Not every raised, rough, or thickened skin lesion is a wart. Many common skin conditions closely resemble warts in appearance, texture, or location, which is why uncertainty is so common. Mistaking another condition for a wart can lead to ineffective treatment, irritation, or unnecessary concern. Accurate identification is important because treatment options, risks, and expected outcomes vary depending on the underlying cause.
Why Warts Are Often Misidentified
Warts can look very different depending on their type, location, and stage of development. Some are raised and rough, others are flat or covered by thickened skin. Pain, colour, and surface texture can vary significantly.
Misidentification often happens because:
- Warts do not have a single “classic” appearance
- Pressure and friction alter how lesions look over time
- Several benign skin conditions share similar features
- Over-the-counter treatments change surface appearance
As a result, visual inspection alone is not always enough to confirm whether a lesion is truly a wart.
Corns and Calluses
Corns and calluses are among the most commonly confused conditions, particularly on the feet.
| Feature | Corns / Calluses | Warts |
|---|---|---|
| Cause | Pressure and friction | Viral (HPV) |
| Skin lines | Continue through lesion | Often disrupted |
| Pain | Pressure-related | Pain when squeezed |
| Black dots | Absent | May be present |
Corns and calluses usually form over pressure points and improve when pressure is relieved. Warts, by contrast, persist despite footwear changes and may spread over time.
Skin Tags
Skin tags are soft, benign growths that are sometimes mistaken for warts, especially in areas where skin rubs together.
Key differences include:
- Skin tags are not caused by a virus
- They are usually smooth and soft
- They do not spread to surrounding skin
- They are commonly found on the neck, armpits, or groin folds
Treating a skin tag as if it were a wart is unlikely to resolve it and may cause unnecessary irritation.
Seborrhoeic Keratoses
Seborrhoeic keratoses are benign growths that often appear with age. They are frequently mistaken for warts because of their rough or “stuck-on” appearance.
Typical features include:
- Waxy or crumbly surface
- Well-defined edges
- Colour ranging from light brown to black
- No viral cause or contagious risk
These lesions are common in adults and are unrelated to HPV, meaning wart treatments are ineffective.
Molluscum Contagiosum
Molluscum contagiosum is a viral condition that can resemble warts, particularly in its early stages.
Differences include:
- Smooth, dome-shaped lesions
- Central dimple or indentation
- Often appear in clusters
- More common in children but also seen in adults
Although viral, molluscum behaves differently from warts and often follows a separate management approach.
Flat Pigmented Lesions
Some flat or lightly pigmented lesions can be mistaken for flat warts, especially on the face or hands.
Examples include:
- Lentigines (sun spots)
- Post-inflammatory pigmentation
- Early seborrhoeic keratoses
These lesions do not contain viral tissue and require a different assessment pathway, particularly if colour or shape changes over time.
Why Location Can Be Misleading
Certain body areas are more prone to confusion:
- Feet: calluses, corns, plantar warts
- Hands: flat warts, scars, thickened skin
- Around nails: periungual warts, nail fold changes
- Face: flat warts, seborrhoeic keratoses, pigmentation
Pressure, shaving, and skin thickness all alter how lesions present, making location an important part of assessment.
When Appearance Changes Over Time
Changes in size, surface texture, or discomfort often prompt concern. While warts can change gradually, so can many non-wart lesions.
Assessment is particularly important when a lesion:
- Becomes painful without pressure
- Changes colour or shape
- Bleeds without trauma
- Does not respond to wart treatments
These features do not automatically indicate a serious problem, but they do warrant professional review.
Why Self-Treatment Can Delay Diagnosis
Over-the-counter wart treatments can alter the surface of a lesion, making later identification more difficult. Acid-based products may cause:
- Skin irritation
- Inflammation
- Crusting or scabbing
When the underlying condition is not a wart, repeated self-treatment can delay appropriate care and prolong symptoms.
Clinical Assessment of Suspected Warts
Assessment focuses on structure rather than appearance alone. Clinicians evaluate:
- Skin line interruption
- Surface texture under magnification
- Presence of clustered viral points
- Lesion response to pressure
This allows differentiation between warts and other benign skin conditions without relying on guesswork.
Specialist Assessment in London
At London Wart Clinic, and City Dermatology Clinic London, lesions suspected to be warts are assessed by clinicians experienced in diagnosing and managing conditions that mimic warts, particularly in high-pressure or cosmetically sensitive areas.
This includes specialists such as Dr Nicki Bystrzonowski, Dr Giulia Luciano, Mr Georgios Pafitanis, and Mr Parviz Sadigh.
Treatment is only considered once the diagnosis is clear, ensuring that management is appropriate for the condition identified.