Wart Vulgaris (Common Wart) ICD-10: B07.9

Viral skin infection

Often searched as: warts on hands, rough bumps on fingers, wart on knuckle, hard wart on hand, warts that spread, common wart treatment, wart removal at home, rough skin bumps on hands…

Clinical urgency level

lowmediumhigh

Systems Affected

skin

Severity Levels

mild

One or few warts on hands or knees, not spreading, causing no pain — manageable with over-the-counter salicylic acid.

moderate

Multiple warts spreading across hands, fingers, or periungual areas, persistent beyond 6 months, causing cosmetic distress — benefits from professional cryotherapy.

severe

Extensive or rapidly spreading warts, periungual warts destroying nail folds, or treatment-resistant warts in immunocompromised individuals — requires specialist management.

Red Flags

Warts spreading rapidly to cover large areas in a short time
Periungual warts causing nail destruction or pain
Any wart that changes color, bleeds spontaneously, or grows unusually fast — rule out other lesions
Extensive warts in an immunocompromised person (HIV, transplant)
Warts on the face spreading after shaving
Wart present for more than 2 years without any sign of resolution

Clinical Presentation

Verruca vulgaris — rough, dome-shaped common wart on the finger with black dots

Source: Wikimedia Commons (CC BY-SA 3.0 )

Common wart image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a dermatologist if warts are spreading rapidly, affecting the face or nail area, not responding to over-the-counter treatment after 3 months, or causing significant pain or distress. Warts in people with weakened immune systems always warrant professional evaluation.

Differential Diagnosis

Molluscum contagiosum (dome-shaped with central dimple — no rough surface)
Seborrheic keratosis (waxy, stuck-on — in older adults)
Actinic keratosis (scaly, on sun-exposed skin — precancerous)
Squamous cell carcinoma (rapidly growing, ulcerated — biopsy needed if uncertain)
Corn (callus) — no viral cause, no black dots
Lichen planus (flat-topped, purple papules)

Comorbidities

Immunosuppression (HIV, organ transplant — extensive or treatment-resistant warts)
Atopic dermatitis (impaired skin barrier — higher susceptibility)
Epidermodysplasia verruciformis (rare genetic condition — widespread HPV lesions)

Prognosis

Common warts resolve spontaneously in approximately 65% of immunocompetent individuals within 2 years as the immune system clears the HPV infection. In children, resolution is faster. Treatment with salicylic acid (daily application for 12+ weeks) combined with gentle paring is the most evidence-based self-treatment, achieving cure in ~70% of cases. Cryotherapy by a professional is the most common office-based treatment. Recurrence is possible since HPV can persist in surrounding skin even after visible warts resolve.

Detailed Overview

Causes, Symptoms, and When to Take Action Wart vulgaris is a benign skin lesion caused by infection of the epidermal keratinocytes with human papillomavirus (HPV). It is a common cutaneous wart that can appear at any age and tends to regress spontaneously over time. How It Looks Texture: Rough, raised papules with a hard, grainy surface Color: Flesh-colored to grayish or brown Shape: Dome-shaped with a rough surface; may display pinpoint black dots (thrombosed capillaries) when pared Location: Commonly found on the hands, fingers, and knees, though it may appear elsewhere Why Does It Appear? Wart vulgaris arises due to infection of superficial skin layers by HPV. The virus triggers proliferation of keratinocytes, resulting in characteristic lesions. Transmission typically occurs through direct skin contact — either from person to person or via contaminated surfaces (fomites) — especially where minor skin breaks are present. Should You Be Concerned? These warts are benign and often harmless but may become bothersome due to appearance, irritation, or spread. It's desirable to consult a healthcare provider if warts: Persist or multiply extensively Cause pain, bleeding, or functional impairment Present for an extended duration beyond several months Can You Prevent It? While you can't always prevent wart formation, risk may be reduced by: Avoiding direct contact with warts (your own or others') Keeping skin intact and protected, especially in communal settings Practicing good hand hygiene 👉 How Piel AI Can Help Piel AI lets you track wart appearance over time using regular imaging. Though not diagnostic, it helps you notice changes in size, number, or appearance, and is a useful tool to share with healthcare professionals if needed. Summary Wart vulgaris is a common, benign skin growth caused by HPV. It appears as hard, rough papules, often on hands or knees. It spreads via skin contact and may persist for months. Observation, hygiene, and image tracking support effective management.

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