The long cold spell is finally coming to an end. With the passing of 입춘 (立春, Ipchun - the onset of spring of the 24 seasonal divisions in the Korean traditional calendar) and 우수 (Usu, 雨水 - the rain water of the 24 seasonal divisions in the Korean traditional calendar), the warm spring breeze is becoming more apparent. During times like these, when we experience the changing seasons, our bodies can become disrupted in harmony and balance. Our immunity can easily weaken, especially with significant temperature fluctuations, making us more susceptible to various illnesses.

One prominent disease is viral skin infections. Skin infections caused by viruses manifest as rashes or blisters on the skin or mucous membranes, with 'warts' being well-known. Skin troubles can occur frequently when fine or yellow dust is prevalent. In such times, even if infected with warts, one may fail to notice, missing the timing for treatment.

Warts can be divided into those caused by Human Papillomavirus (HPV) and those caused by Molluscum Contagiosum Virus (MCV). Warts caused by HPV can be further categorized based on the type of HPV or the symptoms they appear, such as common warts, flat warts, plantar warts, and genital warts. Common warts, the most frequently observed type, often appear around the fingers, nails, or backs of hands, with lesions protruding above the skin surface and having a rough texture.

Verruca plana warts, also known as "flat warts," do not protrude prominently above the skin surface and have a flat appearance. They are more common in children and adolescents than in adults. Dr. Seungyong Jung, co-founder of the SNU Skin Clinic in Mapo Gongdeok, explained, "The reason they occur more often in children is that their immune function is weaker than that of adults. Although the elderly also have weakened immune function, they have accumulated experience with antigens over time, which makes them less susceptible to warts." Flat warts are smaller and smoother in texture compared to common warts, often leading people to overlook them as warts. While they can occur anywhere on the body, they are most commonly found on the face, especially in areas where adults shave or receive skin treatments.

Plantar warts occur on the soles of the feet, and due to pressure from body weight, they do not protrude outward but rather embed into the skin, making them easily mistaken for calluses. However, they can be distinguished by cutting the surface to reveal the cross-section of blood vessels. Walking with plantar warts can cause discomfort, as if stepping on a stone inside the shoe, and in severe cases, they can cause significant pain akin to being pierced by a nail, hindering normal movement.

Genital warts, also known as condyloma or venereal warts, are a type of sexually transmitted infection (STI) characterized by distinct protrusions or flat shapes. They can appear as singular growths or in clusters. In males, they can occur on the penis, scrotum, or around the anus, while in females, they can appear on the labia, vulva, vagina, around the anus, or on the cervix. Unlike other types of warts, genital warts are associated with high-risk HPV infections, which can lead to cervical cancer, among other complications. Immediate medical attention is necessary. Genital warts can be transmitted through a single sexual encounter, and since they have an incubation period of about 2 to 3 months after virus infection, they may not be immediately detectable. Therefore, during this period, there is a high risk of transmission to others through sexual contact.

While most warts feel rough and firm when touched, water warts caused by MCV have a soft, squishy texture and easily rupture when scratched. They appear as small, round bumps on the skin, commonly found on the chest, arms, legs, and other body parts. They are more prevalent in children, earning them the nickname "juvenile warts." It is common for individuals with conditions like atopic dermatitis or psoriasis also to experience water warts.

Moreover, destroying the infected cells early on is crucial due to their highly contagious nature. Treatment methods include CO2 laser therapy, cryotherapy, and electrosurgery, among others, with the choice depending on the type of wart, its location, and the patient's age. The most commonly used treatment, CO2 laser therapy, involves removing the infected area with a laser after local anesthesia. However, it can lead to pigmentation and has a high recurrence rate. Cryotherapy involves spraying liquid nitrogen to freeze and destroy the affected tissue, though it may require multiple sessions. It is often combined with laser therapy and is one of the most widely used treatments. Electrosurgery involves burning the wart with electricity, but it can cause heat damage and may result in poor wound healing. Like CO2 laser therapy, it often leads to scarring and has a high recurrence rate, so it is not commonly used nowadays.

For common warts on the hands, treatments often involve CO2 laser therapy or cryotherapy and sometimes anti-cancer injections to inhibit cell and virus proliferation. Plantar warts can be treated similarly to common warts, and it's helpful to avoid wearing shoes that exert excessive pressure on the feet and to keep the feet dry. Flat warts can also be treated with CO2 laser therapy or oral medications, while genital warts can respond well to topical medications like podophyllin or Aldara Cream. However, wart removal doesn't signify the end of treatment. Wart treatment continues until the virus's roots are removed, and it's crucial to treat new warts as they appear. Since complete recovery in a short period is challenging, prevention is paramount.

Dr. Jung advises, "Since warts are highly contagious and prone to recurrence, it's best to avoid contact with individuals who have warts and refrain from sharing items such as shoes or towels. Additionally, the wart virus thrives in warm, humid environments with poor hygiene, such as swimming pools or damp shower floors, so wearing slippers or protective footwear in public showers or swimming pools can effectively prevent infection."

While warts are a viral infection, not everyone exposed to the virus will necessarily develop them. The fundamental cause lies in weakened skin function or compromised immunity, which hinders the body's ability to fight the virus. Therefore, rather than solely focusing on blocking the virus, it's essential to maintain regular skincare and immune system management to prevent the occurrence of warts.

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