razors, etc.
  

Types of Viral Warts 

Different types of warts vary in color, shape, and location. Here are four common types: 

1. Common warts 

• Common locations: Hands
• Appearance: Rough bumps, sometimes with black dots on the surface
• HPV types: HPV-2, 4, 1, 3, 7, 27, 29, 57  

 2. Flat warts

• Common locations: Any part of the body, most commonly the face and hands 

• Appearance: Flat, smooth, small papules, flesh-colored or yellow-brown 

• HPV types: HPV-3, 10, 28 

3. Genital warts

• Common locations: Genital and anal areas, as well as lips, mouth, tongue, and throat 
• Appearance: Small, rough bumps, flesh-colored or grayish-white; some may be flat 
• HPV types: Low risk (for cancer-related lesions) - HPV-6, 11; High risk (for cancer-related lesions) – HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 & 59
• Symptoms: Usually painless, but may occasionally cause mild bleeding, burning sensation, genital itching, or discomfort

4. Plantar warts

• Common locations: Around the toes, forefoot, heel 
  
• Appearance: Thickened, rough skin, hard lumps embedded in the skin, sometimes with black dots on the surface  
• HPV types: HPV-1, 2, 4, 27, 57 
  
• Symptoms: Pain when standing or walking 

High-Risk Groups for Viral Warts 

• People with weakened immune systems, such as those on long-term immunosuppressants (e.g., azathioprine, cyclosporine) or HIV patients 

• Children and adolescents 

• Dermatitis with damaged skin barrier 

Overview of Treatment Methods for wart removal  

Although most warts are benign and painless, they can spread and increase in number, affecting appearance. It is important to note that current treatments for viral warts do not directly kill HPV but rather remove the virus-containing skin tissue to control the condition. Common methods include: 

1.Topical acids 

Containing salicylic acid or other acids, these gradually soften and destroy wart tissue. Applied once daily, about 70% of warts can be removed after 12 weeks. 

2. Topical immunomodulators 

These stimulate the body’s immune system to help fight HPV. More commonly used for genital warts. Drugs include imiquimod, diphencyprone, levamisole and topical bleomycine & 5-FU. 

3. Cryotherapy 

Uses liquid nitrogen at low temperatures to destroy wart tissue, causing it to fall off. Treatments are usually done every 1–2 weeks and may last for several months. Regular cryotherapy for about 3–4 months has a success rate of up to 70%. However, this method may cause discomfort, and blisters may appear in the days or weeks after treatment. There is also a risk of permanent white scarring. 

4. CO2 laser treatment 

Uses carbon dioxide laser to destroy wart tissue.  

5. Electrosurgical curettage 

Suitable for larger or more recalcitrant warts. Under local anesthesia, the wart tissue is scraped off and the base is cauterized with high temperature. Note that this method may leave permanent scars. 

6. Surgical excision 

Surgical removal of wart tissue, which may also leave scars. 

Frequently Asked Questions 

1. Are viral warts common?

Yes, on average, 1 in 10 people will be infected with viral warts.

2. Can HPV vaccination prevent viral warts?

The HPV vaccine mainly protects against infection from the most common low and high-risk HPV types causing oropharyngeal and anogenital warts but has limited effect in preventing common skin warts.

3. What is the difference between viral warts and corns? 

Many people confuse viral warts with corns, but their causes, locations, and appearances differ. Viral warts are caused by HPV infection, while corns are skin thickening due to prolonged or frequent friction or pressure. Warts can appear anywhere on the body, while corns usually occur near the toes and soles. In appearance, warts are rough bumps with small black dots, while corns are raised hard lumps.

4. What happens if viral warts are left untreated?

In people with healthy immune systems, about 65% of viral warts will disappear on their own within one to two years. However, warts may also persist for years or gradually increase in number and can be transmitted to others. Oropharyngeal and anogenital warts infected with high-risk HPV types can progress to pre-cancerous or cancerous lesions.

5. Does insurance cover wart removal? 

Most general health insurance does not cover cosmetic treatments, but if there is a medical need (such as pain, infection, or impact on daily life), some insurance plans may reimburse the cost. It is recommended to check with your insurance company in advance.

6. Can viral warts recur?

How to Prevent Viral Warts? 

• Do not touch other people’s warts 

• Avoid sharing personal items (such as towels, nail clippers, razors, etc.) 

• Do not bite your nails 

• Cover wounds to prevent HPV invasion 

• Avoid walking barefoot in public changing rooms, swimming pools, and showers 

• Use condoms during sexual activity to prevent genital warts 
  

Maintain Personal Hygiene to Prevent Viral Warts 

Although most viral warts are benign skin disease, they are contagious and prone to recurrence, so early detection and treatment are especially important. Pay attention to personal hygiene and boost your immunity. If you suspect you have viral warts, consult a doctor as soon as possible to help prevent transmission and reduce recurrence. 

References

1. Cleveland Clinic, (2024) Warts. Retrieved 22 July 2025 from https://my.clevelandclinic.org/health/diseases/15045-warts 
2. DermNet, (2023) Viral wart. Retrieved 22 July 2025 from https://dermnetnz.org/topics/viral-wart 
3. Cleveland Clinic, (2022) Flat Warts. Retrieved 22 July 2025 from https://my.clevelandclinic.org/health/diseases/24337-flat-warts 
4. Cleveland Clinic, (2023) Plantar Warts. Retrieved 22 July 2025 from https://my.clevelandclinic.org/health/diseases/24899-plantar-warts 
5. Cleveland Clinic, (2023) Genital Warts. Retrieved 22 July 2025 from https://my.clevelandclinic.org/health/diseases/4209-genital-warts 
6. DermNet, (2004) Imiquimod. Retrieved 22 July 2025 from https://dermnetnz.org/topics/imiquimod 
7. Healthline, (2020) What’s the Difference Between a Wart and a Corn?. Retrieved 22 July 2025 from https://www.healthline.com/health/wart-vs-corn#wart-vs-corn 
8. 信健康, (2025) 脫疣保險包嗎？一個因素決定保唔保！5招提高Claim保險成功率. Retrieved 22 July 2025 from https://health.hkej.com/health/article?suid=4116020&subjectline=%E8%84%AB%E7%96%A3%E4%BF%9D%E9%9A%AA%E5%8C%85%E5%97%8E%EF%BC%9F%E4%B8%80%E5%80%8B%E5%9B%A0%E7%B4%A0%E6%B1%BA%E5%AE%9A%E4%BF%9D%E5%94%94%E4%BF%9D%EF%BC%815%E6%8B%9B%E6%8F%90%E9%AB%98Claim%E4%BF%9D%E9%9A%AA%E6%88%90%E5%8A%9F%E7%8E%87 
9. Cleveland Clinic, (2023). HPV Vaccine. Retrieved 22 July 2025 from https://my.clevelandclinic.org/health/treatments/21613-hpv-vaccine 
10. DermNet, (2023) Carbon dioxide laser treatment. Retrieved 22 July 2025 from https://dermnetnz.org/topics/carbon-dioxide-laser-treatment