Warts are multiple skin growths that appear on the arms, elbows, legs, face, and even the genital area. They have a round shape, protrude above the surface of the skin and, when mechanically damaged, bleed and cause discomfort. Externally, such formations seem quite harmless, but in fact their appearance indicates the presence of the human papilloma virus in the body.
When such tumors appear, doctors advise removing them as quickly as possible. This is the only way to avoid unpleasant consequences and to completely eliminate the existing cosmetic defect. There are many methods of wart removal, each of which has certain features and indications. Let's find out what methods are used in modern dermatology and how to recognize the presence of warts on the body.
Important!
The information from this article cannot be used for self-diagnosis and self-medication. To make a correct diagnosis and prescribe treatment, you should always consult a doctor.
What is a wart?
This is a benign, flesh-colored formation that represents a local growth of the epidermis with papules (nodules) or plaques. To put it simply, such formations do not differ in color or differ only slightly from the skin, but rise above its surface and have a characteristic round shape.
Complications of warts include cracks in the surface, growth of the affected areas and involvement in the infectious process. In addition, some types of growths are painful. However, most often patients do not think about the possible consequences and consult a doctor for only one reason: the unaesthetic appearance of the growths and psychological discomfort due to their appearance.
Warts generally do not develop into malignant neoplasms. However, externally they can be confused with some types of malignant pathologies. Therefore, if such growths are detected, a medical examination is a mandatory measure to maintain health.
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Reasons for appearing
The cause of warts on the body is the presence of the papilloma virus (HPV) in the body. One of the symptoms of this infection is mild neoplasms, which are often multiple in nature.
According to statistics, up to 90% of the world's population is infected with papilloma viruses. More than 100 types of HPV have been identified that can infect the skin and mucous membranes and cause the development of changes characterized by papillomatous growths.
In the body, papillomavirus infection does not always lead to the development of external manifestations. This is only facilitated by certain factors, including:
- avitaminosis;
- Bad habits;
- Pregnancy;
- endometriosis etc.
In addition, the development of HPV can also occur against the background of a normally functioning immune system. It should be noted that infection occurs through direct contact with an infected person. The most common methods of infection are sexual contact with a person infected with human papillomavirus or transmission from parent to child. In addition, the growths on the skin (i. e. warts) themselves are contagious. It is also known that the virus can penetrate the basal layer of the epidermis through microtrauma.
It is worth noting that HPV does not always cause warts as it can be latent (hidden). In addition, the appearance of tumors depends on the subtype of infection that has entered the body. The lesions caused by human papillomavirus are morphologically diverse, so only a doctor can make an accurate diagnosis.
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Types of warts
Human papillomavirus can cause the following formations:
- Common or vulgar (Verrucae vulgares). The most common form, which occurs more often in preschool children (about 70% of cases). These are growths up to several millimeters in size with a rough surface. May be yellowish or grayish in color. Their shade often initially matches the skin tone, but then the formations begin to become darker. Over time, they can increase in size and cause great discomfort to the person. In addition, cracks often occur around the wart. Rough and dense to the touch, covered with keratinized skin on top. The main location is the fingers, the backs of the hands, and in children there are also growths on the knees. Often a cluster of several small warts forms around a common wart, and over time the affected areas only increase in size. As a rule, the formations are not painful, but in rare cases they can disappear on their own. However, most of the time their removal is necessary to prevent injury. The cause of the appearance of these warts are HPV types 1, 2, 4 and 7. The infection occurs through direct contact with a patient. There are also a number of factors that favor infection: microtraumas to the skin, recent shaving, hyperhidrosis, excessive pressure on the skin from clothing or shoes. Children often become infected at school, kindergarten or in the sports department. When identifying such neoplasms, it is important to carry out a differentiated diagnosis and exclude the presence of warty skin tuberculosis, keratoacanthoma and a number of other pathologies.
- Flat or juveniles (Verrucae planae verrucae juveniles). From the name of these neoplasms it is clear that they appear in adolescence or young adulthood. Their distinctive feature is a slight protrusion above the surface of the skin, a round shape and a color that matches the skin tone. Keratinization is usually absent. The size of the growths is up to 5-8 mm. They can be either single or multiple. Located on the face, neck and back of the hands. They can disappear spontaneously after 1-2 years. The differential diagnosis is lichen planus and molluscum contagiosum.
- Plantars (Verrucae plantares). A common form that, as the name suggests, occurs on the soles of the feet. Typically this is the area of the metatarsals, heels or balls of the toes - the areas that are subject to the greatest pressure and friction. Such growths can reach large sizes - up to 2 cm in diameter. Excessive friction can cause them to crumble and cause injury. They usually have clear edges and a rough surface. Black dots are often visible under the calloused skin - thrombosed capillaries. Color – yellow or brown. The cause of the appearance of such growths are HPV types 1 and 4. The pathological process can be superficial and deep. In the second case, warts cause discomfort and pain when walking, which is why they are always removed. The differential diagnosis is made for corneal and fungal skin changes.
