Here’s what you need to know if you have a wart

Warts, these small bumps that appear on the skin and which often bother or cause discomfort, are lesions that manifest the presence of the human papilloma virus (HPV).

“HPV is a large group of viruses: more than a hundred different varieties have been detected,” explains Irene Araya, dermatologist at Clínica Santa María. When one of them colonizes the skin, benign pseudotumoral lesions develop. In other words, “it is not cancer”, even if it affects the skin and mucous membranes.

The big question is: why do they appear? According to Araya, they are normally generated by infection through direct contact between an infected person – who does not necessarily have warts or lesions – and another who does not have them, through the skin or mucous membranes.

“Sometimes HPV is present in someone, but it doesn’t show up as a wart. So, when this person comes into contact with another person through their skin or mucous membranes, they can infect them. This is the main reason why warts appear,” he says.

When this happens, skin cells grow faster than normal, which will generate this excess in the form of volume. They usually develop in the epidermis, the top layer of the skin, and a typical wart has a rough, raised surface, although they can also be smooth and flatter. In some cases, as described in a publication by Harvard Health , the center of a wart may be dotted with dark spots; These are capillaries that supply you with blood.

Although the precise diagnosis is always made by a doctor, if possible a dermatologist, it is not difficult to determine whether a skin lesion is a wart. Typically, Araya says, they have a rough surface and appear more frequently on the hands. However, warts vary, “there are different types, produced by different families of viruses depending on where they are located.”

Andrés Lehman, dermatologist at Clínica Dávila, explains the same thing: the differences between warts are due to the fact that they are caused by different members of the papillomavirus family. “Some cause common warts, which we see on the hands, elbows or fingers; another variant causes flat, smaller warts on the backs of the hands and on the face; others cause plantar warts, which are painful hardnesses on the sole of the foot; and another is the one that produces genital warts, usually in the anogenital region,” he analyzes.

“In dermatology, we classify them according to location, because the prognosis and treatments are going to be different,” Araya explains. The genitals, for example, which are the most worrying, are called condyloma acuminata. They are considered a sexually transmitted disease “but, in general, they are benign lesions, generally produced by certain serotypes of viruses, generally 6 and 11”, underlines the professional.

But there are also those identified as high risk, “in which the mucosa is colonized by other serological viruses, such as 16 and 18, which are more aggressive. In addition to generating warts, they can trigger the production of genital cancers. The most common is cervical cancer, which causes high mortality in Chile,” he explains.

Another commonly distinguished type is flat warts, which tend to be located on thinner skin, such as the face or back of the hands. Palmar and plantar warts, on the other hand, “are characterized by being more flattened and giving a different appearance compared to other types of warts,” says Araya.

Another type of warts are perimingal warts, which he defines as “quite difficult to treat, because they tend to contaminate or extend under the nail; There you need to perform a different procedure. Whereas filiform warts are those that look like a thread, “very thin, which tend to be located on the neck, on a rather thin surface of skin”.

“Often the immune system is able to eliminate them spontaneously,” says Lehman. But when this does not happen, physical mechanisms are used, such as liquid nitrogen, surgery or electrocoagulation.

“There are medications, like creams, which encourage the body to eliminate them itself, even if they are not always effective,” he comments. It is important for the doctor to choose the most appropriate method and avoid self-medication. “It is a viral infection, so it is important not to delay treatment and thus avoid contagion to other people and to oneself, thus causing more injuries,” emphasizes- he.

“The treatment will be different depending on the patient and the area in which the wart is located,” explains Araya. Treating a healthy person is not the same as treating an immunocompromised patient.

Regarding the spontaneous resolution of these lesions, this can happen because “many times the patient is stressed, anxious and scratches the warts; but as soon as we go on vacation, there can spontaneously be an improvement. When the immune system improves, the lesions often heal,” he says.

What if the wart doesn’t go away? “If they are plantar, they are generally deeper lesions, which require several treatments. The most commonly used are liquid nitrogen and caustic products, which remove the wart layer by layer. They are the most used, the most comfortable, but you have to be constant because there is a delay in the response,” underlines Araya.

“It’s not a myth: warts are contagious,” Araya bluntly warns. By touching the wound, “viral particles enter the skin, especially in areas where we have mucous membranes, small lacerations or micro-wounds,” he explains.

That’s why when your feet get small cracks in the summer and you walk around high-traffic areas, like a swimming pool or gym shower, you’re more likely to get them. Same with the hands: “when we wash a lot, maceration of the skin occurs, which constitutes a possible entry point for warts if we come into contact with an infected person”.

They are so contagious “that you can become infected if you touch your own body,” Araya points out. This is why it is important to treat them quickly, especially those on the hands, with which we touch everything.

Preventing warts involves avoiding direct contact with infected people, not sharing personal items, and treating skin lesions to prevent HPV entry. For this reason, the dermatologist emphasizes that at home, when a person has warts, “it is important to disinfect the areas where the other person has been: cleaning bathtubs with chlorine, which is capable of inactivating this type of particles, or that the person “With warts, do not walk barefoot, because obviously you will contaminate the entire surface where you walk,” explains Araya. Once treated by a professional, warts are generally eradicated and therefore do not reappear.

One solution Lehman offers for public places, such as swimming pools and gym showers, is the use of sandals. This way, the foot is not directly exposed to a potentially contaminated surface. If you are the carrier of the wart, you avoid spreading these cells on damp surfaces.

“Walking with chalas, especially in these swimming pool showers, where many people are in the same place, is very important. In any place where another person has set foot, it is always advisable to walk with sandals or something protective,” recommends Araya.