Warts are numerous skin growths that appear on the hands, elbows, feet, face and even in the genital area. They have a round shape, protrude above the surface of the skin, and in case of mechanical damage, they bleed and cause discomfort. Outwardly, such formations look quite harmless, but in fact their appearance indicates the presence of human papilloma virus in the body.
Doctors' judgment 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 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-treatment. 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 is 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 infectious 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 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 the appearance
The cause of the appearance of warts on the body is the presence of the papilloma virus (HPV) in the body. One of the symptoms of this infection is neoplasms with a light body, which often have a multiple character.
According to statistics, up to 90% of the world's population is infected with papillomaviruses. More than 100 types of HPV have been identified, which can infect the skin and mucous membranes and provoke the development of changes characterized by papillomatous formations.
Once in the body, the 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.
In addition, 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 human papillomavirus or transmission from parents to a child. Also, the growths on the skin themselves (ie, warts) are contagious. It is also known that the virus can penetrate the basal layer of the epidermis through microtraumas.
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. The lesions caused by the human papilloma virus 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:
- Common or vulgar (verrucae vulgares). The most common form, which occurs more often in children of preschool age (approximately 70% of cases). They represent growths with a rough surface measuring up to several millimeters. There may be yellowishor grayish color. Initially, 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 the appearance of cracks 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, a group of several small ones forms around one vulgar wart, 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 clothes or shoes. Children often get infected at school, kindergarten or sports section. When identifying neoplasms of this type, it is important to carry out a differential diagnosis and exclude the presence of warty skin tuberculosis, keratoacanthoma and a number of other pathologies.
- Flat or young (verrucae planae verrucae juveniles). From the name of these neoplasms it is clear that they appear in adolescence or young age. Their feature is a slight protrusion above the surface of the skin, a round shape and a color that corresponds to the shade of the skin. Keratinization is mostly absent. The size of growths is up to 5–8 mm. They can be both single and multiple. Located on the face, neck, back of the hands. They may disappear spontaneously after 1-2 years. A differential diagnosis is made 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, this is the area of the metatarsal bones, heels or balls of the toes - the areas that are subjected to the greatest pressure and friction. Such growths can reach large sizes - up to 2 cm in diameter. Excessive friction can cause them to break apart 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 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 frequent manifestations of HPV in the anogenital area. Condylomas are found on the genitals or near the anus, sometimes in the groin, armpits, near the mammary glands and in the corners of the mouth. They come in different sizes and look somewhat like cauliflower. They are flesh-colored and can be on a thin stalk or a broad base in the form of a knot. Such growths are quite "fragile", so they often bleed. It is 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 internalfactors (for example, vitamin deficiency). Another feature is the simultaneous appearance of multiple 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 labia.
There are other, less common types of warts. The classification of formations takes into account the type of HPV that provokes their appearance, the nature of germination, size and external parameters. For example, A. N. Khlebnikova identified 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:
- Filamentous warts. Thin horny growths that appear on the face: near the nose, mouth, eyes. Usually diagnosed in older patients, they can have a broad or narrow base. We are very easily wounded.
- Bushke-Levenstein giant condyloma. This is a separate type of genital warts that initially appear as a cluster 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" warts. This is one of the types of vulgar warts that appear in people who often come into contact with raw fish or meat. They are cauliflower-shaped but flesh-colored neoplasms.
- Cystic warts. A type of growth on the legs 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 the cells of the neoplasm 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 against the virus, CT or MRI.
The treatment of warts in some cases depends on the cause of their appearance or more precisely the type of human papilloma virus. To determine the existing disease, a differential analysis of scrapings from 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 of patients is most often required in the presence of genital manifestations of HPV and includes the use of cytostatics.
To eliminate physical manifestations, physical or chemical methods of destruction are used. More than 30 different methods of treatment are described in modern medical literature, so it is very difficult to talk about a universal method. Y. Y. Stirschneider notes that many of the described techniques have a number of serious drawbacks (for example, incomplete radical removal, risk of developing intra- and postoperative complications, formation of various cosmetic defects). That is why the treatment method is chosen individually and only after a differential diagnosis.
The most popular treatment methods include:
- Cryodestruction. This method of removing warts involves exposing the affected areas to liquid nitrogen. Controlled tissue necrosis occurs, leading to 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 penetration). 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. In general, the procedure is painless and effective, but the result largely depends on the doctor's professionalism.
- 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: 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 growth is removed layer by layer: under the action of a laser beam, the damaged tissue is vaporized until it disappears completely. The exposure time varies from a few seconds to 2-3 minutes (depending on the size and number of formations). The procedure allows you to remove warts, papillomas and condylomas without invasive effects. Thanks to the immediate coagulation of the tissue under the action of a laser beam, the risk of secondary infection is eliminated. Therefore, the rehabilitation process proceeds quickly and without complications.
- Radio wave therapy. This technique involves the use of electromagnetic waves of a certain frequency. The procedure is performed using a special device (the Surgitron device is often used). During the exposure, the tissues are heated, as a result of which the cells of the formation are actually vaporized (similar to what happens with laser therapy).
- Chemicals. Salicylic plasters and applications of milk-salicylic collodion cannot be called a modern method of treatment, but 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 multiple procedures and prior 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 accompanying medical history of the patient, the presence of chronic pathologies and previously used methods are taken into account. Studies conducted using popular treatment methods show that laser destruction gives optimal results (76%). According to Yu. Y. 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 attempts to independently remove growths. In these cases, the patient experiences inflammation, further spread of the virus through the skin, or scar formation. So, if you find a wart or wart-like growth, don't try to burn it or cut it off yourself.