Periungual Warts

What Are Periungual Warts?

Periungual warts are those bothersome growths around the nails (finger or toenails) that begin with tiny pin pricks and can end up ugly, rough, peeling infections on either the hands or the feet. They can appear elevated, round, smooth and/or irregular causing damage in various ways to the nail. This occurs when the growth is so close to the nail edges that its growth begins to interfere with that of the nails. The end result can be a nail lifted from the skin; or partially detached from the nail in the cuticle area in more extreme cases. When this takes place periungual warts are painful.


Periungual warts start small and dot like, are usually painless in the beginning and are always caused by viruses. Generally harmless at this stage, warts can become disfiguring and embarrassing. On the feet they may itch or hurt from the very beginning. Of the types of warts, most are harmless appearing small, flat, on the face or hands and most common in children due to their under-developed natural biological defenses. Genital warts are found in the pubic area, on the genitals, or in the area between the upper thighs (can also appear inside the vagina and anal canal). These along with plantar warts (found on the soles of the feet) are more common in adults.

Often going away on their own the wart is not generally thought of as a treat. Actually, they can be contagious though, but transmission to another person is uncommon. Rarely do warts present themselves as life threatening, affecting day to day living only because of their position or due to side effects such as persistent itching. Periungual warts are a good example of infections that causes such problems.


Periungual warts can be influenced by the onset of several factors. As with other warts, the cause is generally attributed to Human Papilloma-virus (HPV), the cells of which can force their way through the skin-even an opening as tiny as a pinprick, and multiplies rapidly. It can at this point extend to various parts of the body by direct contact with skin-touching, scratching etc. This infectious agent can also dwell on objects that are moist in surroundings such as common bath/shower/dressing areas.

Complications of periungual warts are caused by such things as their spread, their return once they have been dealt with, scarring or the formation of keloids (pink or red fibrous scar tissue) after their removal. In the worst cases, when the infection has caused injury/damage to the nail matrix, any deformities formed during the outbreak and infection period in the nail may remain permanently. Sometimes infections of periungual warts resemble the changes take place in those affected by onychomycosis (a fungal infection). See a doctor if you are not sure.

There are effective over-the-counter medications such as salicylic acid that can remove periungual warts by applying it to the affected areas everyday for a prescribed amount of time. It might help to file the wart down when damp (after bath/shower) before applying these medications. A prescription for stronger medications may be needed for persistent warts. Such treatments as surgical removal, cryotherapy (removal by freezing), burning or laser are also available for more extreme cases. The spontaneous disappearance of periungual warts is normal. As a matter of fact most do disappear on their own after a year or so. This does not guarantee they will not return.

It is never wise to try the removal of a periungual wart or any other type, for that matter-especially it if involves tearing, cutting, picking or burning. This should only be performed by a qualified physician.