One of the most frequent medical consultations regarding the skin is viral warts. Warts are, in fact, skin infections caused by different kinds of human papillomavirus. They are not serious, but if they persist or represent an aesthetic problem, they should be removed.
The first problem posed by warts is the actual term itself. For the dermatologist, it defines an infection of the skin by human papillomavirus (HPV). But it is common to use the term to designate any lumpy skin lesion, like moles, fibroids, seborrheic keratosis and even malignancies. It may seem unimportant, but this confusion potentially leads to hazardous situations. A patient may ask a pharmacist for a treatment for warts when, in fact, they have a different complaint.
A very common problem
Viral warts, also called common warts (or plantar warts when they affect the soles of the feet), are lesions caused by different HPV variants, most commonly affecting young people, especially children.
Warts are transmitted by contact – direct (from other people) and indirect (from objects or clothing) – and also between different body parts of the same patient through touch. It is, in fact, practically impossible to avoid contagion.
Diagnosis is very simple in most cases. Warts form skin-coloured or whitish, well-defined lesions that are rather scratchy to the touch. They mostly develop on the hands and fingers, knees, elbows, feet and sometimes on the face. They are not usually bothersome, except for plantar warts, which may make walking painful.
Warts are a frequent disorder, so popular wisdom has it that, since they can be cured using home remedies, there is no need to go to the doctor. However, many widespread beliefs need to be qualified and others are just plain false. Here are some of the most typical beliefs:
1. “The child has warts because her defences are low.” False. Although the immune system undoubtedly plays a role in any viral infection, it cannot be deduced that all children with warts have immune system problems. So the answer is no – vitamin or other supplements are not necessary for most patients with common warts.
2. “If I have HPV infection, I may have cancer.” False. There are over 100 types of HPV capable of infecting humans. HPV related to cervical cancer is very different from the HPV that causes common warts, so there is no need to worry on that account.
3. “If a wart bleeds, the blood will spread the warts to other parts of the body.” Once again, false. The virus is in the skin, not in the blood, of the wart. A person with warts can certainly spread them to other parts of the body, but the contamination does not occur via the blood.
4. “Warts can be cured if rubbed with garlic.” Traditionally many substances have been used to treat warts, usually with some kind of irritant mechanism, mainly garlic, fig latex, red meat, aubergine, lemon juice, etc. With patience the remedies may eventually work, but the irritant reaction often leads to other kinds of undesired reactions. Given the safer treatments available nowadays, such remedies are not recommended.
5. “Healers can remove warts without using any product.” This statement is not entirely false. We all know patients who visited a healer and suddenly found their warts disappeared even though no product was used. But you do not have to be a healer; warts, like any viral infection, sometimes resolve spontaneously without treatment. Furthermore, poorly understood mechanisms do exist in which self-suggestion plays a role.
So, if I have warts, what should I do?
The first thing to do is to make sure it is a viral wart, so a visit to a dermatologist is in order. If the warts appeared recently, it is not strictly necessary to apply any treatment.
However, if the lesions cause physical discomfort or are aesthetically bothersome due to their visibility, the goal of treatment will be to remove the wart while respecting healthy skin to the maximum.
No treatment is effective in 100% of the cases and the warts may reappear. Your dermatologist will recommend one of the different therapeutic options available, depending on age, number of warts, size and location. The most typical treatments are as follows:
– Topical keratolytic agents: The most commonly used treatment, usually lasting several days, is salicylic acid at 20%-40%.
– Cryotherapy: Warts are removed through freezing by applying liquid nitrogen. This is the cleanest and therefore the most popular treatment currently.
– Electrocoagulation: This can be done with electrocautery or with CO2 laser.
By: Rosa Taberner, dermatologist
Source: British Medical Journal