Are Warts Contagious? Here’s What You Should Know Before Attempting Any Treatment

Warts are common lesions that people may presume harmless because they grow slowly, have the same color as normal skin, and aren’t accompanied by fever. But make no mistake—these lesions are infectious, with the worst cases possibly producing serious complications such as kidney damage and cervical cancer. Healthy people can heal spontaneously from this disease, but what about those around them?

Which brings the question: Are warts contagious?

In this blog, I explain how warts spread and cause complications if untreated. I also discuss the different wart treatment options and measures to prevent this condition.

What Are Warts?

Warts are abnormal skin reactions to human papillomavirus (HPV) infection. The typical lesion is a rough, scaly, dry lump with distinct borders. Warts are skin-toned and have normal pigmentation. They typically don’t itch, though they may cause pain when traumatically hit or develop a bacterial superinfection. Warts can bleed when cut. 

More than 150 HPV types have been identified, associated with different forms of the disease. Some viruses cause only skin infections, while others can involve the mucosal surfaces. “High-risk” virus types are so-called because of their association with cancer.

Warts can affect people of any race or age. Most individuals will develop the condition at least once during their lifetime, but lesion severity varies due to differences in immune status.

Are Warts Contagious?

Yes, warts are contagious. Skin warts affect 30-70% of school-age children. Genital warts are most common among young adults. People with a weakened immune system are most susceptible to infection. For example, around 90% of patients who receive a kidney transplant and are taking immunosuppressants develop warts within 5 years of surgery.

How Do Warts Spread?

Warts most frequently spread from person to person by direct skin contact. Skin surface breaks, such as cracks on your hands and heels, increase the likelihood of transmission. Warts can also spread from one body part to another by a process called “autoinoculation.” Picking at or scratching a wart increases the risk of autoinoculation, especially if fluid or blood flows out.

Virus particles shed from infected skin stay in the environment for an unknown period. Skin contact with these invisible particles can cause infection. These free viruses may be responsible for wart spread after using other people’s belongings or walking barefoot around public pool or bath areas.

Warts grow slowly after skin entry. The lesions don’t become noticeable until months after infection.

What Are the Types of Warts, and Why Does It Matter?

Warts are categorized based on their location and appearance. Each type arises from infection by one or multiple HPV strains. It matters to know because various wart types respond differently to treatment.

I already discussed some of these conditions in a previous article, How to Get Rid of Warts: Which Treatments Are Truly Worth Your Dime and Time? But allow me to briefly describe each.

Skin Warts

Cutaneous or skin warts appear on the skin. Most of these warts are benign and usually arise from low-risk HPV infection. I describe the different types below.

Common Warts

Common warts are also called “verruca vulgaris” and often have the typical wart appearance—scaly on top, skin-toned, and usually dome-shaped. They may appear as single or clustered lumps on any part of the skin. Common wart viruses include HPV 2, 4, 27, and 29.

Flat Warts

Flat warts are also referred to as “verruca plana,” appearing as flat-topped, slightly raised, and minimally scaling lumps 1-4 millimeters in size. Areas commonly affected by flat warts include the face, hands, and lower limbs. Virus types 3, 10, 28, and 49 are the usual causative agents.

Deep Palmar and Plantar Warts

Deep palmar and plantar warts grow inwardly on the palms (palmar) and foot soles (plantar). Common warts may grow in the same areas but are easily distinguished by their protuberant growth. Mosaic warts arise from the merging of deep palmar or plantar warts. HPV 1 and 63 are the viruses that frequently cause deep palmar and plantar wart lesions. Mosaic warts develop from HPV 48 infection.

Butcher’s Warts

Butcher’s warts grow in clusters on the palms, hands’ backsides, and around the fingernails. The condition is associated with meat and fish handling, hence the name. HPV types 2 and 7 are the most common causative agents of butcher’s warts.

Cystic Warts

Cystic warts have smooth surfaces and contain a cheese-like substance. These lesions frequently grow on the soles. HPV 60 is the main culprit.

Filiform Warts

Filiform warts have projections looking like spikes or horns. These warts appear most frequently on the face, neck, and skinfolds. The HPV types most commonly associated with these lesions are 1, 2, 4, 27, and 29.

