Warts are some skin growths that appear on the arms, elbows, legs, face and also in the genital area. They have a round shape, protrude above the surface of the skin, and if damaged mechanically, they bleed and cause discomfort. Outwardly, such formations look quite harmless, but in fact their appearance indicates the presence of human papillomavirus in the body.
The doctor's decision when such a tumor appears is to remove it as soon as possible. This is the only way to avoid unpleasant consequences and completely get rid of existing cosmetic defects. There are many methods to remove warts, each of them has specific characteristics and indications. Let's think about what methods are used in modern dermatology and how to recognize the presence of warts on the body.
Important!
Information from this article should not be used for self-diagnosis and self-treatment. To make a correct diagnosis and prescribe treatment, you should always see a doctor.
What are warts?
These are benign, flesh-colored formations that represent localized proliferation of the epidermis with papules (nodules) or plaques. In short, the formation does not differ or differs slightly from the color of the skin, but rises above its surface and has a characteristic round shape.
Complications of warts include cracks on the surface, growth of the affected area and participation in the infection process. In addition, some types of growth are painful. But often, patients do not think about the possible consequences and seek the help of a doctor only for one reason - the unaesthetic appearance of growths and psychological discomfort due to their appearance.
Warts, as a rule, do not degenerate into malignant neoplasms. However, externally they can be confused with some types of malignant pathology. Therefore, a doctor's examination when the tumor is detected is a mandatory step to maintain health.
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Because of 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 a light-bodied neoplasm, which is often multiple.
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 trigger the development of changes characterized by papillomatous growth.
Once in the body, papillomavirus infection does not always trigger the development of external manifestations. This is only facilitated by certain factors, including:
- avitaminosis;
- bad habits;
- pregnancy;
- endometriosis, etc.
In addition, the development of HPV can also occur against the background of a normal functioning immune system. Keep in mind that infection occurs through direct contact with an infected person. The most common method of infection is through sexual contact with someone infected with human papillomavirus or transmission to children from parents. In addition, the growth on the skin (i. e. the wart) itself is contagious. It is also known that the virus can penetrate the basal layer of the epidermis through microtrauma.
Keep in mind that HPV does not always cause warts, as it can occur incognito (hidden). In addition, the appearance of tumors depends on the subtype of infection that has entered the body. Lesions caused by human papillomavirus are of various morphologies, so only a doctor can make an accurate diagnosis.
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Types of warts
Human papillomavirus can cause the following formations:
- Common, or vulgar (verrucae vulgares). The most common form, which is more common in preschool children (about 70% of cases). It is a growth with a rough surface up to several millimeters in size. May have a yellowish or gray color. At first, their shade often matches the color of the skin, but then the formation begins to darken. Over time, they can increase in size, causing a person discomfort. In addition, there are cases of cracks that often appear around the wart. To the touch - rough and dense, covered with keratin skin on top. The main localization is the fingers, the back of the hand; in children, growths are also present on the knees. Often, around one vulgar wart, a group of several small ones is formed, and over time, the affected area only increases in size. As a rule, formations are not painful, but in rare cases, they can disappear on their own. But often their removal is necessary to avoid injury. The cause of this type of wart is HPV types 1, 2, 4 and 7. Infection occurs through direct contact with the patient. There are also several factors that predispose to infection: the presence of microtraumas on the skin, recent shaving, hyperhidrosis, excessive pressure on the skin from clothes or shoes. Children are often infected at school, kindergarten or sports section. When identifying this type of neoplasm, it is important to carry out differential diagnosis and exclude the presence of warty skin tuberculosis, keratoacanthoma and some 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 on the surface of the skin, a round shape and a color that matches the shade of the skin. Keratinization is most often absent. The growth size 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.
