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. Outwardly, such formations seem quite harmless, but in fact their appearance indicates the presence of the 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 get rid of the existing cosmetic defect. There are many methods for removing warts, each of them has certain features and indications. Let's figure 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 localized proliferation of the epidermis with papules (nodules) or plaques. Simply put, such formations do not differ or differ slightly from the skin in color, but rise above its surface and have a characteristic round shape.
Complications of warts include cracking of the surface, growth of affected areas and joining the infection process. In addition, some types of growths are painful. But most often, patients do not think about the possible consequences and seek the help of a doctor for only one reason - the unaesthetic 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, a doctor’s 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-bodied neoplasms, which are often multiple in nature.
According to statistics, up to 90% of the world's population is infected with papillomaviruses. More than 100 types of HPV have been identified that can infect the skin and mucous membranes and provoke 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;
- pregnancy;
- endometriosis, etc.
Moreover, the development of HPV 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 the human papillomavirus or transmission to a child from parents. In addition, the growths on the skin (that is, 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 occur latently (hidden). In addition, 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 common in preschool children (approximately 70% of cases). They are growths with a rough surface up to several millimeters in size. 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 a person great discomfort. In addition, there are frequent cases of cracks appearing around the wart. 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, around one vulgar wart, a cluster of several small ones forms, 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 often their removal is required to prevent injury. The cause of the appearance of warts of this type is HPV types 1, 2, 4 and 7. Infection occurs through direct contact with a patient. There are also a number of factors that predispose to infection: the 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 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 juveniles (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 surface of the skin, a round shape and a color that matches the shade of the skin. Keratinization is most often absent. The size of the growths is up to 5–8 mm. They can be either 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 (verrucae plantares). 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 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. Under the keratinized skin, black dots are often visible - 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 cause pain when walking, so they are always removed. Differential diagnosis is performed with calluses and fungal skin lesions.
- Genital warts. This form of neoplasm is one of the common manifestations of HPV in the anogenital area. Condylomas are located on the genitals or near the anus, sometimes found in the groin, armpits, near the mammary glands, and in the corners of the mouth. They have different sizes and look somewhat like cauliflower. They are flesh-colored and can be on a thin stalk or a wide base in the form of a nodule. Such growths are quite "brittle", so they often bleed. Transmitted sexually. 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 (for example, vitamin deficiency). Another feature is the simultaneous appearance of multiple genital warts. In men, such formations are often mistaken for a papular necklace of the penis. In women, the pathology can be confused with micropapillomatosis of the labia.
There are other, less common types of warts. Classification of formations takes into account the type of HPV that provoked their appearance, the nature of germination, size, and external parameters. For example, A. N. Khlebnikova identifies 8 clinical types of warts. A number of researchers identify more 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. Very easily injured.
- 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 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 warts vulgaris that appears in people who often come into contact with raw fish or meat. They are cauliflower-shaped neoplasms, but are flesh-colored.
- Cystic warts. A type of growths on the feet that appear as soft nodes with deep cracks. When injured, a white-yellow cheesy discharge appears.
Diagnosis of warts
In most cases, a visual examination and 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 perform an analysis to detect antibodies to the virus, CT or MRI.
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 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 up to 80% effectiveness. Drug therapy for patients is most often required 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. 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, the risk of developing intra- and postoperative complications, the formation of various cosmetic defects). That is why the method of treatment 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 the 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 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. 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 removed.
- Laser destruction. One of the most effective methods for removing warts is laser therapy. This is the method that is preferred in our Altermed Aesthetic clinic in St. Petersburg. The removal of the growth occurs layer by layer: under the action of a laser beam, the damaged tissue is evaporated until it completely disappears. The exposure time ranges 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 without complications.
- Radio wave therapy. This technique involves the use of electromagnetic waves of a given 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 formation cells actually evaporate (much like what happens during laser therapy).
- Chemicals. Salicylic patches and applications of lactic-salicylic collodion cannot be called a modern method of treatment, 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 using 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 attempts to remove growths on your own. In these cases, the patient experiences inflammation, further spread of the virus through the skin, or formation of a scar. So, if you find a wart or a formation similar to it, do not try to cauterize it or cut it off yourself.