Periungual Warts Treatment – Doctor’s Suggested Methods


Warts are a common issue, with around 10 percent of the population affected globally and up to 20 percent among school-age children. Caused by the human papillomavirus (HPV), these harmless blemishes can happen anywhere on your body due to over 100 types of HPV identified.

One type of wart that is particularly difficult to treat is periungual warts. These warts on fingernails and toenails can be quite painful.

What Are Periungual warts?

Common warts

Periungual warts are an uncomfortable nuisance that can affect the growth of fingernails and toenails. Most commonly seen in young children or adolescents who bite their nails, these pesky warts can spread rapidly if left untreated. Fortunately, treatments exist that may reduce the size of your wart(s) and help you avoid spreading them further – however, it’s important to note that even with treatment, there is still a chance for recurrence.

A periungual wart initially appears as rough and pea-sized bumps around the nails, which can be translucent or colored in shades of grey, brown, or black. Over time they may form into clusters and cause pain and discomfort due to their larger size. When first creating these growths are often small pinhead-sized shiny areas that seem smooth to the touch.

Periungual Warts Causes and Symptoms

All periungual warts are directly connected to the HPV virus, specifically strains 1,2,4,5,7,27, and 57. This virus is highly contagious and can be spread through contact with contaminated skin or other items like towels and toys. It usually enters the body via a cut or scratch on the skin – making nail-biters more vulnerable to developing warts than others. People with weaker immune systems and those dealing with atopic dermatitis are particularly susceptible to getting infected by this virus.

5 Periungual Warts Treatment Methods

Treatment of periungual warts can be more challenging than other kinds, due mainly to the difficulty in applying topical medication when a wart is located beneath the nail. When considering treatment options for these pesky growths, your doctor might consider factors such as size and the number of warts, their position on your body, any accompanying infection or discomfort experienced, the age and gender of the patient, and past treatments attempted.

While there are ways to treat warts naturally, it’s best to consult your doctor first. Common ways to treat periungual warts include:

Salicylic acid

Salicylic acid is one of the most extensively researched treatments for warts. Although salicylic acid functions slowly and may require several weeks of application, this method works by destroying affected skin. However, it can result in some irritation of the skin cells. To obtain maximum results without running any risks, seek guidance from your physician on how and when to use salicylic acid and at what strength might be beneficial. Luckily, you don’t need a prescription – it’s over-the-counter!


Cryotherapy to remove wart
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Gloved hands use cryotherapy equipment to remove viral warts from the fingers of a patient. Cryotherapy uses liquid nitrogen (applied using a cryotherapy probe) to kill and freeze the wart caused by the human papilloma virus (HPV).

With cryotherapy, a physician will swiftly and effectively freeze away your warts using liquid nitrogen. Even though this action is often quicker than traditional salicylic acid wart treatments, it may require up to four separate sessions spaced two to three weeks apart for maximum efficacy. Cryotherapy treatments boast an impressive success rate of up to 70 percent, allowing you to gain the clear skin you desire sooner rather than later!

Antigen Injections

Introducing antigens derived from mumps or Candida into the wart can work wonders. These powerful agents activate your body’s immune system to attack and eradicate unwelcome skin growths. However, your physician may choose to check whether you will have a suitable response before injection before proceeding. Common side effects of this kind of treatment may include itchiness and burning sensations at the injection site, which should improve with time.

Pulsed Dye Laser Therapy

Pulse dye treatment for wart

Another treatment method is to use laser light to heat and eliminate the cells in your wart. As a result, it cuts off its blood supply, causing the wart’s death. Laser treatment aims to burn away your wart but with varying success rates depending on the chemicals used.

Surgical Removal

Surgery may be recommended when a periungual wart is particularly severe or causes adverse effects. Although this solution may not always work for all types of warts, curettage and cautery are the two steps involved in the process – where firstly, the warts are cut away with precision, followed by heat being applied to ensure proper healing of the wound. This method has proven success rates ranging from 65 to 85 percent, yet it’s also worth noting that around 30 percent have experienced scarring upon completion or even faced recurring issues afterward.

Comparison Of Subungual and Periungual Warts

Aside from periungual warts, there are other types of warts, too, such as a subungual wart under the fingernail. One of these is the subungual wart. The primary difference between these two stubborn warts is that periungual warts are situated on the skin around the nails, whereas subungual warts reside beneath them.

Subungual and periungual warts are incredibly irritating, as they can cause severe discomfort due to their location. Subungual warts grow beneath the nail bed, making them difficult to treat. Periungal warts appear in the crevices of your nails- either lengthwise or sideways on your finger- resulting in even more annoying symptoms.

Prevention Tips

Staying safe from HPV is the best way to prevent periungual warts. Given that the virus causing warts is so widespread, this may prove to be a difficult feat. Furthermore, these pesky skin lesions are highly contagious and can be transmitted even when treated.

Here are a few recommended tips to help protect you and your family from periungual warts:

  • Habitual hand washing is essential.
  • Refrain from biting and picking at fingernails or cuticles, as this will increase the chances of transmitting a virus.
  • If your hands are submerged in water for extended periods, it is essential to wear protective gloves.
  • Avoid sharing all personal items, including towels and nail polish.
  • Steer clear of anyone with warts and avoid touching items they may have interacted with.

If you plan to visit a nail salon, observe the following to avoid contracting the health issue:

  • Ask salon workers to switch their gloves between each customer.
  • Request for a new pumice stone.
  • Ensure that the technician disposes of nail files and cuticle sticks following each customer’s service.
  • Avoid shaving your legs before visiting the salon. Shaving beforehand can increase the chance of HPV entering through any cuts made in the skin, so it’s best practice to avoid this risk altogether.

Periungual warts can be both painful and uncomfortable, but treatments are available to help reduce the size of your wart(s) and prevent them from spreading further. But remember that prevention is always better than cure. So, practicing good hygiene habits is essential to avoid an increased risk of contracting the health issue. If you suspect that you or someone close to you has periungual warts, seek medical advice as soon as possible for proper diagnosis and treatment options.

Frequently Asked Questions

1) How can you prevent the spreading of periungual warts?

The best way to prevent periungual warts is to practice good hygiene habits, such as frequent handwashing with soap and water. Additionally, avoid sharing personal items and wear protective gloves.

2) How do I get periungual warts?

Periungual warts are caused by the human papillomavirus (HPV), and they can be spread through contact with contaminated items such as towels or toys.

3) How do I know I have a periungual wart?

Periungual warts can be identified by their rough and pea-sized bumps around the nails. They may also form into clusters and cause pain and discomfort due to their larger size.

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