Warts: causes, treatment and care in Luxembourg

Warts are small, harmless skin growths caused by human papillomaviruses (HPV) that infect the outer layer of the skin. They are extremely common, appear mostly on the hands and the soles of the feet (where they are called verrucas or plantar warts), often clear up on their own over time, and can be treated when they hurt or bother you. In Luxembourg, a general practitioner is the usual first port of call, a dermatologist handles stubborn or unclear lesions, and a podiatrist can help with painful plantar warts.

What exactly is a wart?

A wart is a localised overgrowth of skin triggered by a very ordinary virus. The HPV types behind skin warts are different from the strains involved in genital infections, and they are not dangerous. The virus enters through a tiny break in the skin, often one you never noticed, and makes skin cells multiply into the familiar rough little bump.

There are several forms. Common warts sit as rough domes on fingers and the backs of hands. Plantar warts grow on the sole of the foot, flattened by body weight, and can feel like walking on a small stone. Flat warts are smaller and smoother, sometimes appearing in clusters on the face or legs.

How warts spread: pools, changing rooms and bare feet

The virus passes on through direct contact with a wart or, more often, via contaminated surfaces. Warm, damp environments suit it well: swimming pool surrounds, communal showers, changing rooms and gym mats. Walking barefoot on these floors is the classic way to pick up a plantar wart, because water-softened skin lets the virus in more easily.

A few simple habits lower the risk without giving up swimming:

• wear flip-flops or pool shoes in changing rooms and communal showers;
• dry your feet thoroughly, including between the toes;
• do not share towels, socks or nail files;
• cover an existing wart with a waterproof plaster before swimming, out of consideration for others;
• avoid picking or biting warts, which spreads them across your own skin.

Do warts always need treatment?

No. The immune system frequently clears the virus by itself, and many warts disappear without any treatment within months to a couple of years, especially in children. If a wart is painless, small and not spreading, simply keeping an eye on it is a perfectly sensible choice.

Treatment makes sense when a wart hurts, spreads, multiplies, interferes with walking, or is cosmetically bothersome. The most common approaches are keratolytic preparations, which gradually peel away the infected hard skin, and cryotherapy, which destroys the lesion with cold. For resistant warts, a doctor may suggest curettage or laser treatment. No method works instantly for everyone: several sessions are often needed, and warts can come back as long as the virus lingers in the skin.

When to see a doctor, and which one

Most warts are no emergency, but some situations deserve a professional look:

• warts on the face: the skin there is thin and visible, so treatment belongs in the hands of a dermatologist rather than do-it-yourself peeling products;
• diabetes: any foot lesion in a person with diabetes should be checked by a professional — GP, podiatrist or dermatologist — because self-treatment risks wounds that heal poorly;
• diagnostic doubt: a lesion that bleeds, changes colour, grows quickly or simply does not look like a typical wart should be shown to a doctor, as other skin conditions, some of them serious, can be deceptive;
• numerous, recurrent warts, or warts that resist properly followed treatment;
• pain when walking caused by a plantar wart.

A GP can treat most warts in the practice. A dermatologist steps in for delicate locations, widespread warts and atypical lesions. A podiatrist looks after foot comfort, particularly when a plantar wart changes the way you walk.

How it works in Luxembourg

The usual route starts with your general practitioner, who diagnoses a wart — often at a glance — and either treats it or refers you to a dermatologist. You can also book directly with a dermatologist; no referral is required. Through Doctipro you can find a GP, dermatologist or podiatrist near you and book an appointment online.

Medical consultations for warts are covered by the national health fund (Caisse nationale de santé) under the standard reimbursement rules for medical care: patients generally pay upfront and are then reimbursed. Details and conditions are available on the CNS website. Podiatry care follows its own coverage rules, worth checking case by case.

Living with warts and preventing them

A treated wart can return, in the same spot or elsewhere; that does not mean the treatment failed, only that the virus was still present. Keeping skin healthy and moisturised, protecting small cuts on hands and feet, and sticking to good hygiene in damp communal areas all reduce the chance of a new infection. Children do not need to skip swimming or sport: pool shoes and a plaster cover the vast majority of situations.