- Plantar (verrucae plantares). A common form that, as the name suggests, occurs on the soles of the feet. As a rule, this is the metatarsal area, the heel or the ball of the toe - the area that is subject to the greatest pressure and friction. Such growths can reach large sizes - up to 2 cm in diameter. Excessive friction can cause it to crush and cause injury. They usually have clear edges and a rough surface. Under the keratin skin, black spots are often visible - thrombosed capillaries. Color - yellow or brown. The cause of the appearance of the tumor is HPV type 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 like cauliflower. They are flesh-colored and can be on thin stalks or wide bases in the form of nodules. 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 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 a formation is often mistaken for a penile papular necklace. In women, the pathology can be confused with micropapillomatosis of the labia.
There are other types of warts that are less common. The classification of formations takes into account the type of HPV that causes their appearance, the nature of proliferation, size, and external parameters. For example, A. N. Khlebnikova identified 8 types of clinical warts. Some 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.
- Buschke-Levenshtein giant condyloma. This is a separate type of genital wart, which initially appears as a group of multiple papillomas. As a rule, the growth is located in the area of the inguinal fold or the vulva; over time, extensive lesions are formed with the inclusion of neighboring tissues in the process.
- "Butcher's" warts. This is one of the types of warts vulgaris that appear in people who often come into contact with fish or raw meat. It is a cauliflower-shaped neoplasm, but flesh-colored.
- Cystic warts. A type of growth on the leg that appears as a soft nodule with deep fissures. When injured, a brownish-white discharge appears.
Diagnosis of warts
In most cases, visual examination and history taking are sufficient to make the diagnosis. To confirm the conclusion and exclude other pathologies, a histological examination of neoplasm cells can be performed.
If other infections are suspected, the doctor may prescribe additional diagnostic procedures. For example, it is possible to perform an analysis to detect antibodies to viruses, 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 differential analysis of scraping of epithelial cells of the urogenital tract is performed.
Removal method
The goal of treatment is to remove the tumor 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 eliminate physical manifestations, physical or chemical destruction methods 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 states that many of the described techniques have some serious drawbacks (for example, incomplete radical removal, the risk of developing intra- and postoperative complications, the formation of various cosmetic defects). That is why treatment methods are chosen individually and only after a different diagnosis.
The most popular treatment methods include the following:
- Cryodestruction. This method of removing warts involves exposing the affected area to liquid nitrogen. Controlled tissue necrosis occurs, resulting in complete removal of the existing tumor. Cryodestruction can be done by application (suitable for warts up to 10 mm in diameter) and aerosol (necessary for growth with deep growth in tissue). Removal takes place 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. This procedure is generally painless and effective, but the results depend on the professionalism of the doctor.
- Electrocoagulation. Layer by layer removal of the tumor due to the action of electric current. This 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 ways to get rid of warts is laser therapy. This is the preferred method at our Transforming Aesthetics clinic in St. Petersburg. The removal of the growth occurs layer by layer: under the action of the laser beam, the damaged tissue is vaporized until it disappears completely. Exposure time ranges from a few seconds to 2–3 minutes (depending on the size and number of growths). This procedure allows you to remove warts, papillomas, and condylomas without invasive effects. Due to the immediate freezing of tissue under the action of the laser beam, the risk of secondary infection is eliminated. Therefore, the recovery process is quick and without complications.
- Radio wave therapy. This technique involves the use of electromagnetic waves at a certain frequency. This 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 (similar to what happens during laser therapy).
- Chemical substance. Salicylic stains and the use of lactic-salicylic collodion cannot be called modern treatment methods, 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 initial mechanical removal of affected tissue.
It is very difficult to say clearly which method of removing warts is better. When choosing a technique, the doctor takes into account the type of formation, its size, number, and location.
The concomitant medical history of the patient, the presence of chronic pathology, 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, this figure is higher than the figure of electrocoagulation (56%) and cryodestruction (44%).
Complications after removing warts are very rare. As a rule, the consequences are possible after an attempt to remove the growth itself. In this case, the patient experiences inflammation, further spread of the virus through the skin, or scar formation. So, if you find a wart or a similar formation, do not try to burn it or cut it yourself.