Epidermodysplasia Verruciformis

This rare, hereditary condition arises in the setting of immunodeficiency. The lesions typically develop in late childhood or adolescence, appearing as widespread, scaly, flat warts on sun-exposed areas. The condition can mimic fungal infection and may be misdiagnosed for years.

Patients with epidermodysplasia verruciformis are prone to developing skin cancer. Many HPV types can cause this condition, but the ones associated with malignancy are 5, 8, 14, 17, 20, 21, 47, 93, and 96.

Mucosal Warts

Mucosal warts appear on the mucous membranes, entering the body via the mouth, nose, genitals, and anus. Some of these lesions are associated with high-risk HPV infection and cancer. I briefly discuss them below.

Genital Warts

Genital warts are typically sexually transmitted in adults. These lesions may also be found in children, though less commonly. Babies younger than 6 months may acquire the infection at birth from their mothers, but genital warts in older children are suspicious for sexual abuse.

Genital HPV produces cauliflower-like lesions of different sizes and shapes on both the skin and mucosal surfaces of the private areas. HPV 6 and 11 cause benign genital warts. Meanwhile, high-risk HPV types identified in these lesions include 16, 18, 31, 33, and 35, which can cause cancer of the skin, male and female genital tracts, and anus.

Oral Warts

Like genital warts, oral warts are also typically sexually transmitted, though young infants may acquire them from birth. The lesions can grow on the lips, mouth, and breathing passages. Oral warts have the same causative agents as genital lesions, with high-risk HPV types increasing cancer risk.

Heck Disease

Heck disease is a rare condition characterized by clustered wart growth on the mouth’s mucosal surfaces. The warty lesions are soft and bulging. Heck disease is often associated with HPV 13 and 32, though susceptibility to the infection may be hereditary.

Correctly identifying wart lesions helps tailor treatment strategies. Patients who know their cancer risk can also monitor their health and begin adopting tumor-preventive practices.

How Are Warts Diagnosed?

Classic lesions may be diagnosed simply by visual inspection. However, atypical lesions, especially ones that look malignant, usually need further testing. We may recommend a biopsy or HPV genetic testing in such cases to ensure we manage the condition appropriately. Biopsies can confirm if the lumps are benign. Meanwhile, HPV genetic testing identifies high-risk virus types and determines the need for close cancer monitoring.

What Can Happen if Warts Are Left Untreated?

That depends on factors like the person’s immune status and what they do to keep existing warts from spreading. Young individuals with good immunity can clear small lesions in 2-4 years, even without treatment. People with poor immunity often develop large, widespread lesions poorly responsive to treatment. 

Complications can arise from warts that grow exceedingly large, though the manifestations differ based on the affected body area. For example, genital warts big enough to obstruct the urinary tract can cause severe urinary tract infections and kidney damage. Laryngeal warts—lesions in the voice box—may impair breathing and speech. As mentioned previously, high-risk HPV can cause cancer.

How Do Dermatologists Treat Warts?

Various wart treatments are available, each with different efficacy levels and side effects. I also discussed them in my previous article about wart treatment, but let’s explore them briefly here.

Home Wart Treatments

Some home medications have proven efficacy against warts. They include the following:

Salicylic Acid

Salicylic acid is a widely available exfoliant and can be purchased without a doctor’s prescription. The research-based recommended routine is a 6-week regimen requiring nightly cleaning of the lesion, followed by drying, applying the drug, and covering with an impermeable dressing overnight. Salicylic acid triggers skin immunity and loosens up the thick, virus-infected skin. The skin sheds on its own or becomes easy to remove at the end of the regimen.

If done under medical supervision, around 60-85% of patients experience wart resolution after one treatment course. However, the 6-week regimen is typically performed differently than recommended in the real world, hence the high failure or recurrence rates.

Small lesions require only small amounts, causing only mild skin irritation. However, applying salicylic acid to large areas may produce toxicity, manifesting with confusion, ringing of the ears, vomiting, breathing difficulty, and other symptoms. Other potential risks of salicylic acid treatment include HPV autoinoculation and bacterial superinfection.

Retinoids

Retinoids are drugs that behave like vitamin A. Tretinoin, acitretin, isotretinoin, and etretinate are retinoid agents commonly used for wart treatment. Oral and topical formulations are available. Retinoids enhance the skin’s immune reaction toward HPV and stabilize skin cell growth.

