Story at-a-glance -

• Warts are a benign skin growth triggered by a viral infection. Research finds covering the wart with duct tape and replacing the tape every six days is more effective than cryotherapy or salicylic acid treatments, less painful and more cost effective
• Warts are triggered by the human papilloma virus (HPV); although some sexually transmitted strains are linked to cancer, those causing skin warts are not
• Most come in contact with HPV repeatedly, but not everyone develops warts; several activities may increase your risk, including skin breaks often associated with childhood play, nail biting, shaving pubic hair, weakened immune system and sexual activity, which is associated with genital warts
• Other effective home remedies include salicylic acid available in over-the-counter preparations, garlic, banana peel, pineapple juice and aloe vera; genital warts are different and should be treated by a medical professional to avoid permanent damage

Warts are benign skin growths that occur when a virus infects the top layer of skin. Viruses triggering wart growth are from human papillomavirus (HPV). Although warts are contagious, most come in contact with HPV repeatedly but only some develop warts.1

The common wart appears as a small, grainy skin growth, usually on the fingers or hands.2 It may take as long as six months to develop a wart after you've been exposed to the virus. The common wart is usually harmless and eventually disappears without any treatment. It's more likely the warts will disappear in children than in adults.3

Of the 200 currently known strains of HPV,4 only 10 trigger skin warts. Others are involved in the development of anal warts and genital warts. Although some sexually transmitted types of HPV may cause cervical or other genital cancers, most strains causing skin warts are not linked to cancer.5

Warts appear more often when the top layer of skin has been broken. Common warts are often skin colored and feel rough but may have small black dots in the center, sometimes called “seeds.”6 Other types of warts may appear flat and smooth or may be large and disfiguring.

According to the American Academy of Dermatology,7 although most warts are harmless, dermatologist may choose to treat them. While there is no cure for the wart virus, there are methods of removing the current wart. However, since the virus stays within your body, it may return at the same site or appear in a new spot.

Try duct tape for wart removal

There are few reliable population-based studies evaluating the incidence of nongenital warts. It's likely the incidence varies between different age groups and populations. Two past studies found rates of 0.84% in the U.S. and 12.9% in Russia.

Prevalence is highest in children, and two school age population studies8 showed warts in 12% of 4- to 6-year-old children in the U.K. and 24% in 16- to 18-year-olds in Australia. Cryotherapy, or the application of liquid nitrogen to freeze the wart and destroy the cells, is a conventional way of getting rid of warts quickly. However, it often requires repeated treatments and leaves a blister.

A study9 done in 2002 compared the efficacy of duct tape to remove warts against cryotherapy. The researchers used a prospective, randomized control trial in a general pediatric and adolescent clinic at a military base.

They enrolled 61 patients from 3 to 22 years, of which 51 completed the study. The main outcome measurement was complete resolution of the wart being studied. The group was divided into two groups; 26 were treated with duct tape and 25 were treated with cryotherapy.

Results showed the simple application of duct tape was more effective than cryotherapy in the treatment of a common wart. They also discovered warts responding to duct tape typically demonstrated partial resolution after two to three weeks of treatment, and those that were unchanged in appearance by three weeks were unlikely to respond.10

Benefits of duct tape over cryotherapy

The results of this study, which had an 85% cure rate using duct tape,11 compared to 60% in the cryotherapy group, was much higher than a systematic review of literature published in the British Journal of Dermatology12 in which the researchers concluded:

“The results of the pooled analysis found a cure rate of 23% (5-73%) in placebo trials, 52% (0-87%) in SA (salicylic acid) trials, 49% (0-69%) in cryotherapy trials, 54% (45-75%) in aggressive cryotherapy trials and 58% (38-78%) in the combined cryotherapy and SA trials.

Aside from the use of SA and aggressive cryotherapy there is insufficient evidence from RCTs to support the use of other therapies. Higher quality evidence is needed to evaluate other therapies.”

In addition, there were other potential benefits for using duct tape over cryotherapy as it's more practical for parents and patients to use at home, requires less clinical visits, is less painful and more cost-effective.

In the featured JAMA study, the researchers found although many tolerated the cryotherapy, children younger than 6 years typically remembered the previous applications as painful and one child vomited in fear of pain before each application. The only adverse effect in the duct tape group was a minimal amount of local irritation.

Some patients found keeping the duct tape in place to be difficult and there may be cosmetic inconvenience of using duct tape on the face. The researchers found though there are many therapies to eradicate warts, duct tape appears to be safe and nonthreatening and more effective than cryotherapy with few adverse side effects.13

Common types of warts

There are three common types of skin warts that appear on your hands, feet or anywhere outside of the genital area. The common wart has a raised rough surface that may be light in color to gray brown and appearance.14 These are found mostly on the hands, around the fingernails or toenails. However, they may also appear on the face or anywhere else on the body.

