Warts are multiple skin growths that appear on the hands, elbows, legs, face, and even in the genital area. They have a round shape, protrude above the surface of the skin, and if they are mechanically damaged, they bleed and cause discomfort. From the outside, such formations look quite harmless, but in fact their appearance indicates the presence of the human papilloma virus in the body.
Doctors' verdict 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 characteristics and indications. Let's understand 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-treatment. In order 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 the affected areas and joining the process of infection. 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 growths and psychological discomfort due to their appearance.
As a rule, warts do not degenerate into malignant neoplasms. However, externally they can be confused with some types of malignant pathologies. Therefore, a medical examination when such growths are detected is a mandatory measure to preserve health.
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Reasons for occurrence
The cause of warts on the body is the presence of papilloma virus (HPV) in the body. One of the symptoms of this infection are light body 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 that characterize papillomatous growths.
Once in the body, infection with the papilloma virus does not always cause the development of external manifestations. This is only facilitated by certain factors, including:
- avitaminosis;
- bad habits;
- pregnancy;
- endometriosis etc.
Moreover, the development of HPV can also occur against the background of the normal functioning of the immune system. It is worth noting that infection occurs through direct contact with an infected person. The most common ways of infection are sexual contact with a person infected with the human papillomavirus or transmission to a child from a parent. In addition, growths on the skin (or warts) are themselves 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 appear latently (hidden). In addition, the appearance of tumors depends on the subtype of infection that entered the body. Lesions caused by the human papillomavirus are morphologically different, so only a doctor can make an accurate diagnosis.
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Types of warts
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). These are growths with a rough surface up to several millimeters in size. It can 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 around the nipple. 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 one vulgar wart, and over time the affected areas only increase in size. As a rule, formations are not painful, but in rare cases they can disappear on their own. But most often it is necessary to remove them to prevent injuries. The cause of warts of this type are HPV types 1, 2, 4 and 7. Infection occurs through direct contact with the patient. There are also a number of factors that predispose to infection: the presence of microtrauma on the skin, recent shaving, hyperhidrosis, excessive pressure on the skin from clothing or shoes. Children often get infected at school, kindergarten or sports. When identifying neoplasms of this type, it is important to carry out a differential diagnosis and rule out the presence of warty tuberculosis of the skin, 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 specialty 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 growths is up to 5-8 mm. They can be single or multiple. It is 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.
- Verrucae plantares. A common form that, as the name suggests, occurs on the soles of the feet. As a rule, it is the area of the metatarsal bones, the heel or the pads 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 injure you. 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 type 1 and 4. The pathological process can be superficial or 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 frequent manifestations of HPV in the anogenital area. Condylomas are located on the genitals or near the anus, sometimes in the groin, armpits, near the mammary glands and in the corners of the lips. They are of different sizes and somewhat resemble 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 quite "fragile", so they often bleed. It is 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 characteristic is the simultaneous appearance of several genital warts. In men, such formations are often mistaken for 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. 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. Numerous 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 elderly patients, they may have a wide or narrow base. Very easily injured.
- Large Buschke-Levenshtein condylomas. This is a separate type of genital warts, which initially appears as a set of multiple papillomas. As a rule, the growths are located in the area of the inguinal folds or the vulva, over time an extensive lesion is formed with the involvement of neighboring tissues in the process.
- "butcher's" nipples. This is one of the types of warts vulgaris that occurs 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 nodules with deep fissures. In case of injury, a white-yellow cheesy discharge appears.
Diagnosis of warts
In most cases, visual examination and history taking are sufficient to establish the diagnosis. To confirm the conclusions and exclude other pathologies, a histological examination of 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 a virus, CT or MRI.
Treatment of warts in some cases depends on the cause of their appearance, more precisely on the type of human papillomavirus present. To determine the existing disease, a differentiated analysis of scraping of the epithelial cells of the urogenital tract is performed.
Removal methods
The goal of treatment is to remove growths to prevent regrowth and recurrence. Modern treatment methods provide up to 80% efficiency. Drug therapy for patients is most often required in the presence of genital manifestations of HPV and includes the use of cytotoxic drugs.
Physical or chemical methods of destruction are used to remove physical manifestations. 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, risk of developing intra- and postoperative complications, creation 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, which results 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 (necessary for growths with deep tissue growth). Removal is done in one session; if necessary, the procedure is repeated after 1-2 weeks. This technique is used for a small number of warts (up to 4-5 elements on average) and a small treatment area. The procedure is mostly painless and effective, but the result largely depends on the professionalism of the doctor.
- Electrocoagulation. Tumor removal layer by layer by electric current. The technique is considered more effective than cryodestruction, but it also has its drawbacks: 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 preferred method at our Altermed Aesthetic clinic in St. Petersburg. The removal of growths takes place layer by layer: under the influence of the laser beam, the damaged tissue is vaporized until it completely disappears. Exposure time ranges from a few seconds to 2-3 minutes (depending on the size and number of growths). The procedure allows the removal of warts, papillomas and condylomas without invasive effects. Due to the instant tissue coagulation under the influence of the laser beam, the risk of secondary infection is eliminated. Therefore, the rehabilitation process is fast and without complications.
- 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 the exposure, the tissue is heated, due to which the formed cells actually evaporate (similar to what happens during laser therapy).
- Chemicals. Salicylic plasters 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 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 accompanying history of the patient, the presence of chronic pathologies and previously used methods are taken into account. Research conducted using popular treatment methods has 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 wart removal are extremely rare. As a rule, consequences are possible after trying to remove 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 similar formation, do not try to cauterize it or cut it off yourself.