Warts in Children: What You Need to Know

Warts are small growths on the skin caused by an infection from the human papillomavirus (HPV). In this handout, you will learn about different types of warts and how you can help prevent or treat warts.

Warts in the genital (private) area are not discussed in this handout. Talk with the doctor if your child has warts in the genital area.

What are Warts?

Warts are very small growths on the skin caused by the human papillomavirus (HPV). Warts are not harmful, but they are very contagious (can spread easily). In children, most warts appear on the fingers, hands and feet.

What are Common Types of Warts?

Warts look like small, hard bumps on the skin. The 3 main types of warts include:

• Common warts are raised, rough and lightcolored. They can also have brown or have black dots.
• Plantar warts appear on the bottom of the foot. They are rough, spongy and gray or brown with black dots. They can also be painful.
• Flat warts are smooth, flat or slightly raised. They often appear in groups on the face, hands or shins (front of the lower leg).

How Do Warts Spread?

Warts are spread through skin-to-skin contact. Warts can also spread if you touch something that a person with warts has also touched. The risk of spreading warts is also higher if you have a cut or open area on your skin.

How Can I Prevent Warts?

• Wear flip-flops or sandals in locker rooms and shared showers. Do not walk barefoot.
• Wash your hands after touching your own warts.
• Keep the wart covered with a bandage or duct tape.
• Clean any grooming tools that have been used near a wart, like nail clippers.
• Do not pick at or shave a wart.
• Do not share towels with other people.
• Have your child get the HPV vaccine if he is old enough. All children can have the HPV vaccine starting between ages 9-11. The HPV vaccine protects your child from spreading or catching warts and other diseases (like genital warts or cervical cancer) caused by HPV.

How are Warts Treated?

In most cases, warts go away on their own in 2 years or fewer. Other warts do not go away or come back after treatment. Depending on the type of wart, you can treat warts at home or at the doctor’s office.

Common at-home treatments include:

• Salicylic acid (typically 17%). Buy this at your local pharmacy without a prescription. It comes as a gel, liquid or patch. Common brands include Dr. Scholls®, Compound W® or Duofilm®. This works by peeling away the dead skin from the wart. Stronger salicylic acid (30-40%) preparations, such as Mediplast® or WartStick® are okay in pediatric patients, but only on thicker skin (palms and soles).
• Duct tape. Doctors are unsure if duct tape really helps, but it is easy to try at home.

Common treatments at the doctor’s include:

• Freezing (also called cryotherapy). Liquid nitrogen is used to freeze off the wart. This can be uncomfortable, but it can get rid of a wart for good. Your child might need to repeat this treatment every 2-3 weeks until the wart is gone.
• Removal. Doctors numb your child’s skin and remove the wart with a scalpel (very sharp knife) or a laser. This gets rid of the wart, but it can also leave a scar.
• Prescription creams or injections. If nothing else is working, a dermatologist (skin doctor) might prescribe a cream, topical liquid or injection such as imiquimod and cantharidin.

When Should I Call the Doctor?

• If your child has many warts.
• If the wart is growing or changing quickly.
• If the wart is painful, bleeding, oozing or causing other concerns.

At-home treatments for warts

You can use these two treatments together or separately.

Salicylic acid

Do not use salicylic acid for more than 12 weeks without asking the doctor.

1. Soak the wart in warm water (up to 110°F on hands/feet) for 5 minutes. You can use a candy thermometer to test the water temperature. Be sure the water is not too hot to avoid burns.
2. Scrub/file down the dead dry skin with a disposable emery board (nail file) or pumice stone. Make sure it is labeled for wart use only to avoid spreading the wart virus.
3. Apply salicylic acid medicine to dry skin over the wart. *Note: If the healthy skin surrounding the wart becomes red and irritated, apply Vaseline® to that area. This helps protect it before applying the medicine to the wart.
4. Cover the wart with a bandage or duct tape for 24 hours.
5. Repeat steps 1-4 every 1-2 days until the wart is gone for 2 weeks, then take a break for 1 week. You can repeat another 2 week cycle if needed.

Duct tape

1. Cut a piece of duct tape the size of the wart. Keep the duct tape on the wart for 6 days.
2. Take the tape off and soak the wart for 5 minutes in water.
3. File the wart down with a disposable emery board or pumice stone. Leave the wart uncovered overnight.
4. In the morning, repeat steps 1-3 again for 2 months (8 weeks) or until the wart goes away.

Rev. 9/2017. Content adapted from MGH Primary Care Office Insite (PCOI). ©2017 CARMA. Mass General and MGfC do not endorse any of the brands in this handout. This document is intended to provide health-related information so that you may be better informed. It is not a substitute for a doctor’s medical advice and should not be relied upon for treatment for specific medical conditions.