Warding off Subungual Woes

Treating peringual and subungual, also called nail warts caused by HPV can be challenging due to their location under or around the nails. Subungual warts are caused by HPV, and the virus enters the skin through small cuts or abrasions. The warm and moist environment around the nails provides an ideal setting for the virus to thrive. Here are some additional details on the treatment options for subungual warts.

Treatment options may include:

Over-the-Counter (OTC) Treatments:

Salicylic Acid: Topical solutions or patches containing salicylic acid can be applied to the wart. These products work by breaking down the wart tissue over time. It’s important to follow the instructions carefully and avoid using these treatments on the face or genital area.

Prescription Medications:

Topical Immunotherapy: Prescription creams containing immune-boosting substances like imiquimod may be recommended. These medications stimulate the body’s immune response to target and eliminate the wart.


This involves freezing the wart using liquid nitrogen. Cryotherapy is a common and effective method for wart removal, but multiple sessions may be required.

Options for Ungual Warts

Subungual or Nail Warts Cause Discomfort

Subungual and peringual warts are a type of wart that occurs underneath or around the fingernails or toenails. These warts are caused by the human papillomavirus (HPV), specifically certain strains that infect the skin. Here are some key points about subungual warts.


Subungual warts often appear as raised, rough growths with a cauliflower-like texture. They can be flesh-colored or have a slightly darker tint. Due to their location beneath or around the nails, they may cause distortion or thickening of the nails.

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In addition to the visible appearance of the wart, individuals with subungual warts may experience pain or discomfort, especially when pressure is applied to the affected nail. There may also be changes in the texture and shape of the nail.

The terms “periungual” and “subungual” refer to the locations of warts around or under the nails, and they describe the specific areas where the warts are located.

Subungual Warts:

  • Location: “Subungual” refers to warts that are located under the nail. These warts can grow beneath the nail plate, affecting the nail bed.
  • Appearance: Subungual warts may cause distortion of the nail, and they can lead to changes in the color and texture of the nail. In some cases, the nail may lift or become detached from the nail bed.

Periungual Warts:

  • Location: “Periungual” refers to warts that are located around the nails, typically near the edges of the nail or under the cuticle.
  • Appearance: These warts may appear as raised, rough growths with a cauliflower-like texture. They can affect the skin surrounding the nail.


HPV is highly contagious, and subungual warts can be spread through direct contact with an infected person or by touching surfaces that have the virus. The risk of transmission increases in moist environments such as swimming pools and communal showers.


To reduce the risk of subungual warts, it’s important to practice good hand and foot hygiene. Avoid walking barefoot in public areas, especially in warm and moist environments. If you have a wart, avoid picking at it to prevent spreading the virus to other areas.

It’s crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan for subungual warts, as well as to rule out other potential nail conditions.

Medical Procedures:

  • Laser Therapy: Laser treatment uses focused light to destroy the wart tissue. It’s often employed when other treatments have not been successful or for particularly stubborn warts.
  • Electrosurgery: This involves using an electrical current to cut or burn off the wart. Electrosurgery may be recommended for larger or more persistent warts.
  • Surgical Removal: In some cases, especially when the subungual wart is causing significant pain or deformity to the nail, a healthcare professional may recommend surgical removal. This could involve excision of the wart or, in severe cases, removal of the affected part of the nail.

Combination Therapy: A healthcare provider may recommend a combination of treatments to enhance effectiveness. For instance, cryotherapy or laser therapy may be followed by topical medications to target the remaining wart tissue.

Patient Monitoring: Subungual warts can be persistent, and treatments may require patience and consistency. It’s important to follow up with a healthcare provider for monitoring and adjustments to the treatment plan if necessary.

It’s crucial to consult with a healthcare professional for a proper diagnosis and guidance on the most suitable treatment for subungual warts. Additionally, good hygiene practices and preventive measures can help reduce the risk of spreading the virus to other areas or individuals.

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