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Warts in children on hands and feet: causes, treatment
Last reviewed: 12.07.2025
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Warts are among the three most common skin conditions, and skin warts most often appear in children and adolescents.
Warts are contagious, and children with their immature immune systems are most susceptible to infection.
Epidemiology
Skin warts are contagious and occur in 7-10% of the population - regardless of age, but most cases of warts occur between the ages of 12 and 16, affecting up to 15-25% of children and adolescents. But in early childhood, they appear extremely rarely.
According to statistics from the American Academy of Dermatology, vulgar viral warts in children are diagnosed in 10-20% of cases of treatment for skin lesions.
The most common types of warts in children and adolescents are flat (on the face), plantar (on the feet) and common, or vulgar (on the hands, elbows and knees).
Causes baby warts
In both adults and children, an infectious wart is a small but noticeable
The formation that appears on the skin of some parts of the body - has the same causes, which consist in the defeat of the epidermal layer by the human papillomavirus (HPV) of the Papovaviridae family. For more details, see - Human papillomavirus
This tissue-specific DNA virus is common in the skin and mucous membranes, and there is indirect evidence that it lives on our skin and can persist for a long time in squamous epithelium without causing any damage.
Different strains (types) of HPV cause different types of warts, depending on their location or visual characteristics. For example, strains 1, 2, 4, 27, and 57 tend to affect the soles of the feet, which can cause verruca plantaris, a plantar wart in children.
HPV strain 2 has also "chosen" the palms of the hands, and when its virions replicate in the nuclei of keratinocytes of the skin, warts appear on the child's hands or fingers. In this case, HPV types 2, 7, 22 can cause common or vulgar warts (verruca vulgaris).
And if flat warts appear in children and adolescents, called juvenile warts, then most likely this is the result of skin damage by papillomaviruses of strains 3, 10, 28 and 49.
According to dermatologists, warts can appear on the face, forehead, nose, chin, lips, and in the mouth of a child. In the latter case, we are talking about focal epithelial hyperplasia associated with HPV types 13 and 32
And rare cases when an oral papilloma or a wart on a stalk is detected are associated with HPV types 6, 7, 11, 16 or 32.
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Risk factors
Today, it is known that risk factors for the activation of the human papilloma virus are decreased immunity due to any other infection (for example, flu or frequent tonsillitis), stress or poor nutrition. It is still believed that infection from an infected person and poor personal hygiene play an important role in the appearance of warts.
Indeed, HPV can survive for many months and at low temperatures without a host; therefore, an infectious wart can appear even after contact with objects used by a person with HPV, and a person with plantar warts can spread the virus by walking barefoot.
True, doctors are now convinced that if a wart grows in a child, it is evidence of a decrease in the functions of his immune system, which is manifested in the absence of a local immune response to HPV infection mediated by T cells.
Any damage to the skin (i.e., disruption of the epithelial barrier) and increased moisture (in particular, on the feet and palms), which facilitate the introduction of the virus into the epithelial cells, increases the risk of wart growth.
Pathogenesis
Papillomavirus virions penetrate into epithelial cells of the basal layer of stratified epithelium via receptor-mediated endocytosis.
From polycistronic mRNA, the virus replicates its genomes in the nuclei of infected host cells, forming an episomal form. This activates the viral gene expression cascade, and several dozen extrachromosomal copies of viral DNA are formed per cell.
And the pathogenesis is due to the fact that the life cycle of HPV is associated with the differentiation of skin cells, and the dominant type of cells in the upper layers of the epidermis is most affected - keratinocytes, which begin to divide and synthesize too much fibrillar protein keratin. As a result of hyperkeratosis initiated by the virus, a gradual local thickening of the epidermis occurs - in the form of a wart.
According to the currently accepted version, viral warts are more common in children than in adults, since proliferative processes in the skin cells of children and adolescents (up to about 18 years of age) are characterized by increased activity - under the influence of growth hormone (GH), insulin-like growth factors (IGF-1 IGF -2) and epidermal growth factor (EGF), as well as due to the higher susceptibility of skin receptors of growth hormone (IGF-1 and IGF-2), vitamin D receptors and nuclear retinoid alpha and gamma receptors.
Symptoms baby warts
The first signs of HPV damage to the epithelial cells of the basal layer do not appear immediately, on average, within two to six months. Contrary to popular belief, warts do not have "roots". They grow only in the upper layer of the skin and in the process of growth can displace the underlying layer of the skin - the dermis, but warts do not grow through it, and their lower side is smooth.
Warts usually grow from the skin in the form of a cylinder; on thicker skin, there may be several such structures, tightly pressed against each other, and they merge, giving the surface a characteristic mosaic appearance.
Vulgar warts in children look like keratinized seals up to one to one and a half centimeters in diameter, which rise above the surface of the skin. Sometimes external symptoms are observed in the form of tiny black dots in the wart. These are capillaries that have grown into it and are clogged with coagulated blood.
