Warts: why they appear and how to get rid of them

Warts are multiple skin growths that appear on the arms, elbows, legs, face, and even the genital area. They are round and protrude above the surface of the skin, and if mechanically damaged, they can bleed and cause discomfort. On the surface, the structures may seem harmless, but their presence actually indicates the presence of human papillomavirus in the body.When such a tumor appears, doctors conclude that it should be removed as quickly as possible. This is the only way to avoid unpleasant consequences and completely get rid of existing cosmetic flaws. There are many ways to remove warts, each with certain characteristics and indications. Let's figure out what methods are used in modern dermatology and how to identify the presence of warts on the body.

important!

The information in this article is not intended to be used for self-diagnosis and self-medication. In order to make a correct diagnosis and develop a treatment plan, you should always consult a doctor.

What are warts?

This is a benign, flesh-colored structure that represents a localized epidermal hyperplasia with papules (nodules) or plaques. In short, such structures are not different in color from the skin or slightly different, but are higher than its surface and have a characteristic rounded shape.Complications of warts include surface cracking, growth in the affected area, and joining the infection process. Additionally, some types of growths are painful. But most of the time, patients do not think about the possible consequences and seek help from a doctor for one reason only: the unsightly appearance of the growth and the psychological discomfort caused by its appearance.Generally, warts do not degenerate into malignant tumors. However, superficially, they may be confused with certain types of malignant lesions. Therefore, when such a growth is discovered, a doctor's examination is mandatory to maintain health.

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How to remove warts

Reason for occurrence

Warts appear on the body due to the presence of papillomavirus (HPV) in the body. One of the symptoms of this infection is light body tumors, which are often multiple in nature.According to statistics, up to 90% of the world's population is infected with papillomavirus. More than 100 HPV types have been found to infect the skin and mucous membranes and cause changes characterized by papilloma growth.Once inside the body, papillomavirus infection does not always cause the development of external manifestations. This can only be facilitated by certain factors, including:
  • Vitamin deficiency;
  • bad habits;
  • Pregnant;
  • Endometriosis, etc.
Additionally, the development of HPV can occur even in the presence of a functioning immune system. It is important to note that infection occurs through direct contact with an infected person. The most common methods of infection are through sexual contact with someone infected with human papillomavirus or from parent to child. Additionally, growths on the skin (i. e. warts) themselves are contagious. Viruses are also known to penetrate the basal layer of the epidermis through microtrauma.It's important to note that HPV does not necessarily cause warts, as it can be latent (hidden). Furthermore, the appearance of tumors depends on the subtype of infection that enters the body. The lesions caused by human papillomavirus come in many forms, so only a doctor can make an accurate diagnosis.

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warts on palms

Types of warts

Human papillomavirus can cause the following formation:
  • Common or vulgar (verrucae vulgares). The most common form, it is more common in preschool children (about 70% of cases). They are growths with a rough surface and can be several millimeters in size. May be yellowish or grey. At first, their color usually matches skin tone, but then the structure begins to darken. Over time, they can grow in size and cause great discomfort. In addition, cracks often appear around warts. It feels rough and dense, and is covered with keratinized skin. The main areas are the fingers and the back of the hands; in children, there are also growths on the knees. Often, a cluster of several small warts will form around a common wart, and the affected area will only grow larger over time. Generally, these forms are not painful, but in rare cases they disappear on their own. But in most cases, they need to be removed to prevent injury. These warts are caused by HPV types 1, 2, 4, and 7. Infection occurs through direct contact with a sick person. There are also many 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 become infected in schools, kindergartens or sports departments. When identifying this type of tumor, it is important to make a differential diagnosis and exclude the presence of verrucous cutaneous tuberculosis, keratoacanthoma, and many other lesions.
  • Verrucae planae verrucae juveniles. It is clear from the names of these tumors that they appear in adolescence or early adulthood. They are characterized by a slight bump above the skin's surface that is rounded in color and matches the skin's tone. Keratinization is usually absent. Growths can reach 5-8 mm in size. They can be single or multiple. Located on the face, neck, and back of hands. They may disappear on their own after 1-2 years. Differential diagnosis with lichen planus and molluscum contagiosum.
  • Plantar warts on the soles of the feet. As the name suggests, this is a common form that occurs on the soles of the feet. Generally speaking, this is the area of the metatarsal bone, heel, or toe ball—the area that experiences the most pressure and friction. This growth can reach large sizes - up to 2 cm in diameter. Excessive friction can cause them to splinter and cause injury. They usually have sharp edges and rough surfaces. Under the keratinized skin, dark spots - thrombosed capillaries - can often be seen. Color - yellow or brown. The cause of this growth is HPV types 1 and 4. Pathological processes can be superficial or deep-seated. In the second case, the warts cause discomfort and cause pain when walking, so they must be removed. Differential diagnosis is made through calluses and fungal skin lesions.
  • Genital warts. This form of neoplasia is one of the common manifestations of HPV in the anogenital region. Genital warts are found near the genitals or anus, sometimes in the groin, armpits, near the breasts, and at the corners of the mouth. They vary in size and look a bit like cauliflower. They are flesh-colored and can have thin stems or a broad, nodular base. The growth is very "fragile" and therefore bleeds frequently. Transmitted sexually. Risk factors include sexually transmitted infections, frequent changes in sexual partners, disruption of the normal vaginal microbiota, pregnancy, and various internal factors (such as vitamin deficiencies). Another characteristic is the simultaneous appearance of multiple genital warts. In men, this structure is often mistaken for a necklace of papules on the penis. In women, this pathology may be confused with labial micropapillomatosis.
There are other less common types of warts. Classification of morphologies takes into account the HPV type responsible for their appearance, the nature of germination, size and external parameters. For example, A. N. Khlebnikova identified 8 clinical types of warts. Many researchers have identified more options and divided them into small subgroups. Other common tumor types include:
  • Filiform warts. Thin keratinous growths appear on the face: nose, mouth, and around the eyes. Typically diagnosed in older patients, the base may be wider or narrower. Very prone to injury.
  • Giant Buschke-Lewenstein genital warts. This is a separate type of genital warts that initially presents as a group of multiple papillomas. Typically, the growth is located in the inguinal fold or vulvar area; over time, widespread lesions can develop, encompassing adjacent tissue in the process.
  • "Butcher's" wart. This is a type of common wart that appears in people who are frequently exposed to raw fish or meat. They are cauliflower-shaped tumors but are flesh-colored.
  • Cystic warts. A growth on the feet that appears as soft nodes with deep cracks. When injured, white-yellow cheese-like discharge will appear.

