Wart - Symptoms and Treatment

What is a wart? We will analyze the causes, diagnoses and treatment methods in a dermatologist article with 37 years of experience.

Warts on hand

Definition of disease. Causes of the disease

Wartsare mild benign irregular skin lesions in the form of localized overgrowth of the upper layer of the skin (epidermis) with papules (nodules) or plaques.

The incidence of warts in adults is 7-12%, in school-aged children - up to 10-20%.

Warts are very similar to other skin lumps. Usually, a person cannot accurately determine the disease on his own, so a dermatologist should be consulted to make a diagnosis.

Human papillomavirus is the cause of warts. The type of virus affects the type of warts that can develop. Thus, each type of human papillomavirus infects the tissue at its most characteristic location.

HPV type Preferred location
Types of warts
1 Feet, knees, palms,
hands, fingers
Plantar and palmar warts,
rarely simple warts
2, 4 Hands, fingers, knees,
less often - feet
Simple warts,
occasionally plantar, palmar
and mosaic warts
3, 10 Shins, hands, face Flat warts
7 Hands, fingers Butcher's warts
5, 8, 9, 12, 14,
15, 17, 19-24
Face, arms,
front trunk
Verruciform epidermodysplasia

Virus infection usually occurs through contact - direct contact with infected and healthy skin (for example, by shaking hands) or indirectly (through handrails, toys, etc. ). Therefore, you can become infected with human papillomavirus, which causes warts, in the most diverse places - in public transport, at school, at work, at home, in places of high contact and in a humid environment (swimming pools, saunas, gyms). Minor trauma to the epidermis, where viruses enter, as well as skin inflammation, contribute to infection.

Also contributing to the appearance of warts:

  • immunodeficiencies (including HIV infection);
  • hot and humid environment;
  • the need for professional contact with meat and fish ("butcher's warts").

Some types of human papillomavirus are transmitted by parents.

But frogs and toads, despite the horror stories that scare us so much in childhood, cannot be infected - this is one of the most popular myths about this disease, which has no basis.

If you encounter similar symptoms, consult your doctor. Don't self-medicate - it's dangerous to your health!

Symptoms of warts

Symptoms vary depending on the type of wart.

Common wart on examination and dermatoscopy

Common wart:

  • Round and dense papule of normal color, 1-10 mm and more.
  • The wheal surface is covered by cracks, layers.
  • If the wheal is on the finger, the impression disappears and is distorted. The same goes for the palm design.
  • Simple warts are located individually and in several parts - they usually appear in the places of greatest injury (hands, fingers, knees).
  • When seen with a dermatoscope, the doctor may see small brown spots - clogged (clogged) capillaries. Patients often refer to these points as "roots". This is the main signal for a doctor: a dermatologist can use it to distinguish a mole from other similar diseases (for example, molluscum contagiosum and keratoma).

Plantar wart (horny):

  • The main symptom that usually causes a patient to see a doctor is pain when pressing and walking.
  • These warts are usually located on the feet.
  • When contacting the doctor, as a rule, an irregular keratinous plaque of the usual color is visible, although in the first stage you may see a uniform and smooth papule. With keratinization, capillaries can be seen only if the keratinized layer of the skin is removed.
  • The sole's leather pattern is distorted.
  • Plantar warts are usually solitary, but there are also 2 to 6 warts;
  • these warts are often mistaken for corn (especially dry) - this is the description of the problem that patients usually look for.
Flat warts on the face

Flat wart (juvenile):

  • It looks like a round, transparent and smooth papule of normal color, pink or brown, with size 1-5 mm.
  • Appears on the hands, shins and very often on the face.
  • There are always several of these warts - they are located in groups.

Verruciform epidermodysplasia (senile wart):

  • Large, round, numerous confluent neoplasms of normal pink or brown color.
  • Appear more often on the face, arms, front of the torso.
  • May be confused with keratoma, shingles and skin cancer.

Pathogenesis of warts

When it enters the body, the human papillomavirus can remain in a latent state for a long time - the person generally does not even know about its existence. When factors favorable to the virus appear, it begins to "multiply" in the epithelium, leading to tissue changes.