Clearance rates approach 85% with good patient compliance. Side effects include mild skin irritation for topical formulations and skin dryness, photosensitivity, and pregnancy problems for oral forms.

Virucides

Virucides include formaldehyde and glutaraldehyde. These skin-applied agents deactivate HPV and make infected skin tissue easier to remove. Clearance is up to 80% after 3 months. Mild local irritation is the most common side effect associated with virucide use.

Imiquimod

This topical immune-enhancing medication is marketed under the brand name “Aldara.” Imiquimod is usually prescribed for genital lesions and resistant common warts. The clearance rate of the 5% cream formulation after 9.5 weeks is only up to 51% when used alone, though most patients see a 50% wart reduction. Combining imiquimod with other treatments increases its efficacy.

Podophyllin

Podophyllin breaks down wart tissue by disrupting skin cell growth. It is mainly used on genital warts because it cannot penetrate skin warts sufficiently. Clearance rates can reach 94%, though recurrence rates are also high, depending on the formulation.

The upsides of home treatments include convenience, availability, and affordability. However, their biggest downside is that they are not consistently effective, as home treatments are not administered within the clinic’s controlled environment. Home therapies usually take weeks to months to complete. Patients may misuse some of the drugs, while others may not comply with the prescribed regimen.

There’s a long list of home treatments unsupported by scientific evidence, and I won’t discuss them in detail here. These remedies include cimetidine, heat therapy, home cryotherapy, and alternative treatments like duct tape, aloe vera topical creams, and tea tree oil. If you think these remedies may relieve your symptoms, you may consult your primary care physician regarding their use on top of medically recommended therapies.

In-Office Wart Removal Procedures

Dermatologists can perform various wart removal procedures. The following are routinely done at dermatology clinics:

Cantharidin

Cantharidin is a beetle-derived tissue irritant that can cause blistering when applied to the wart. Cantharidin application is quick and painless, though the blisters can sting for a few days. Downtime is minimal except if the wart is in a weight-bearing area, which can stay sore for 1-2 weeks.

Cryotherapy

Dermatologists may also use liquid nitrogen to freeze warts. The procedure causes only mild discomfort, but posttreatment blister formation can make the treated area feel sore for a few days. Downtime is similar to cantharidin.

Electrosurgery and Curettage

This technique uses a penlike electric device to burn the wart tissue and cauterize its blood vessels. A metallic instrument, such as a surgical blade, scoops out the singed tissue afterward. The procedure is performed under local anesthesia. A rounded wound often results, which can take a few weeks to heal, depending on size and location. Recovery from plantar wart removal may take up to a month. 

Simple Excision

Simple wart excision involves injecting local anesthesia and cutting out the wart manually. The healing process is similar to electrosurgery and curettage.

Radiofrequency Ablation

In this procedure, we use a radio wave-emitting device to cauterize the lesion. We typically give topical or injectable pain medication at the start of the session. The recovery time is similar to simple excision.

Photodynamic Therapy

Photodynamic therapy involves applying the photosensitizer aminolevulinic acid to the treatment area before exposing it to blue or red light. This treatment selectively destroys HPV-infected cells and is effective in treating widespread lesions. You will be given pain medication before the session. Downtime may take 2 weeks.

Bleomycin Injection

Injecting the anti-cancer medication bleomycin into the wart stimulates the skin’s immune cells to contain HPV. Bleomycin injection may be used as a stand-alone therapy or combined with other wart treatments to enhance effectiveness against highly resistant lesions. The injections produce discomfort, though pain medication is rarely required. Downtime is minimal to none, but the treated area may feel sore for about 2 weeks.

Laser Treatment

Lasers are highly energetic light beams that, depending on the type, can vaporize the wart tissue or burn its blood vessels. For CO2 lasers, we typically inject numbing medication before the session. These instruments create an open wound that may take 1 or 2 weeks to heal, depending on the size.

In contrast, VBeam and Nd:YAG lasers have attached cooling equipment that lessens the need for anesthesia. These lasers don’t leave open wounds, but the wart dries up in a few days or blisters before scabbing and falling away. 

What Is the Best Treatment for Warts?

I discussed the benefits of laser wart removal in my previous article, Laser Wart Removal: Blast Away HPV Painlessly and Effectively. Studies show that laser surgery bests other in-office wart treatments for several reasons.