A wart may feel rough or grainy to the touch, may itch, and in some cases warts may be painful or spread to other parts of the body, such as a wart on the stomach.
Flat warts in children are most often found on the hands and face; such warts on the hands (and the back of the hands) are smoother and smaller in size. Branched warts are distinguished by the fact that several formations on a limited area of skin (often on the face or upper limbs) are shaped like a twig or fern leaf.
But a wart on a child's finger can often look like a blister, but only a dense one. There are also sub- and peri-gangular warts - formed under the nail, around the nail or on the cuticle. They are more difficult to treat than warts in other places.
Plantar warts on the feet, soles, and heels of children usually appear as very dense formations in the form of yellow, gray, or light-brown plaques covered with the black dots mentioned above. Such a wart “grows” into deeper layers of the skin due to pressure; it can cause discomfort and even be painful when moving. Mosaic warts predominate on the soles of the feet – under the toes. For more information, see – Warts on the feet
A hanging wart or a wart on a stalk is diagnosed extremely rarely, which can be in the form of a hairy growth near the eyelids or lips. The second type of elongated warts with a stalk - acrochordon or filiform wart does not form in a child.
If a red wart has grown in a child aged 2-12 years, then most likely it is a skin lesion caused by poxvirus - the molluscum contagiosum virus, when a whitish pimple similar to a wart is found on a red background. Or it may be a benign and harmless vascular tumor - hemangioma, resembling a red birthmark (nevus).
Complications and consequences
Fortunately, warts do not harm children's health. But a child can inadvertently damage a wart, for example, tear it off, then the most likely consequences and complications are bleeding and the addition of a secondary infection - with the development of inflammation, possibly purulent.
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Diagnostics baby warts
Warts are identified by their appearance and changes in the papillary lines of the skin, which dermatologists examine when examining the patient's skin. Instrumental diagnostics also help - visualization using a dermatoscope.
Genetic amplification methods in combination with genotyping can determine the specific type of HPV, but for skin warts in children and adolescents this is not essential and does not affect the choice of therapy.
How to diagnose warts, read in the publication - Warts: causes, symptoms, diagnosis, treatment
Differential diagnostics with possible ultrasound of the affected skin is designed to distinguish a wart from a callus, seborrheic keratosis, focal or diffuse keratoderma, epidermal nevus, molluscum contagiosum or hemangioma.
Also, when a wart on a child turns out to be a birthmark that forms after birth and continues to grow rapidly and becomes denser, the possibility of amelanotic melanoma should be considered.
Treatment baby warts
Flat warts in children usually go away on their own: within two years, they disappear in 40% of children (according to other data, in 78%) without any treatment.
The question arises: is it worth removing warts in children? If a child's wart does not go away, spoils the appearance or, especially, causes physical discomfort, it needs to be removed.
What kind of doctor treats warts? For all skin problems, including warts, you should see a dermatologist.
How to remove a wart from a child, and what wart medications do dermatologists recommend?
First of all, externally (by lubricating the wart with the application of a plaster) salicylic acid from warts is recommended, acting as an effective keratolytic agent. It should be used daily for one to two months. Salicylic acid preparations are available in various forms, including gels and ointments, and they often also include lactic acid, resorcinol, urea. Useful information in the material - Treatment of warts
For a small flat wart, it is recommended to use a pencil with silver nitrate (lapis), but there is no convincing evidence of the effectiveness of this remedy.
What ointments are used for warts in children (Tretinoin, Fluorouracil, etc.), read in detail in the article - Ointments for warts.
Homeopathy offers Cantharidin, an extract of Spanish fly, the application of which to the surface of a common wart leads to the formation of a crust, together with which (after some time) the wart is removed from the skin.
To kill the virus, external antiviral drugs are used (including Imiquimod), all the details are in the material Ointments for papillomas.
As a systemic immunomodulatory agent, the drug Levamisole (Adiafor, Dekaris, Levazol, Nibutan and other trade names) is used in tablets, the dosage of which is determined by the doctor.
The main remedies for warts in folk treatment include: garlic, onions and raw potatoes (in the form of compresses under a bandage); cauterization of the wart with an alcohol tincture of iodine and a concentrated solution of hydrogen peroxide. Since flat warts are often found on the face, it is recommended to consult a doctor before using a home remedy that can cause a skin burn or leave a scar.
And herbal treatment involves applying celandine juice and milky juice of dandelion flower stalks to the wart. Also read - How to get rid of warts?
Removal of warts in children is usually done in one of three ways:
- laser wart removal, more details on how wart removal is performed with a laser in children and adults, see – Wart Removal
- electrocoagulation or cauterization of warts in children using electric current;
- cryodestruction of warts, that is, removing a wart from a child with liquid nitrogen. More about this method - Removing warts with nitrogen
Prevention
Although there is no 100% guaranteed way to prevent warts, prevention can include teaching children to wash their hands regularly with soap; to use only their own towel; and to wear waterproof flip-flops at the beach, in the pool, and in the gym locker room (to protect against plantar warts and other skin infections).
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