In this age of many selfies, the cult of appearance and the use of filters and image editing programs, people seem to have flawless, flawless skin. But in real life this is very rarely true. Almost all of us have signs, marks such as birthmarks, scars, large and small, epidermal traces of severe acne, freckles and warts.
Although they are benign, having warts is not a welcome thing and you usually want to get rid of them. Perhaps this rejection was reinforced from a very early age by characters in cartoons and certain movies, whose bad personality is reinforced by an appearance that is not always pleasant and… with warts. Who doesn’t remember the evil queen from “Sleeping Beauty”?
However, not many people know exactly what warts are, what causes them, and the best way to get rid of them, as they try to do it themselves. Reckless thing, because not everything that looks like a mole is. It could even be something more serious…
What are warts?
As explained by the dermatologist John Veasey, a member of the Brazilian Society of Dermatology – São Paulo Regional (SBD-RESP), warts are skin lesions caused by the human papillomavirus virus. And, according to the Ministry of Health, there are over 150 different types of HPV!
Infection caused by this virus leads to an abnormal growth of cells in the epidermis and the lesions can have different shape, texture and color and be located in different parts of the body.
What are the types of warts?
• Common or common warts
More frequent in childhood, these warts present as irregular, hardened and rough lesions, which usually appear in areas of friction, such as the hands, fingers, elbows and knees. When they appear around the nails, they are called periungual warts.
• Plantar warts
They get their name because of their location: the soles of the feet. They are popularly known as “fish eye”, due to their dark dots in the center. They are often confused with corns and can be painful due to the pressure of the body weight.
• Anogenital warts (or condylomas)
They can appear in the genital mucosa and also in the urethra, vagina, cervix, perianal region or oral mucosa, and have a similar appearance to a cauliflower. They can be single or multiple. There are approximately 40 subtypes of HPV related to this type of wart. The most worrying are 12 of them, as they can progress to cancer of the cervix, vulva, vagina, penis, anus and oropharynx.
• Filiform warts
Older people are the most affected, presenting them on the face, neck, eyelids and lips. The name is due to the thin and elongated shape.
• Flat warts
They have the shape of brownish or yellowish balls and a smooth surface. They usually appear on the face and back of the hands of teenagers.
How does HPV cause warts?
The transmission of this virus occurs through contact with infected people or objects. For it to penetrate the skin, explains dermatologist Veasey, there must be a loss of epithelial cohesion, a break in the continuity of the skin, either by visible wounds to the naked eye, or by microfissures, which are imperceptible.
So it’s not a good idea to poke around at the wart, which can lead to self-inoculation. HPV can also be transmitted through sexual contact and via maternal-fetal at the time of delivery. Detail: the wart does not appear immediately. For the lesion to manifest, it can take weeks and even months after transmission. People with low immunity are more vulnerable to infection, as is the case with transplant patients.
Is it or is it not a wart?
The skin can present many “disorders”, such as moles or nevi (which arise from melanin-producing cells), lumps (such as lipomas, benign tumors composed of fat cells) and warts, among other manifestations. This creates a lot of confusion.
However, most of these lesions do not result from an HPV infection. In other words: they are not warts. And be careful: a skin cancer can be mistaken for a wart by a lay person.
Hey, is the wart gone?
Warts can disappear spontaneously, especially in children. On the other hand, it must not be forgotten that there is always a risk that the virus will proliferate through the skin and mucous membranes. As physician Veasey reminds us, the wart is an infectious disease, contagious through direct and/or indirect contact with the lesion, in addition to self-contamination and transmission to other people.
How to treat warts
The most important thing is an appointment with a dermatologist, who is trained to correctly make the diagnosis. John Veasey warns: not treating lesions, or worse, incorrectly treating a lesion such as a wart can complicate the condition and worsen an illness that can be serious.
Treating a wart varies depending on the type, location and age of the patient. The approach is divided into three major groups:
- Destructive/surgical: acids, electrocautery, cryotherapy, laser, or surgical removal of the lesion are used;
- Immunostimulation: systemic (oral drugs), intralesional (injections) or topical (creams);
- Antiproliferative: through topical or intralesional medications.
It is important to highlight that the vaccine for HPV virus is not therapeutic, that is, it does not treat clinical lesions, but acts to prevent the appearance of new lesions.
Sources: Health.com, with advice from the American Academy of Dermatology (AAD); Brazilian Society of Dermatology – São Paulo Regional (SBD-RESP)