Laser therapy has the highest clearance rates of all in-office procedures, reaching up to 100% for treatment-responsive warts and greater than 90% clearance for stubborn warts. Wart recurrence after laser therapy is also the lowest at 6-13%, depending on the laser type and treatment protocol.

Lasers produce the best cosmetic and functional outcomes. A laser expert can easily avoid complications like scarring and nerve damage. Laser therapy may indeed be the best wart treatment. However, only a specialist can perform this procedure, and its cost can be prohibitive for many patients. 

Still, all in-office wart removal procedures are better than home treatments. First, procedures performed by medically trained providers have higher clearance and lower recurrence rates. Second, these treatments are also less likely to cause complications, as factors like infection, wart bleeding, and technique are controlled within the clinic. Third, in-office treatments are more cost-effective than home remedies due to their higher success rates.

What can, however, make wart removal therapy risky is if an unlicensed provider performs it. So, to get the best results, trust only a board-certified dermatologist for these procedures.

To learn more about what to expect during wart removal recovery, you may read the article I previously wrote on the subject.

How Do You Stop Getting Warts?

Prevention is the best way to deal with HPV infection, especially if you have a close contact with poor immunity. You can avoid warts and wart recurrences by the following measures:

• Maintaining good hygiene
• Refraining from sharing personal items
• Putting on proper footwear in public bath and pool areas
• Sanitizing shared equipment in other communal spaces, such as the workplace, gym, dorm kitchens, and others
• Moisturizing your skin, especially the feet and hands, to prevent cracking
• Avoiding picking at warts
• Getting the HPV vaccine

Preventing warts not only helps you keep your skin healthy but also lets you ward off complications like skin and cervical cancer. Additionally, wart prevention helps you avoid risky and costly treatments.

Can Warts Go Away on Their Own?

Yes, warts can disappear on their own. However, spontaneous resolution is possible only after mounting an adequate immune response against the wart virus, which takes time even in healthy people. If you wait for a wart to vanish on its own, you may inadvertently spread it to others. As previously mentioned, HPV disease control is challenging for individuals with poor immunity.

When Should You Get a Wart Checked?

The American Academy of Dermatology suggests seeing a medical professional for a wart as soon as it appears. Most warts are harmless, but immediate treatment is important for the following reasons:

• Warts are highly contagious. Most lesions don’t cause serious issues to healthy individuals, but they put people with poor immunity at risk.
• Warts can grow bigger or spread by autoinoculation if not treated immediately. Widespread lesions are generally less treatment-responsive and increase your risk of developing posttreatment complications, such as scarring.
• Warts can recur on HPV re-exposure or if your immune resistance wanes. In-office procedures have high success rates against recurrent warts.
• Atypical warts can resemble life-threatening lesions, such as skin cancer. A board-certified dermatologist’s keen clinical eye allows them to diagnose the condition accurately and ensure you get the right treatment promptly.

In many cases, warts cause both cosmetic and functional problems. For example, plantar warts can make walking painful. Finger lesions can be unsightly and make writing difficult for children. Functional impairment is an important reason for prompt wart medical consultation.

Warts Are Contagious but Preventable and Treatable

Warts are highly contagious lesions arising from HPV infection. They can spread by direct contact with infected skin or touching objects where the virus can remain indefinitely. Healthy individuals can mount an immune response against HPV and eliminate the lesions even without treatment. However, immediate resolution helps avoid complications and limits viral spread to other people.

Various wart therapies are available. Studies show that laser treatment offers the highest wart clearance rates and the best functional and cosmetic outcomes. However, if laser treatment is out of your reach, you should also consider other in-office wart removal procedures, which are generally safer and more effective than home remedies. The sooner you control this infection, the easier you avoid complications.

Finally, among all medical professionals you can consult for warts, only board-certified dermatologists can expertly distinguish these lesions from serious conditions like skin cancer. Additionally, only highly trained, bona fide skin specialists can perform wart procedures with the best cosmetic results. Trust a board-certified dermatologist to provide the best treatment for any skin concern.

FAQs

Can You Get Warts from Your Partner?

You can get HPV infection from your partner. The virus is transmissible by direct contact, especially if the skin surface is traumatized. Sharing personal items like towels and clothes also risks HPV transmission.

