Warts are multiple skin growths that appear on the arms, elbows, legs, face and even in the genital area. They are round in shape, protrude from the surface of the skin and, if mechanically damaged, bleed and cause discomfort. Outwardly, these formations seem quite harmless, but in reality their appearance indicates the presence of the human papillomavirus in the body.
The doctors' verdict when these types of tumors appear is to remove them as soon as possible. Only in this way can unpleasant consequences be avoided and the existing cosmetic defect completely eliminated. There are many methods to remove warts, each of them has certain characteristics 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 in this article cannot be used for self-diagnosis or self-medication. To make a correct diagnosis and prescribe treatment, you should always consult a doctor.
What is a wart?
It is a benign flesh-colored formation that represents a localized proliferation of the epidermis with papules (nodules) or plaques. Simply put, such formations do not differ or slightly differ from the color of the skin, but rise above its surface and have a characteristic round shape.
Complications of warts include cracking of the surface, growth of the affected areas, and joining the infection process. Additionally, some types of growths are painful. But most often, patients do not think about the possible consequences and seek help from a doctor for only one reason: the unsightly appearance of the growths and psychological discomfort due to their appearance.
Warts, as a rule, do not degenerate into malignant neoplasms. However, outwardly they can be confused with some types of malignant pathologies. Therefore, medical examination when such growths are detected is a mandatory measure to maintain health.
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Reasons for appearance
The cause of warts on the body is the presence of the papillomavirus (HPV) in the body. One of the symptoms of this infection is light body neoplasms, which are often multiple in nature.
According to statistics, up to 90% of the world's population is infected with the papillomavirus. 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.
Once in the body, papillomavirus infection does not always provoke the development of external manifestations. This is facilitated only by certain factors, including:
- avitaminosis;
- bad habits;
- the pregnancy;
- endometriosis, etc.
Additionally, HPV development can also occur against the background of a normally functioning immune system. It is worth noting that infection occurs through direct contact with an infected person. The most common methods of infection are through sexual contact with a person infected with human papillomavirus or transmission from parents to a child. Additionally, skin growths (i. e. warts) 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 they can occur latently (occult). Furthermore, the appearance of tumors depends on the subtype of infection that has entered the body. The lesions caused by the human papillomavirus are morphologically diverse, so only a doctor can make an accurate diagnosis.
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types of warts
The human papillomavirus can cause the following formations:
- Ordinary or vulgar (verrucae vulgares). The most common form, which is most common in preschool children (about 70% of cases). They are growths with a rough surface up to several millimeters in size. It may have a yellowish or grayish color. At first, their shade usually matches the skin tone, but then the formations begin to darken. Over time, they can increase in size, causing the person great discomfort. In addition, cases of cracks appearing around the wart are common. To the touch: rough and dense, covered with keratinized skin on top. The main location is the fingers, the back of the hands, in children there are also growths on the knees. Often, a group 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. But most of the time it is necessary to remove them to avoid injuries. The cause of the appearance of warts of this type is HPV types 1, 2, 4 and 7. The infection occurs through direct contact with a patient. There are also a series of factors that predispose to infection: presence of microtrauma to the skin, recent shaving, hyperhidrosis, excessive pressure on the skin from clothing or shoes. Children usually become infected at school, daycare or in the sports section. When identifying neoplasms of this type, it is important to make a differentiated diagnosis and exclude the presence of verrucous cutaneous tuberculosis, keratoacanthoma and other pathologies.
- Planes or juveniles (verrucae planae verrucae juveniles). From the name of these neoplasms it is clear that they appear in adolescence or early adulthood. Its peculiarity is a slight protuberance on 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 to 8 mm. They can be unique or multiple. Located on the face, neck, back of the hands. They may disappear spontaneously after 1 to 2 years. The differential diagnosis is made with lichen planus and molluscum contagiosum.
- Plantars (plantar warts). A common form that, as its name suggests, occurs on the soles of the feet. As a general rule, this is the area of the metatarsals, heels, or balls of the toes, the areas that are subject to the most pressure and friction. These growths can reach large sizes, up to 2 cm in diameter. Excessive friction can cause them to fall apart and cause injury. They usually have clear edges and a rough surface. Under the keratinized skin, blackheads are often seen - thrombosed capillaries. Color: yellow or brown. The cause of the appearance of such growths is HPV types 1 and 4. The pathological process can be superficial and deep. In the second case, warts cause discomfort and pain when walking, so they are always removed. The differential diagnosis is made with calluses and fungal skin lesions.
