Warts are small, rough growths on the skin caused by the human papillomavirus (HPV). They commonly occur on hands and feet but can appear anywhere on the body. A common myth about warts is that they have a small hole or black dot in the middle. This is not true for most warts. However, some specific types of warts may have a visible dark spot in the center.
Do common warts have a hole in the middle?
The most common warts found on hands and feet, called verruca vulgaris, do not have a hole or dot in the center. These warts have a rough, bumpy texture and are usually flesh-colored. The surface may look like the top of a cauliflower.
Sometimes very small black dots are visible on the surface of a common wart. However, these are not holes. They are actually clotted blood vessels within the wart tissue. So no, common warts do not have a literal hole in the middle.
Wart types that may have central dots
While common warts do not have a hole in the center, some other types of warts sometimes do:
Seed warts
Also known as myrmecia, these warts have small black dot in the middle that looks like a seed or insect bite. The central black dot is often surrounded by a white halo and the wart itself is usually skin-colored and smooth.
Filiform or digitate warts
These finger-like warts often have a central dark dot at the “root” of each finger. The dot is essentially the blood supply for that warty growth coming up from the deeper layers of skin.
Mosaic warts
These warts occur in clusters or groups. Individual warts may have central dots that are the blood vessels feeding each wart. Overall the pattern looks like a mosaic.
What causes the central black dot in some warts?
The central dots, holes, or lines seen in some warts represent blood vessels feeding the wart tissue. As the HPV causes wart growth in the epidermis layer of the skin, it stimulates formation of new blood vessels for blood supply.
The newly formed capillaries loop into the wart from the deeper dermis layer of skin. The central dots are essentially the cross-sectional view of these capillaries.
In very thick or dark-colored warts, you can also see dark lines instead of dots which are the long view of the blood vessels extending into the wart.
Can the hole or dot be squeezed out?
Sometimes people try squeezing or pricking the central black dot to get it out. This is not recommended, as it can cause bleeding and spread the wart virus deeper into surrounding skin.
The dots or holes do not have any particular warty tissue that can be “squeezed” out. They represent blood vessels that supply nutrients to the whole wart.
Trying to dig out this central area can damage the blood supply leading to a larger wound which can get infected. It can also push virus particles into the bloodstream and cause new warts to pop up elsewhere.
Should the black dots in warts be removed?
The black dots or holes in the middle of some wart types are not something that needs removal. They fade as part of the wart removal process.
Warts are removed through methods that destroy the whole wart tissue including the blood vessels. This includes:
Cryotherapy
Freezing warts with liquid nitrogen causes the wart tissue including the blood supply to die and slough off.
Salicylic acid
Chemical destruction of warts removes the central dots. Stronger concentrations work better.
Electrocautery
Burning off warts also destroys the blood vessels feeding the wart.
Laser
Laser treatment destroys wart tissue and its blood supply, eliminating any central holes.
So in summary, the black dots tend to disappear as the wart itself is destroyed and falls off. Trying to target them specifically is not needed.
Can warts heal on their own?
Warts sometimes go away on their own without treatment, but may take years. The body’s immune system can attack the HPV virus causing the wart growth.
When the virus is cleared from that area, the wart can gradually fade as the blood vessels also regress. So warts healing naturally over time will also lose any central dots or holes.
However, because untreated warts can spread or persist for long periods, it is better to get them treated. Methods like freezing, burning and peeling are effective to destroy warts more promptly.
When to see a doctor
See your doctor if you have any of the following situations:
– Large or spreading warts interfering with function
– Painful warts
– Warts on the face or genital area
– Warts that keep recurring after treatment
– An immune disorder that make warts hard to treat
The doctor can prescribe stronger medications, perform procedures to remove warts, or monitor troublesome lesions.
Home treatment for warts
Over-the-counter preparations can be used to remove common warts on the hands, feet and body:
– Salicylic acid – Apply daily to slowly destroy warts
– Duct tape – Taping warts to block air causes them to die and fall off
– Garlic – Contains acids that eat away at warts
– Vitamin C – Crushed vitamin tablets applied to boost immunity against wart virus
– Banana peel – Contains enzymes that may digest warts
However, home remedies work slowly and are not as effective as medical procedures performed by a doctor.
Preventing warts
HPV infection and warts can be prevented by:
– Avoid picking/biting warts as it can spread virus to other areas
– Keep warts covered with bandages or dressing when possible
– Don’t share towels, shoes, bathroom accessories with others
– Check that pedicure/manicure tools are sterilized before using
– Get the HPV vaccine – protects against strains that cause warts
– Practice safe sex and use condoms – prevents genital warts
Conclusion
In summary, common warts do not have a literal hole or opening the middle. The dark dots seen in some wart types are cross sections of blood vessels feeding the wart tissue, not holes that can be squeezed out. Trying to remove the dots can make warts worse. Effective wart removal methods destroy the whole lesion including the blood supply, making the central dots disappear. Being aware of the facts can prevent mistaken attempts at digging out wart dots that can cause harm.