Are Warts Permanent?

Warts can go away without treatment in healthy people, but it can take time. There’s no cure for HPV itself, so the virus can stay in your body indefinitely even if you treat the lesions. Warts can recur if you’re re-exposed to HPV or your immunity weakens, as in times of severe illness, stress, or poor nutrition. Early treatment and HPV vaccination can reduce the chance of wart recurrence.

Should You Cut a Wart on Your Own?

Home wart treatments are available, but you shouldn’t snip a wart on your own. Cutting a wart without the proper surgical materials and preparation can lead to excessive pain and bleeding, infection, and autoinoculation. There’s also a chance that the lesion is not a wart but something life-threatening, such as cancer, which must be identified by biopsy for proper treatment.

Frustrated by Ineffective Wart Treatments? Let LA’s Top Wart Specialists Help

Developing warts in functional or cosmetically prominent sites can lead to physical and emotional challenges. Early wart treatment keeps your skin flawless and prevents complications. But warts can recur, and some recurrent warts can be particularly stubborn. How can you reclaim your flawless skin if that happens?

BHSkin Dermatology’s wart experts can help. Our award-winning board-certified dermatologists can perform a wide range of wart procedures that can get rid of those lesions scar-free. Visit us at our Glendale or Encino office or use our telederm portal for your consultation.

Book your appointment today!

References:

1. American Academy of Dermatology. (2024). How to Heal Warts More Quickly and Prevent New Ones. Retrieved March 18, 2024, from https://www.aad.org/public/diseases/a-z/warts-heal 
2. American Academy of Dermatology. (2024). Warts: Diagnosis and Treatment. Retrieved March 18, 2024, from https://www.aad.org/public/diseases/a-z/warts-treatment
3. Araujo, M. G., et al. (March-April 2021). Update on human papillomavirus—Part II: complementary diagnosis, treatment, and prophylaxis. Anais Brasileiros de Dermatologia. 96(2). 125-138. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007546/
4. Atkinson, A. L., et al. (2014, September 25). The Giant Condyloma (Buschke-Lӧwenstein Tumor) in the Immunocompromised Patient. Case Reports in Obstetrics and Gynecology. 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190693/
5. Bosworth, T. (2020, December 24). HPV vaccine appears effective for treating warts, particularly in children. MDEdge. Retrieved March 18, 2023, from https://www.mdedge.com/dermatology/article/233988/infectious-diseases/hpv-vaccine-appears-effective-treating-warts
6. Brodell, RT and Johnson, SM (eds.) (2003) Warts: Diagnosis and Management: An Evidence-Based Approach. Taylor and Francis Group. https://www.taylorfrancis.com/books/edit/10.3109/9780203011584/warts-robert-brodell-md-sandra-marchese-johnson-md 
7. Das, S. (2020, August 7). Human Papillomavirus Infection: Management and Treatment. Human Papillomavirus. https://www.intechopen.com/chapters/72773
8. Mukherjee, A. G., et al. (2022, December 23). Exploring the Molecular Pathogenesis, Pathogen Association, and Therapeutic Strategies against HPV Infection. Pathogens. 12(1). https://www.mdpi.com/2076-0817/12/1/25
9. Nguyen, J. et al. (2016, September 1). Laser Treatment of Nongenital Verrucae: A Systematic Review. JAMA Dermatology. 152(9). 1025-1034. https://escholarship.org/content/qt4t21196v/qt4t21196v.pdf
10. Sfyri, E., et al. (2021, December 2) Viral Cutaneous Infections in Swimmers: A Preliminary Study. Water. 13(23). https://www.mdpi.com/2073-4441/13/23/3401
11. Sterling, J. C. (2019). Chapter 167: Human Papillomavirus Infections. Fitzpatrick’s Dermatology, 9th ed. https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210439884
12. Wichey, DJ, et al. (2018, February 1).  Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management. The Journal of the American Osteopathic Association. 118(2). https://www.degruyter.com/document/doi/10.7556/jaoa.2018.024/html
13. Wu, C., et al. (2022, November 15). Effect of 5-Aminolevulinic Acid Photodynamic Therapy with Transfer Factor Capsules in the Treatment of Multiple Plantar Warts. BioMed Research International. https://www.hindawi.com/journals/bmri/2022/1220889/

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online