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Common wart - Anogenital in
See also in: Overview,External and Internal Eye
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Common wart - Anogenital in

See also in: Overview,External and Internal Eye
Contributors: Mary Spencer MD, Ann Lenane MD, Sireesha Reddy MD, Amy Swerdlin MD, Manasi Kadam Ladrigan MD, Carol Berkowitz MD, Susan Burgin MD
Other Resources UpToDate PubMed


Anogenital warts can be solitary or multiple and are found on the perineum, genitalia, crural folds, and anus. Warts may extend into the urethra and peri-rectal epithelium. They can be associated with itching, bleeding, tenderness, or be asymptomatic. The finding of anogenital warts in children requires health care providers to always consider possible sexual abuse. However, it is possible that these lesions are acquired non-sexually as well.

In children, introduction of human papillomavirus (HPV) into the anogenital area can be from several modes of transmission. Vertical transmission has been reported to be responsible for at least 20% of lesions. It can occur as the newborn descends the birth canal, by viral ascent, or hematogenous route. Horizontal transmission by caregivers in the first days of life is another modality of HPV contamination in newborns. Though rare, contaminated fomites, such as underwear, swimwear, bath towels, etc, have also been implicated in acquired HPV infections. There is also heteroinoculation by affected family members with common warts (verruca vulgaris) and autoinoculation from children who have cutaneous or oral infection.

In children, anogenital warts can be caused by HPV serotypes typically associated with cutaneous warts. There is no relationship between HPV types and modes of transmission (vertical or horizontal).


B07.8 – Other viral warts

57019003 – Verruca vulgaris

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Last Updated:06/03/2013
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Warts are growths of the skin and mucous membranes (inside the mouth or genitals) that are caused by a virus known as the human papillomavirus (HPV). Common warts (verruca vulgaris) are usually found on areas of the body prone to trauma, such as the elbows, knees, and hands. The virus causes thickening of the top skin layer. They are usually painless and go away on their own, sometimes taking a few months or up to a couple years to resolve.

Warts are usually acquired from person-to-person contact. The virus is not highly contagious but can cause an infection by entering through a small break in the skin. In the same way, warts can be spread to other places on the body (self-inoculation). The virus can sometimes be transferred by touching an object used by an infected person, so family members should refrain from sharing towels and other personal items.

Who’s At Risk

Warts can affect people of any age, but they are most common in those aged 12-16 years. It is estimated that 20% of schoolchildren and about 10% of the general population have warts. Warts can affect any race / ethnicity. People with organ transplants or who are on chemotherapy have a higher incidence of warts due to their weakened immune system.

Signs & Symptoms

Warts may occur singly or in groups and often have what appear as multiple small black "dots" at the surface from tiny blood vessels.
  • Common warts are rough, thick papules (solid bumps) ranging in size from 1 mm to over 10 mm, often on the hands, face, elbows, and knees.
  • Filiform warts are long and narrow, like tufts of thread, and they are usually small at the base (1-3 mm). They often affect the face, eyelids, or nose.
  • In lighter skin colors, warts may be pink, skin-colored, or light brown. In darker skin colors, warts may be pink, skin-colored, purple, brown, or gray.
  • Warts can be covered with scale, which can be whitish, yellow, brown, or gray.

Self-Care Guidelines

Because warts can resolve on their own, it is not necessary to treat all warts. Additionally, treatment of warts may not always destroy them, nor will it necessarily keep other warts from appearing. Treatment can be painful, cause scars, and might need to be repeated, so it should only be done in cases where the warts are bothersome or interfere with daily life.
  • Over-the-counter wart removers (eg, Compound W) have a high percentage of salicylic acid and work by dissolving away the layer of skin infected with the virus. This treatment needs to be used daily and can sometimes be irritating to unaffected skin around the wart.
  • Duct tape applied daily to the affected area can help remove warts. The tape should be very sticky and kept on for a few days. Some children may have a reaction to the adhesive on the tape.
  • Over-the-counter freezing medications are available but have not been found to be very effective.
  • Coupled with the above therapies, the wart should be soaked in warm water, and any loose skin should be removed every few days with a mild abrasive, like a pumice stone.
  • Family members should avoid sharing personal items such as towels.

When to Seek Medical Care

Call a health professional if your child has:
  • Painful or bleeding warts.
  • Warts on the face or warts interfering with daily life that do not improve with self-care.
  • Warts on the genital or anal area.


  • Application of cantharidin (Ycanth), podophyllin (Condylox), tretinoin (Retin-A), or acid (Tri-Chlor).
  • Destruction with freezing (cryosurgery), burning (electrocautery), or laser. These treatments are painful, though, and may be avoided in younger children.
  • Application of imiquimod (Aldara, Zyclara), an immunotherapy agent, that triggers an immune reaction to destroy the wart.
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Common wart - Anogenital in
See also in: Overview,External and Internal Eye
A medical illustration showing key findings of Common wart : Fingers, Verrucous scaly papule, Feet, Knees, Dorsal hands
Clinical image of Common wart - imageId=885707. Click to open in gallery.  caption: 'A close-up of a verrucous plaque with overlying white scale and a similar smaller papule.'
A close-up of a verrucous plaque with overlying white scale and a similar smaller papule.
Copyright © 2023 VisualDx®. All rights reserved.