- Genital warts. This form of neoplasia is one of the most common manifestations of HPV in the anogenital region. Condylomas are found on the genitals or near the anus, sometimes in the groin, armpits, near the mammary glands, and in the corners of the mouth. They are different sizes and look a bit like cauliflower. They are flesh-colored and may stand on a thin stem or a broad, tuberous base. Such growths are quite "brittle" and therefore often bleed. Sexually transmitted. Risk factors include the presence of sexually transmitted infections, frequent changes of sexual partners, disruption of the normal microflora of the vagina, pregnancy, as well as various internal factors (e. g. vitamin deficiency). Another feature is the simultaneous appearance of several genital warts. In men, such formations are often confused with a papular chain of the penis. In women, the pathology can be confused with micropapillomatosis of the labia.
There are other, less common types of warts. When classifying formations, the type of HPV that provoked their appearance, the type of germination, size and external parameters are taken into account. For example, A. N. Khlebnikova identifies 8 clinical types of warts. A number of researchers identify additional options and divide them into small subgroups. Other common types of neoplasms include the following:
- Thread warts. Thin horny growths that appear on the face: near the nose, mouth, eyes. They are usually diagnosed in older patients and can have a wide or narrow base. Very easily injured.
- Huge Buschke-Levenshtein condyloma. This is a separate type of genital warts that initially appears as a collection of several papillomas. As a rule, growths are located in the area of the inguinal folds or vulva; over time, an extensive lesion is formed, involving neighboring tissues.
- "Butcher's warts". This is one of the types of warts vulgaris that occurs in people who often come into contact with raw fish or meat. They are cauliflower-shaped neoplasms, but flesh-colored.
- Cystic warts. A type of growth on the feet that appears as soft nodules with deep cracks. When injured, a white-yellow, cheesy discharge appears.
Diagnosis of warts
In most cases, a visual examination and a history taking are sufficient to make a diagnosis. To confirm the conclusions and exclude other pathologies, a histological examination of the neoplasm cells can be performed.
If another infection is suspected, the doctor may prescribe additional diagnostic procedures. For example, it is possible to carry out an analysis to detect antibodies to the virus, CT or MRI.
Treatment of warts in some cases depends on the cause of their appearance, more specifically the type of human papillomavirus present. To determine the present disease, a differentiated analysis of scrapings of epithelial cells from the urogenital tract is carried out.
Removal methods
The goal of treatment is to remove the growths to prevent regrowth and recurrence. Modern treatment methods offer an effectiveness of up to 80%. Drug therapy for patients is most often required for genital manifestations of HPV and includes the use of cytostatic drugs.
To eliminate physical manifestations, physical or chemical destruction methods are used. More than 30 different treatment methods are described in modern medical literature, so it is very difficult to talk about a universal method. Yu. Yu. Stirschneider points out that many of the techniques described have a number of serious disadvantages (e. g. incomplete radical removal, the risk of intra- and postoperative complications, the emergence of various cosmetic defects). That is why the treatment method is chosen individually and only after a differentiated diagnosis.
The most popular treatment methods include the following:
- Cryodestruction. This method of wart removal involves exposing the affected areas to liquid nitrogen. Controlled tissue necrosis occurs, leading to the complete removal of the existing tumor. Cryodestruction can be carried out by application (suitable for warts up to 10 mm in diameter) and aerosol (required for growths with deep growth in the tissue). The removal is carried out in one session; if necessary, the procedure is repeated after 1-2 weeks. This technique is used for a small number of warts (on average up to 4-5 elements) and a small treatment area. The procedure is generally painless and effective, but the result largely depends on the professionalism of the doctor.
- Electrocoagulation. Removal of the tumor layer by layer using electric current. The technique is considered more effective than cryodestruction, but it also has disadvantages: scars often remain on the skin after removal. Therefore, this method is not used in cases where a good aesthetic result is important. However, with the help of electric current, large affected areas can be removed.
- Laser destruction. One of the most effective methods for removing warts is laser therapy. This is the method preferred in our Altermed Aesthetic clinic in St. Petersburg. The growth is removed layer by layer: under the influence of a laser beam, the damaged tissue is vaporized until it disappears completely. The exposure time is a few seconds to 2-3 minutes (depending on the size and number of growths). The procedure allows you to remove warts, papillomas and condylomas without invasive effects. Immediate coagulation of tissue under the influence of a laser beam eliminates the risk of secondary infection. Therefore, the rehabilitation process is quick and without complications.
- Radio wave therapy. This technique uses electromagnetic waves of a specific frequency. The procedure is carried out using a special device (the Surgitron device is often used). During exposure, heating of the tissue occurs, which actually causes the formation cells to vaporize (similar to laser therapy).
- Chemicals. Salicylic patches and the use of lactic acid-salicylic collodion cannot be called a modern method of treatment, but in some cases this technique is still used. For example, if there are contraindications to other procedures. Chemical removal is a complex process that requires repeated procedures and prior mechanical removal of the affected tissue.
It is very difficult to say unequivocally which method of wart removal is better. When choosing a technique, the doctor takes into account the type of formations, their size, number and location.
The patient's concomitant diseases, the presence of chronic pathologies and previously used methods are taken into account. Studies conducted using common treatment methods have shown that laser destruction provides optimal results (76%). According to Yu. Yu. According to Stirschneider, these numbers are higher than those for electrocoagulation (56%) and cryodestruction (44%).
Complications after wart removal are extremely rare. As a rule, consequences are possible after attempts to remove growths on their own. In these cases, the patient experiences inflammation, further spread of the virus through the skin, or scarring. So if you find a wart or similar formation, do not try to cauterize it or cut it off yourself.