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 completely harmless, but in reality their appearance indicates the presence of the human papilloma virus in the body.
The doctors' verdict when such tumors appear is to remove them as quickly 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 which 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 slightly differ in color from 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 adhesion to 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 one reason only: the unsightly appearance of the growths and psychological discomfort due to their appearance.
As a rule, warts do not degenerate into malignant neoplasms. However, outwardly they can be confused with certain types of malignant pathologies. Therefore, a medical examination when such growths are detected is a mandatory measure to maintain health.
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Reasons for the appearance
The cause of warts on the body is the presence of the human papillomavirus (HPV) in the body. One of the symptoms of this infection is mild, often multiple, neoplasms.
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 only facilitated by certain factors, including:
- vitamin deficiency;
- 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 to a child from parents. Additionally, the growths on the skin (i. e. warts) themselves are contagious. We also know that the virus can penetrate the basal layer of the epidermis through microtrauma.
It should be noted that HPV does not always cause warts, as it can appear latent (hidden). In addition, the appearance of tumors depends on the subtype of infection that has entered the body. 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 papilloma virus can cause the following formations:
- Ordinary or vulgar (verrucae vulgares). Most common form, more common in preschool children (around 70% of cases). These are growths with a rough surface that can reach severalmillimeters. 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, their size can increase, causing great discomfort to the person. 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 location is the fingers, the backs of the hands; In children, growths are also found 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 may disappear on their own. But more often than not, their removal is necessary to avoid 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 predisposing to infection: the presence of microtrauma to the skin, recent shaving, hyperhidrosis, excessive pressure on the skin from clothing or shoes. Children are often infected at school, kindergarten or in the sports section. When identifying neoplasms of this type, it is important to carry out differentiated diagnosis and exclude the presence of warty skin tuberculosis, keratoacanthoma and a number of other pathologies.
- Flats or juveniles (verrucae planae verrucae juveniles). From the name of these neoplasms it is clear that they appear in adolescence or early 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 most often absent. The size of the growths can reach 5-8 mm. They can be single 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.
- Plantar (plantar warts). A common shape which, as its name suggests, appears on the soles of the feet. Typically, this is the area of the metatarsals, heels or tips 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 sharp 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 pain when walking, so they are always removed. Differential diagnosis is carried out with calluses and fungal skin lesions.
- Genital warts. This form of neoplasm is one of the common manifestations of HPV in the anogenital region. Condyloma 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 come in different sizes and look a bit like cauliflower. They are flesh-colored and can be on a thin stem or on a broad, nodule-shaped base. Such growths are quite "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, as well as various internal factors (for example, vitamin deficiency). Another characteristic is the simultaneous appearance of several genital warts. In men, such 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. A number of researchers are identifying more options and dividing them into small subgroups. Other common types of neoplasms include:
- Filiform warts. Thin horny growths that appear on the face: near the nose, mouth, eyes. Typically diagnosed in older patients, they can have a wide or narrow base. Very easily injured.
- Giant Buschke-Levenshtein condyloma. This is a distinct 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, and over time, an extensive lesion is formed with the inclusion of neighboring tissues in the process.
- "Butcher" warts. This is one of the types of common warts that appear in people who often come into contact with raw fish or meat. These are cauliflower-shaped neoplasms, but flesh-colored.
- Cystic warts. A type of growth on the feet that appears as soft knots with deep cracks. In case of injury, a white-yellow cheesy discharge appears.
Diagnosis of warts
In most cases, a visual examination and history are sufficient to make a diagnosis. To confirm the findings and exclude other pathologies, histological examination of neoplasm cells can be carried out.
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 scan or 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 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 up to 80% effectiveness. Drug treatment of patients is most often necessary in the presence of genital manifestations of HPV and includes the use of cytotoxic drugs.
To suppress 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 drawbacks (for example, incomplete removal of radicals, the risk of developing intra- and postoperative complications, the formation of various cosmetic defects). That is why the treatment method is chosen individually and only after differentiated diagnosis.
The most popular treatment methods include:
- Cryodestruction. This method of wart removal involves exposing the affected areas to liquid nitrogen. Controlled tissue necrosis occurs, resulting in complete elimination of the existing tumor. Cryodestruction can be carried out by application (suitable for warts up to 10 mm in diameter) and by aerosol (necessary for deep-growing growths in the tissues). The withdrawal is carried out in a single 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 to 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 elimination of the tumor thanks to the action of electric current. The technique is considered more effective than cryodestruction, but it also has disadvantages: 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 in our Altermed Aesthetic clinic in St. Petersburg. The removal of the growth is done layer by layer: under the action of a laser beam, the damaged tissue evaporates until it disappears completely. Exposure time varies from a few seconds to 2 to 3 minutes (depending on the size and number of growths). The procedure allows you to remove warts, papillomas and condyloma without invasive effects. Thanks to instantaneous coagulation of tissues under the action of a laser beam, the risk of secondary infection is eliminated. The rehabilitation process is therefore 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, resulting in evaporation of the forming cells (much like what happens during laser therapy).
- Chemical products. 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 is better for removing warts. 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 gives optimal results (76%). According to Yu. Yu. Stirschneider, 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 trying to remove growths yourself. In these cases, the patient suffers from inflammation, further spread of the virus through the skin or the formation of a scar. So if you find a wart or similar formation, do not try to cauterize or cut it off yourself.