Warts are multiple skin growths that appear on the arms, elbows, legs, face and even in the genital area. They have a round shape, protrude above the surface of the skin, and if mechanically damaged, they bleed and cause discomfort. Externally, such formations seem quite harmless, but in fact their appearance indicates the presence of human papillomavirus in the body.
The verdict of doctors when such tumors appear is to remove them as soon as possible. This is the only way to avoid unpleasant consequences and completely eliminate the existing cosmetic defect. There are many methods for removing 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 and 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 differ slightly from the color of the skin, but rise above its surface and have a characteristic round shape.
Complications of warts include breaking of the surface, growth of the affected areas and joining the infection process. Additionally, some types of growths are painful. But very 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 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 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 cause the development of external manifestations. This is facilitated only by a few factors, including:
- avitaminosis;
- bad habits;
- pregnancy;
- endometriosis, etc.
Furthermore, the development of HPV can occur even in a context in which the immune system functions normally. 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 the human papillomavirus or transmission to a child from parents. Furthermore, the growths on the skin themselves (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 it can occur latently (hidden). Also, 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 more frequent 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 often matches the skin tone, but then the formations begin to darken. Over time, they can increase in size, causing great discomfort to a person. Furthermore, cases of cracks around the wart are frequent. To the touch: rough and dense, covered with keratinized skin on top. The main localization is the fingers, the back of the hands, in children growths are also found on the knees. Often, a cluster of several small ones forms around a vulgar 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 very often their removal is necessary to prevent injury. The cause of the appearance of warts of this type are HPV types 1, 2, 4 and 7. Infection occurs through direct contact with a patient. There are also a series of factors that predispose to infection: presence of microtraumas on 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 section. When identifying neoplasms of this type, 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 juvenile (verrucae planae verrucae juveniles). From the name of these neoplasms it is clear that they appear in adolescence or young adulthood. Their peculiarity is a slight protrusion above the skin surface, a round shape and a color that matches the skin tone. Keratinization is very often absent. The size of the growths is up to 5–8 mm. They can be single or multiple. Located on the face, neck, back of the hands. They may disappear spontaneously after 1-2 years. Differential diagnosis is carried out with lichen planus and molluscum contagiosum.
- Plantars (plantar warts). A common form that, as the name suggests, occurs on the soles of the feet. As a rule, this is the area of the metatarsals, heels or balls of the feet, the areas 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 sharp edges and a rough surface. Under keratinized skin, black dots are often visible - 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, so they should always be removed. Differential diagnosis is performed with calluses and fungal skin lesions.
- Genital warts. This form of neoplasm is one of the most common manifestations of HPV in the anogenital area. Warts 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 are different sizes and look a bit like cauliflower. They are flesh-colored and can be on a thin stem or on a wide base in the form of a nodule. Such growths are rather "fragile", so they often bleed. Sexually transmitted. Risk factors include the presence of sexually transmitted infections, frequent changes of sexual partners, disruption of normal vaginal microflora, pregnancy and various internal factors (for example, vitamin deficiency). Another feature is the simultaneous appearance of several genital warts. In men, such formations are often mistaken for a penile papular necklace. 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. Some researchers identify multiple options, dividing them into small subgroups. Other common types of neoplasms include the following:
- Filiform warts. Thin horny growths that appear on the face: near the nose, mouth, eyes. Usually diagnosed in older patients, they can have a wide or narrow base. Hurt very easily.
- Giant Buschke-Levenshtein condyloma. This is a separate type of genital warts, which initially appears as a cluster of multiple papillomas. As a rule, growths are located in the area of \u200b\u200bthe inguinal folds or vulva, over time an extensive lesion is formed with the inclusion of nearby tissues in the process.
- Butcher's warts. This is one of the types of verruca vulgaris that appears in people who often come into contact with raw fish or meat. They are cauliflower-shaped tumors, but they are flesh-colored.
- Cystic warts. A type of growths on the feet that appear as soft knots with deep cracks. When injured, a yellow-white cheesy discharge appears.
Diagnosis of warts
In most cases, visual examination and medical history are sufficient to make the diagnosis. To confirm the conclusions and exclude other pathologies, a histological examination of the neoplastic cells can be performed.
If another infection is suspected, your doctor may prescribe additional diagnostic procedures. For example, you can do an analysis to detect virus antibodies, a CT scan or an MRI.
The treatment of warts in some cases depends on the cause of their appearance or, more precisely, on the type of human papillomavirus present. To determine the existing disease, a differentiated analysis of scrapings of epithelial cells of the urogenital tract is performed.
Removal methods
The goal of treatment is to remove the growths to prevent regrowth and recurrence. Modern treatment methods provide effectiveness of up to 80%. Drug therapy for patients is often necessary in the presence of genital manifestations of HPV and includes the use of cytotoxic drugs.
To remove physical manifestations, physical or chemical methods of destruction are used. In modern medical literature, more than 30 different treatment methods are described, so it is very difficult to talk about a universal method. Yu. Y. Stischneider 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 method of removing warts 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 aerosol (required for growths with deep growth in the tissue). Removal occurs in one session; if necessary, the procedure is repeated after 1-2 weeks. This technique is used for a limited number of warts (on average up to 4-5 elements) and a small area to be treated. 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 thanks to the action of electric current. The technique is considered more effective than cryodestruction, but it also has 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, it is possible to remove large affected areas.
- Laser destruction. One of the most effective methods for removing warts is laser therapy. This is the preferred method in our Altermed Aesthetic clinic in St. Petersburg. Removal of growth occurs layer by layer: under the action of a laser beam, the damaged tissue is evaporated until it disappears completely. The 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. Thanks to the instant coagulation of the 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 performed using a special device (often the Surgitron device is used). During exposure, tissue heating occurs, following which the forming cells evaporate (very similar to what happens during laser therapy).
- Chemical substances. Salicylic patches and lactic-salicylic collodion applications cannot be called 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 the methods previously used are taken into consideration. Studies conducted using popular treatment methods have shown that laser destruction shows optimal results (76%). According to Yu. Y. Stischneider, these figures 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 scar formation. So, if you find a wart or a formation similar to it, do not try to cauterize or cut it yourself.