Everything You Need to Know About Facial Warts

• Facial warts are benign skin growths caused by the highly contagious human papillomavirus
• Types of warts that develop on the face include common, flat and filiform
• They can be removed with professional procedures or treated with topical, oral or injectable medications
• These growths will typically resolve in about 2 years without treatment

Warts are raised, flesh-colored skin growths that can develop on any body area. They are usually painless and resolve on their own; however, they can spread easily, are sometimes annoying  and can be a source of embarrassment. Facial warts in particular can have a detrimental effect on self-image.

A wide range of treatment options are available, including removal procedures, medical treatments and home remedies.

What Causes Facial Warts?

Facial warts, like all types of warts, are caused by the human papillomavirus (HPV). They develop when HPV infects the DNA of skin cells, causing them to multiply rapidly and overgrow. HPV is highly infectious, and spreads through physical contact – through direct skin contact with an infected person or by using a contaminated item, such as a razor or towel.

Where do facial warts tend to develop?

Facial warts are most likely to develop on areas of skin that are soft and moist, or that have recently been injured, as these are ideal breeding grounds for the virus. Specific areas of the face that are prone include the lips, eyelids, forehead, cheeks and nose.

Can pregnancy cause facial warts?

Pregnancy itself cannot cause facial warts to develop. However, pregnant women are more susceptible to HPV infection. Science has established that pregnancy alters hormone levels and decreases immunity, making the body more prone to infection.

Types of Facial Warts

There are more than 100 strains of HPV, and each can cause several different types of warts. The three most frequently found on the face are common, filiform and flat.

Common warts

Common warts are raised, rounded growths with a rough surface. They are either pinkish or skin-colored and often feature an outer layer of hardened, whitened dead skin. In some cases, they may be covered with sparse black dots caused by clotted blood vessels. Common warts can develop anywhere on the face.

Filiform warts

Filiform warts differ greatly in appearance from other types, and appear as small clusters of elongated, spiky growths. They are typically reddish pink at the base and yellow toward their tips. They most commonly develop on the outer edges of the eyelids and lips, but may also develop on the nose and ears.

Flat warts

Flat warts are round, smooth in texture, very slightly raised and flat on top. They may be brown, yellowish or skin-colored and usually very small – about the size of a poppy seed. They typically appear on the forehead or cheeks, and typically grow in clusters.

Treatment Options for Facial Warts

A wide range of treatments are available; however professional removal is the fastest and most effective. Dermatologists can also provide topical, oral and injectable medications that will clear warts in a few weeks. Natural treatments are also available although they tend to be less effective and take longer to treat. 

Treatments to avoid

Avoid picking at, clipping or tweezing warts as this can damage healthy skin and lead to infection. You can also spread the virus by doing so.

Facial Wart Removal 

Dermatological clinics offer cryotherapy, electrosurgery and curettage, and laser treatments. All three methods typically require a series of sessions in order to fully remove all infected tissue and prevent regrowth.

Cryotherapy

Cryotherapy, also known as cryosurgery, is a minimally invasive treatment that uses extreme cold to destroy lesions and ulcers. One study demonstrated that cryotherapy effectively eliminated warts after a series of 1–3 treatments scheduled 2–3 weeks apart. 

Cryotherapy treatments typically use liquid nitrogen or liquid nitrous oxide as a cooling agent. This agent is applied either with a spray or a contact applicator with a foam or metal tip. The process takes 10–20 seconds to complete, and causes a sharp burning sensation that quickly dissipates. Side effects are minor and include redness and blistering.

Electrosurgery and curettage

Electrosurgery and curettage is a removal technique with a similar success rate to cryotherapy. It involves piercing a wart with a needle, administering an electrical charge through it to heat up the unwanted tissue and destroying it. Any remaining tissue is then removed with a curette – a surgical debridement tool with a rounded or hook-shaped tip.

Electrosurgery and curettage is performed under local anesthesia, so that the procedure itself is painless. However, this treatment carries higher risks of postprocedural pain, infection, delayed healing and scar formation compared to cryotherapy.

Laser treatments

Laser treatments use laser light to apply focused, controlled heat damage to targeted areas of skin tissue marked by textural and visual imperfections. This heat damage eliminates facial warts and stimulates the growth of healthy new skin tissue in their place. This treatment is typically performed under local anesthesia.

