What should you know about warts around fingernails?

Periungual warts form beside or beneath a nail and may look rough, thickened or cracked. They can interfere with the cuticle, cause tenderness when pressed, or make the nail grow unevenly. Nail biting, picking and cutting the cuticle can create small breaks that help the infection spread to nearby fingers.

A dark streak, persistent swelling or a damaged nail is not automatically a wart. A clinician can distinguish a wart from infection, trauma and other nail conditions by examining the growth and nail plate.

Arrange a review if the growth is spreading, painful, recurrent, or changing the nail. Options may include prescribed Imiquimod Treatment, Cryotherapy (Lesion Removal), Electrosurgery or another form of Wart Removal. The chosen approach depends on whether the lesion touches the nail matrix or sits only in the surrounding skin.

Do not bite or tear the area, and avoid sharing clippers, files or nail tools. Keep the surrounding skin moisturised if it cracks, but do not cover a treated site with polish or adhesive unless instructed.

Seek prompt assessment for increasing pain, pus, warmth, spreading redness, a nail lifting from its bed, or a dark mark that does not grow out with the nail. Rapid change or bleeding without clear injury also warrants review.

Does the wart involve the nail matrix or only the skin beside the nail? Could the nail change have another cause? Which treatment protects future nail growth, and how should I care for the area between visits?