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Last Updated on March 23, 2024

Periungual warts develop around the nails of fingers or toes and can be challenging to treat due to their location. These warts first start small and look like a pinhead. It gradually enlarges into rough, textured bumps that may resemble cauliflower.

Periungual Warts On Girl Shoulder

In this blog, we will explore everything you need to know about periungual warts, including what they are, their complication, ongoing clinical trials, and how to treat them.

What are Periungual Warts?

Periungual warts, also referred to as subungual warts, are caused by the human papillomavirus (HPV), particularly types 2 and 4, and they grow around the nails and cuticles.

Furthermore, these warts are highly contagious and can spread from person to person through direct contact or through sharing personal items like nail clippers and towels. The virus enters the skin through a small cut or abrasion, leading to the development of these warts.

Additionally, periungual warts are frequently seen in children and young adults, affecting about 10% to 20% of the population. Those who are particularly prone to these warts are individuals who bite their nails or have compromised immune systems. They are often mistaken for hangnails or ingrown nails but are caused by a viral infection.

Causes of Periungual Warts

As mentioned earlier, periungual warts are caused by the human papillomavirus (HPV). This virus is highly contagious and can be easily transmitted from person to person. It thrives in warm and moist environments, making the skin around the nails and cuticles an ideal breeding ground for the virus.

Certain risk factors can increase the chances of developing them. These include having a weakened immune system, biting or picking at the nails, frequent exposure to water, and sharing personal items with someone who has them.

Additionally, one of the reasons is poor nutrition. It can significantly impact your immune system, leading to vulnerabilities such as increased production of histamine and susceptibility to viral infections like HPV. Consuming salty, sugary, or fatty snacks along with alcohol and caffeine can exhaust immune cells and contribute to digestive, liver, and skin issues. On the other hand, maintaining a diet rich in whole grains, fruits, vegetables, and water can help strengthen immune cells and overall health.

Moreover, stress is another factor that can adversely affect the immune system, digestive system, and liver function. When stressed, the body triggers the sympathetic nervous system, leading to increased blood pressure, slowed digestion, and heightened production of inflammatory chemicals like adrenaline. This can exhaust adrenal glands and weaken the skin, making it easier for viruses like HPV to penetrate.

What are the Symptoms?

Periungual warts can have a variety of symptoms and appearances. They typically start as small, flesh-colored bumps around the nails and cuticles. Over time, they may grow and develop a rough, cauliflower-like texture. Moreover, pressure applied to the affected area can cause pain, especially with these warts.

Understanding these symptoms can provide reassurance and help you recognize any unusual or recurring signs.

  • Dry, rough bump: Warts typically result in dry, hardened skin caused by excess keratin, leading to rough patches around the nails. The cuticle may become brittle and flaky, while the warts appear as small, toughened lumps. They may vary in size.
  • Skin discoloration: Discoloration of the skin is common during a wart outbreak, with warts often appearing pale or grayish and sometimes darkening over time. Consequently, this symptom usually diminishes as the wart heals, returning to normal pigment once fully resolved.
  • Clotted blood vessels: Warts may feature small, dark pinpricks, indicating clotted blood vessels. While not usually serious, this symptom can be uncomfortable, especially in areas like the fingers that are constantly in motion.
  • Onychauxis: Onychauxis refers to nail overgrowth or thickening, which can occur in periungual warts if the virus is unchecked. Nails may harden, become discolored, or even rise or detach if warts spread beneath them.

Potential Treatment Options for Periungual Warts

There are several treatment options available for periungual warts, depending on the severity and location. Over-the-counter remedies, such as salicylic acid-based products, can be effective in treating mild cases. These products work by gradually breaking down the wart tissue and stimulating the immune system to fight off the virus causing periungual warts. Also, medical intervention may be needed for more stubborn or severe cases.

Cryotherapy, which involves freezing the warts with liquid nitrogen, is a common treatment option. This can be done in a healthcare professional’s office and may require multiple sessions for complete removal.

Other medical treatments include laser therapy, electrocautery, and surgical excision. Trained healthcare professionals typically perform these procedures for more severe or persistent cases.

Additionally, new treatments are being explored by ongoing clinical trials, including immunotherapy and targeted antiviral medications. These trials aim to improve the efficacy and safety of treatments while minimizing potential side effects, offering hope for more effective management of this challenging condition in the future.

Home Remedies for Periungual Warts

Aside from medical treatments, home remedies can offer relief from periungual warts. While not guaranteed to eliminate the warts, they can ease symptoms and limit virus spread.

One popular home remedy is apple cider vinegar. Applying diluted apple cider vinegar to the affected area can help soften the wart and promote healing. Tea tree oil, garlic, and duct tape are also commonly used home remedies for periungual warts.

It is important to note that home remedies may not be as effective as medical treatments. If you decide to try a home remedy, make sure to consult with a healthcare professional first.

Prevention of Periungual Warts

Preventing periungual warts can be challenging, but there are several steps you can take to reduce your risk of developing them. Good hand hygiene is crucial, especially after touching surfaces that may be contaminated with the virus. Avoid biting or picking at your nails, as this can create openings for the virus to enter the skin.

Moreover, it’s crucial to refrain from sharing personal items such as nail clippers, towels, and socks with individuals who have periungual warts. When using public swimming pools or locker rooms, wear protective footwear to reduce the risk of exposure.

Complications of Periungual Warts

While periungual warts are generally harmless, they can cause several complications and risks if left untreated. These include the spread of the virus to other areas of the hands or body, secondary bacterial infections, and nail deformities.

Individuals with weakened immune systems, like those with AIDS/HIV or undergoing chemotherapy, may struggle to treat them and may require specialized medical care. It’s crucial to maintain good hygiene and seek medical advice promptly if you suspect periungual warts.


In conclusion, understanding the causes, symptoms, and treatment options for periungual warts is crucial in managing and preventing their spread. Additionally, clinical trials are paving the way for innovative treatments, including immunotherapy and targeted antiviral medications. These trials highlight the importance of continued research and development in finding better solutions for managing periungual warts and enhancing patient outcomes.

Moreover, if you suspect you have periungual warts, it is important to seek medical advice for a proper diagnosis and treatment plan.

Remember to practice good hand hygiene, avoid sharing personal items, and seek medical advice. With the right approach, one can effectively manage and treat periungual warts.


MetroBoston Clinical Partners is a well established and experienced research center in the greater Boston area. Under the leadership of qualified physicians and medical professionals, we coordinate a range of clinical research trials in Dermatology and Internal Medicine.

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