Laser treatments can be ablative or nonablative. Ablative lasers, such as CO2 lasers, work by stripping away infected tissue down to the base. Nonablative lasers, such as Nd:YAG and pulsed dye lasers, directly target the blood vessels within warts.

After a laser treatment, a scab will form and will take 1–4 weeks to heal. In general, nonablative lasers require a slightly shorter healing period than ablative lasers, and pose a lower risk of scarring and postprocedural pain.

Facial wart removal costs

Facial wart removal procedures will vary widely in price depending on the type of procedure, the provider and the number of growths being treated. Providers will often provide a discounted price for a series of treatments and wart removal is usually covered by health insurance.

Medical Treatments for Facial Warts

In addition to physical removal methods, warts can also be treated with a range of topical, oral and injectable medications. Some of the most common treatments in this class include bleomycin injections, topical cantharidin, immunotherapy and both oral and topical retinoids.

Bleomycin is a potent antibiotic. It effectively treats warts by causing DNA strand breakage and preventing cells from replicating. Bleomycin is typically mixed with a saline solution and a small amount of lidocaine, an anesthetic, and injected directly into infected tissues. 

Bleomycin treatments typically cause no adverse effects other than minor pain around the injection site for 2–3 days. Multiple injections are usually needed for successful treatment; they can be administered in 2–3 week intervals.

Cantharidin

Cantharidin is a topical blistering agent produced by several species of blister beetle that can safely and effectively eliminate warts. Due to its potential to cause chemical burns when administered improperly, it must be applied by a licensed care provider.

Once a wart is treated with cantharidin, it is covered with a small piece of tape and left to rest for 4–6 hours. After this period, the tape is removed and the site is washed with soap and water. Over the course of the following 1–2 days, a blister will form around the wart, lifting it away from the skin. When this blister dries and falls away, the wart will fall off with it.

Successful treatment with cantharidin typically requires 2–3 sessions scheduled 3 weeks apart. Side effects are minor and include discomfort, a burning sensation and the development of additional blisters. Treated skin will fully heal after 4–7 days.

Immunotherapy

A wide variety of treatments that work to modify the body’s immune response can help to eliminate warts in various ways. Such treatments are typically used as a last resort, when warts prove resistant to other forms of treatment.

Some effective immunotherapy treatments include the following:

• Topical medications such as imiquimod
• Oral supplements such as zinc and echinacea
• Injectable treatments such as tuberculin and vitamin D3
• A range of vaccines, including Mycobacterium w and measles, mumps and rubella 

Retinoids

Retinoids are vitamin A derivatives used to treat a wide range of skin concerns, including facial warts. They include topical agents such as tretinoin, as well as oral medications such as isotretinoin. Of the two treatment methods, topical retinoids tend to be slightly more effective.

Oral and topical retinoids are typically prescribed as a second-line treatment or for treatment-resistant cases.

Home Remedies for Facial Warts

Although scientific research on their efficacy is limited, anecdotal evidence and several studies suggest some home remedies may also help to treat facial warts. These include the following:

• Aloe vera has proven antiviral properties, and a wealth of anecdotal evidence suggests it can be effective in treating warts
• Garlic extract can help reduce viral proliferation, and has been proven to resolve warts after 3–4 months of regular application
• Salicylic acid, an exfoliating agent found in many over-the-counter skin care products, can successfully treat warts after 12 weeks of application with minimal side effects
• Tea tree oil has antiviral and antimicrobial properties; one study found it could effectively clear common warts with 10–20 days of daily application

Can Facial Warts Go Away on Their Own?

They will eventually resolve without treatment, but this can take time. Research suggests that most cases of warts will resolve within 1–2 years.

For this reason, many patients prefer to undergo medical treatments rather than wait for their warts to resolve naturally.

Takeaway

Facial warts are a symptom of HPV, a highly infectious virus that spreads through direct skin contact and contact with contaminated surfaces. Pregnant women are especially prone to developing warts.

Different strains of HPV cause different types of warts. Those on the face include common, flat and filiform warts. These growths will resolve with time, however this can take several years.

Medical professionals can remove warts using procedures such as cryotherapy, electrosurgery and curettage and laser treatments. They can also eliminate them with treatments such as bleomycin injections, cantharidin, immunotherapy and retinoids. Home remedies such as aloe vera, garlic extract, salicylic acid and tea tree oil can also help reduce their appearance.