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, histological examination of tumor cells can be performed.If another infection is suspected, the doctor may prescribe additional diagnostic procedures. For example, analysis can be done to detect viral antibodies, CT or MRI.In some cases, treatment of warts depends on the cause of their appearance, or, more precisely, on the type of human papillomavirus present. To identify existing disease, differential analysis of scrapings of urogenital epithelial cells was performed.

Removal method

The goal of treatment is to remove the growth to prevent regrowth and recurrence. Modern treatments are up to 80% effective. When genital manifestations of HPV are present, patients most often require medical treatment, including the use of cytotoxic drugs.To eliminate physical manifestations, physical or chemical destruction methods can be used. More than 30 different treatments are described in modern medical literature, so it is difficult to speak of a universal approach. Yu. Yu. Stirschneider pointed out that many of the described techniques have a number of serious disadvantages (eg, incomplete radical resection, risk of intraoperative and postoperative complications, development of various cosmetic defects). That is why treatments are chosen individually and only after differential diagnosis.The most popular treatments include the following:
  • Freezing damage. This method of wart removal involves exposing the affected area to liquid nitrogen. Controlled tissue necrosis occurs, resulting in complete removal of the existing tumor. Cryodestruction can be carried out by application (for warts up to 10 mm in diameter) and aerosol (required for warts growing deep in the tissue). Removal is complete in one visit; the process can be repeated after 1-2 weeks if necessary. This technique is used for small numbers of warts (up to 4-5 elements on average) and smaller treatment areas. The procedure is usually painless and effective, but the results depend largely on the doctor's expertise.
  • Electrocoagulation. The tumor is removed layer by layer due to the effect of electric current. The technique is considered more effective than cryodestruction, but it has its drawbacks: scars often remain on the skin after removal. Therefore, this method is not used in situations where good aesthetics are important. However, with the help of electrical current, large affected areas can be removed.
  • Laser destruction. One of the most effective ways to remove warts is laser therapy. This is the preferred method at our Altemed Aesthetic clinic in St. Petersburg. The growth is removed layer by layer: under the action of the laser beam, the damaged tissue is evaporated until it completely disappears. Exposure times vary from a few seconds to 2-3 minutes (depending on the size and amount of growth). This surgery can remove warts, papillomas, and genital warts without invasive effects. Since the tissue coagulates immediately under the action of the laser beam, the risk of secondary infection is eliminated. Therefore, the recovery process is quick and complication-free.
  • Radio wave therapy. The technology involves the use of electromagnetic waves of a given frequency. The surgery is performed using special equipment (often a Surgitron device is used). During the exposure, the tissue heats up, so the cells that form actually evaporate (just like what happens during laser treatment).
  • Chemicals. The application of salicyl patches and lactated salicyl collodion cannot be called modern treatment methods, however, in some cases this technique is still used. For example, are there any contraindications to other surgeries. Chemical removal is a complex process requiring repeated procedures and preliminary mechanical removal of the affected tissue.
It's difficult to say definitively which method of wart removal is better. When choosing a technique, doctors consider the type, size, number, and location of the morphology.Taking into account the patient's concomitant medical history, the presence of chronic diseases, and previously used methods. Studies using popular treatments show that laser destruction shows the best results (76%). These numbers are higher than electrocoagulation (56%) and cryodestruction (44%), says Yu. Yu. Stirschneider.Complications after wart removal are extremely rare. Generally speaking, there can be consequences after trying to remove a growth on your own. In these cases, patients experience inflammation, further spread of the virus through the skin, or scarring. Therefore, if you find a wart or similar structure, do not try to cauterize or cut it off yourself.