A wart is a small growth produced when a virus infects the outer layer of the skin and drives those cells to multiply faster than usual. A verruca is the same infection on the sole of the foot, where body weight presses it inwards and changes how it looks and feels.
What is actually happening in the skin?
A virus infects the cells of the epidermis and changes their instructions. Instead of maturing and being shed at the usual pace, they divide faster and pile up, and the thickened result is what pushes above the surface. Nothing grows into the skin here: a wart is the skin itself, made in excess.
The surface texture follows from that. Rough, dry and irregular is characteristic, and small dark points are sometimes visible within it: tiny blood vessels that have grown up into the thickened tissue to supply it. Those points are frequently mistaken for something embedded.
Location changes everything about the appearance. On a hand, a wart rises outward because nothing opposes it. On the sole of a foot, standing pushes it inward instead, so a verruca sits flush with the surface, feels like a stone underfoot, and is often more uncomfortable than a wart of the same size elsewhere.
Transmission needs contact, and softened or broken skin makes it far easier. That combination explains why communal floors, shared footwear and damp environments recur in every account of how somebody acquired one. The delay between contact and appearance can be long enough that reconstructing the source is usually guesswork.
How would a dermatologist describe it?
Verruca vulgaris is the clinical term for the common form, and the qualifier simply means ordinary. Plantar describes the sole of the foot, which is where the word verruca gets used on its own in everyday speech.
Mosaic describes a cluster of small warts merged into a patch rather than a single lump, an arrangement seen on the feet in particular. Filiform describes the thin, finger-like form that appears more often on the face and neck.
Clinicians examine with a dermatoscope here for a specific reason. It reveals the pattern of small vessels within the thickened tissue, and that pattern helps separate a wart from other things producing a rough lump, several of which are entirely unrelated.
That separation is the real work of the examination. Not everything rough and raised is viral, and something assumed to be a wart because it looks familiar is one of the more common reasons a lump gets left too long.
What usually happens at a consultation?
The history covers how long it has been present, whether it has changed, whether there are others, what has already been tried, and whether anything about it hurts. Occupation, sport and swimming come up because they bear on exposure and on what is practical afterwards.
The examination looks at the growth itself and at the surrounding skin, usually with magnification. A clinician will check other likely sites even if you came about one, because a second finding changes the conversation.
Anything not behaving like an ordinary wart may be examined further, and where a sample is appropriate that procedure is described elsewhere on this site. Uncertainty is a normal outcome of an examination rather than a failure of it.
Discussion of what to do next depends heavily on the site. A wart on a weight-bearing part of the foot, on the face, or near a nail raises considerations that one on a knuckle does not, and that is a conversation for the room.
What is worth asking?
Ask what the clinician saw under the dermatoscope. The answer is short, it tells you what the assessment rested on, and it is more informative than a conclusion delivered alone.
Ask whether treating the wart is worth it in your case, and be prepared for the answer to be no. Many resolve on their own, some approaches are uncomfortable, and the balance depends on where the wart sits and how much it bothers you.
Ask what to avoid doing to it. Picking and shaving move the virus, and the practical advice on that point costs nothing and prevents a spreading pattern that is tedious to reverse.
If discomfort is your main reason for coming, say so at the start. A painful verruca is a different conversation from a cosmetic one, and starting from the right question saves half the appointment.
What this page does not do
Nothing here tells you whether a lump on your skin is a wart. Several unrelated things produce a rough raised area, and telling them apart is what an examination achieves. No treatment is recommended, no product named, and no method, strength or interval appears anywhere on this page.
Common questions
Is a verruca different from a wart?
It is the same kind of infection in a different place. On the sole of the foot, body weight presses the growth inwards rather than letting it rise, so it appears flat, feels like standing on a small stone, and is often more uncomfortable than one elsewhere.
Why do some people get them and others do not?
Susceptibility varies, and the immune response to the virus differs considerably between people. Broken or softened skin makes infection easier, which is why swimming pools and communal changing areas come up so often in the history.
Do they need treating?
Many resolve without anything being done, though that can take a long time. Whether to treat is a judgement involving discomfort, site, spread and how long something has been present, and it belongs to a clinician who can see it rather than to a page.
Can they spread on the same person?
Yes. Contact moves the virus, so picking, scratching or shaving over one can produce others nearby. That pattern is one reason clinicians ask what you have been doing to it.
When should one be looked at rather than ignored?
Anything changing in a way that seems unlike the others, anything painful, bleeding or in an awkward site, and anything you are unsure about. Not every rough lump is a wart, and that distinction is exactly what an examination is for.
Sources
- Warts and verrucas — NHS (United Kingdom) · accessed
- Patient information on skin conditions — British Association of Dermatologists (United Kingdom) · accessed
Last updated . How this page was written.