Plantar warts are found on the soles of the feet and are clustered, sometimes called mosaic warts.15 They're rough and spongy in appearance and are kept flat as you walk on them. They may be gray or brown. The dark dots sometimes seen are called seeds but are actually clotted blood vessels. They often cause pain or tenderness when you're walking or standing on them.16

Flat warts are found mostly on the face, hands and shins and are much less common than others.17 However, when they do appear, they often come in large numbers, sometimes in clusters of 20 to 200.18

Although they are called flat warts, they may sometimes be slightly raised and are usually smooth and pink, smaller in size than other warts. They're often hardly visible and not painful. More often than not, they occur in children and are sometimes referred to as juvenile warts.19

Five activities that increase your risk of warts

Skin warts are not highly contagious, although they may spread from person to person through direct contact, mainly when there is a break in the skin. According to Harvard Health Publishing,20 you may theoretically pick up a wart from locker room floors or showers but there is no way to evaluate how often this happens.

Although most come in contact with HPV repeatedly, each person’s immune system will respond differently, so not everyone develops warts.21 However, there are several activities that may increase your risk:

• Age — Children and teens are at higher risk of warts, especially common warts, plantar warts and flat warts.22 HPV is more easily contracted when there is a break in the skin, which might explain why children and teens are at greater risk as they often incur more cuts than adults.23

• Nail biting — Nail biting or pulling at hangnails increases your risk of contracting periungual warts located at the base of the nail bed and spreading those warts to the mouth or other areas of the skin.24 These types of warts may raise the nail, cause abnormal growth of the nail and be a source of pain, disfigurement and embarrassment.

• Shaving pubic hair — Men and women increase their risk for HPV infection-causing warts by shaving pubic hair.25 Researchers examining individuals at a private skin clinic found 93% of those who had Molluscum contagiosum, a mild sexually transmitted disease, also had removed their pubic hair through waxing, shaving or clipping.26 Warts were also found and may easily be spread to the area during sex or from scratching the open and irritated skin, transferring the HPV.

• Weak immune system — The immune system may be weakened by poor nutrition, lack of sleep, certain medications or by diseases.

• Sexual activity — The more sexual partners you are engaged with the higher your risk of contracting genital warts. If you have sex with a partner who has a high number of sexual partners, this also increases your overall risk for contracting genital warts from HPV.27

Other effective home remedies for warts

Common warts may go away on their own, especially in children. However, if you would like to get rid of them quickly, there are several other strategies you can try, depending on your condition or your health care provider’s advice.

It's important to remember these treatments are only applicable for common warts and not those found on your face or genitals. In these cases, seek medical advice to avoid complications.

Salicylic acid — This product comes in patches, ointments and pads to help remove layers of the wart.28 Before application, immerse your wart in warm water and file dead skin with an emery board or pumice stone. It may not remove the virus causing the wart, however, and may result in recurring warts.

Cantharidin — This is a topical vesicant or blistering agent that may effectively help remove warts.29 One meta-analysis30 found it was effective on warts on the feet when combined with salicylic acid and podophyllotixin, a plant derived product used to help remove venereal warts.

Garlic — Antiviral properties in garlic may help fight the virus and support your immune system. Apply the garlic to your warts but do not leave it in contact with your skin overnight, since this may cause a burn.31

Banana peel — The inside of a banana peel may be placed in direct contact to the wart and taped in place for a few days. Remove it and replace with a new banana peel until the wart disappears, which may take up to three weeks.32

Pineapple juice — Apply the juice directly to the wart on a cotton ball or put a small slice of pineapple on the wart and cover it with a bandage for three to five minutes. Repeat two to three times a day.33,34

Aloe vera — Dab a cotton ball with aloe vera gel and place it in contact with the wart, taping it in place to leave it on for a few days. Reapply every aloe vera every few hours.35

Genital warts are different

Although genital warts are also caused by HPV, they are usually sexually transmitted and are not treated the same as the common or flat wart. Genital warts should never be treated at home and require medical care as some HPV strains are linked to cancer.36

Genital warts will appear as a flesh-colored small bump or a group of bumps in the genital area and may look like cauliflower. Some are so small you can't see them. Symptoms may include itching, burning and discomfort. While there is no cure, they may be removed using prescription-only treatments.37

As with other types of warts, they are spread by contact with an infected person. There are more than 40 strains of HPV specifically affecting the genital area. The Centers for Disease Control and Prevention estimates nearly all sexually active individuals will become infected with one type or another of HPV at some point during their lives.38

Your risk of HPV infection of any type increases by having unprotected sex with multiple partners, having another sexually transmitted infection or having sex with a partner whose history you don't know.39 Genital warts may also cause problems during pregnancy as they change the ability of the vaginal tissue to stretch during childbirth and may bleed during delivery.

Reduce your risk of getting warts by supporting optimal immune health

You may reduce your risk of warts and improve your ability to fight the infection by supporting your immune function. Those with a weakened immune system have an increased risk of getting warts as the body may not be able to eliminate the virus.

Your immune system is dependent on several factors including your nutrition, quality of sleep, vitamins and your gut health. Each of these strategies will help to support your immune system to fight not only warts but also other illnesses. Find more tips and strategies in my previous article, “Top tips to boost your immunity.”