- Genital warts. This form of neoplasia is one of the common manifestations of HPV in the anogenital area. Condylomas are found on the genitals or near the anus, sometimes they are found in the groin, armpits, near the mammary glands and in the corners of the mouth. They come in different sizes and look a bit like cauliflower. They are flesh-colored and may have a thin stem or a wide nodule-shaped base. These growths are quite "brittle", so they often bleed. Sexually transmitted. Risk factors include the presence of sexually transmitted infections, frequent changes in sexual partners, disruption of the normal microflora of the vagina, pregnancy and various internal factors (for example, vitamin deficiency). Another characteristic is the simultaneous appearance of multiple genital warts. In men, these formations are often confused with a papular collar of the penis. In women, the pathology can be confused with micropapillomatosis of the lips.
There are other less common types of warts. The classification of formations takes into account the type of HPV that caused their appearance, the nature of germination, size and external parameters. For example, A. N. Khlebnikova identifies 8 clinical types of warts. Various researchers identify more options and divide them into small subgroups. Other common types of neoplasms include the following:
- Filiform warts. Fine horny growths that appear on the face: near the nose, mouth, eyes. Generally diagnosed in older patients, they can have a wide or narrow base. He gets injured very easily.
- Giant Buschke-Levenshtein condyloma. This is a separate type of genital warts, which initially appears as a group of multiple papillomas. As a rule, the growths are located in the area of the inguinal folds or vulva, over time an extensive lesion is formed with the inclusion of neighboring tissues in the process.
- "Butcher's" warts. This is one of the types of common warts that appears 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 growths on the feet that appear as soft nodules with deep cracks. When injured, a yellowish-white cheesy discharge appears.
Diagnosis of warts
In most cases, a visual examination and a history are sufficient to make a diagnosis. To confirm the conclusions and exclude other pathologies, histological examination of neoplastic cells can be performed.
If another infection is suspected, the doctor may prescribe additional diagnostic procedures. For example, a test for antibodies to the virus, CT, or MRI may be performed.
The treatment of warts in some cases depends on the cause of their appearance, or more precisely, the type of human papillomavirus present. To determine the existing disease, a differentiated analysis of epithelial cell scrapings from the urogenital tract is performed.
Removal methods
The goal of treatment is to remove the growths to prevent them from growing and recurring. Modern treatment methods provide up to 80% effectiveness. Drug therapy for patients is often required in the presence of genital manifestations of HPV and includes the use of cytotoxic medications.
To eliminate physical manifestations, physical or chemical methods of destruction 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 notes that many of the described techniques have a number of serious disadvantages (for example, incomplete radical removal, risk of developing intra- and postoperative complications, formation 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 wart removal method involves exposing the affected areas to liquid nitrogen. Controlled tissue necrosis occurs, resulting in complete removal of the existing tumor. Cryodestruction can be performed by application (suitable for warts up to 10 mm in diameter) and spray (required for growths with growth deep into the tissue). The extraction is carried out in one session, if necessary, the procedure is repeated after 1 to 2 weeks. This technique is used for a small number of warts (on average, up to 4 to 5 items) and a small treatment area. The procedure is generally painless and effective, but the result largely depends on the professionalism of the doctor.
- Electrocoagulation. Layer-by-layer removal of the tumor due to the action of electric current. The technique is considered more effective than cryodestruction, but it also has its drawbacks: after removal, scars often remain on the skin. 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 eliminated.
- Laser destruction. One of the most effective methods for removing warts is laser therapy. This is the preferred method at our Altermed Aesthetics clinic in St. Petersburg. Removal of growth occurs layer by layer: under the action of a laser beam, damaged tissue evaporates until its complete disappearance. Exposure time varies from 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. Due to the instant coagulation of tissue under the action of a laser beam, the risk of secondary infection is eliminated. Therefore, the rehabilitation process is quick and uncomplicated.
- Radio wave therapy. This technique involves the use of electromagnetic waves of a certain frequency. The procedure is carried out using a special device (the Surgitron device is often used). During exposure, tissue heating occurs, as a result of which the forming cells actually evaporate (very similar to what happens during laser therapy).
- Chemical products. Salicylic patches and lactic-salicylic collodion applications cannot be considered a modern treatment method, however, in some cases this technique is still used. For example, if there are contraindications for other procedures. Chemical removal is a complex process that requires repeated procedures and preliminary mechanical removal of the affected tissue.
It is very difficult to say unequivocally which method of removing warts is better. When choosing a technique, the doctor takes into account the type of formations, their size, number and location.
The patient's concomitant medical history, the presence of chronic pathologies and previously used methods are taken into account. Studies conducted with popular treatment methods have shown that laser destruction shows optimal results (76%). According to Yu. Yu. Stirschneider, these figures are higher than those of electrocoagulation (56%) and cryodestruction (44%).
Complications after removing warts are extremely rare. As a rule, consequences are possible after trying to remove the growths on your own. In these cases, the patient experiences inflammation, further spread of the virus through the skin, or the formation of a scar. Therefore, if you find a wart or a formation similar to it, do not try to cauterize or cut it off yourself.