Unlike other viruses, the human papillomavirus does not destroy the cells of the epithelium itself - they die on their own, naturally, in the process of keratinization and desquamation.

Local factors and the state of the immune system affect the spread of the infection. For example, people with HIV infection or kidney transplants are more likely to develop warts. In addition, these neoplasms are often difficult to treat. With normal immunity, the virus does not affect the deep layers of the skin, so many people acquire warts on their own after a few months.

The main stage in the appearance of warts is the acceleration of the rate of division and cell growth with the help of the virus. This rapid metabolism leads to thickening of the skin layers. As the tissues grow in a certain small area, a tuber appears, which is called a wart.

Classification and stages of development of the wart

There is no universally accepted classification for warts. However, there are several common varieties:

  • The common wartis the most common type (70% of the warts are just them). These neoplasms are not felt and cause only aesthetic discomfort to the person.
  • Plantar wart- appears on the soles of the feet, is painful, therefore requires treatment. Trauma to the skin due to uncomfortable, tight and abrasive shoes contributes to the occurrence of this wart.
  • Flat warts- appear more frequently in young people, adolescents. This is due to the unstable hormonal context of young people, which affects the whole body. Typically, flat warts are almost invisible.
  • Senile warts- are typical of the elderly. They often appear on the part of the body that is covered with clothing, but they can occur on the face and hands. If there is no discomfort, these warts should not be treated - healing in older people can be much slower than in younger people, due to slow metabolism.
Mosaic wart and butcher wart

Other authors distinguish several other types of warts:

  • Warts in mosaic(HPV 2, 4) - neoplasms on the palms and soles. They look like foci of hyperkeratosis, that is, thickening of the stratum corneum (usually in the forefoot), covered with deep fissures.
  • Cystic warts(HPV 60) are a very rare type of growth on the foot. It is a soft knot with cracks. After opening, a white-yellow discharge looks like curd.
  • Filiform wartsare thin horny bulges near the mouth, nose or eyes.
  • "Butcher" warts(HPV 7) - appear on the hands and fingers of people who are constantly in contact with meat and fish. Presented as hypertrophied neoplasms similar to cauliflower, but of normal color.

In addition, the types of warts are differentiated depending on their location.

For example, anogenital warts - tumor-like neoplasms that appear on Organs genitals (especially where the skin transitions to the mucous membrane) are common diseases. They are usually caused by HPV types 6 and 11.

Wart complications

The main reason why patients with warts see a doctor is an aesthetic defect that can affect the patient's quality of life, their self-confidence and develop many complexes. Complications include cracks on the surface of the wart and addition of infection and, in some types of warts, pain when walking.

Skin warts generally do not degenerate into malignant neoplasms, they are quite harmless, however, in very rare cases, such a complication can still occur in people with suppressed immunity.

Other complications arise when you try to remove the tumor yourself. In this sense, inflammation and aesthetic defects in the form of scars can occur, as well as the additional spread of the virus through the skin, so that in the morning after the self-removal of a wart, the individual may wake up with several new ones.

Remember that, under the guise of a wart, a completely different disease can be hidden, which cannot be determined without the advice of an experienced doctor.

Dermatoscopy of the wart

Diagnosis of warts

An examination (clinical picture) and a history (medical history) are usually sufficient to make a diagnosis.

To confirm the diagnosis, the doctor may perform a histological examination - the study of the neoplasia cells.

It is very important to make a differential diagnosis - to distinguish warts from other diseases. For example,common wartsshould be differentiated from the following diseases:

  • Molluscum contagiosum- appears more frequently on the body and genitals, less frequently on the hands and feet. It is a hemisphere with an impression on the surface; when pressed on the sides, a whitish "porridge" is released.
  • Epidermal warty nevus- most often solitary, a person has had since birth. It rises above the surface of the skin, usually covered with hair.
  • Basalioma- a tumor in the form of a roll of nodules, covered by a crust in the center. Typical for the elderly.

Palmar-plantar wartsmust be differentiated from the following diseases:

  • Keratoderma- large areas of keratinization and inflammation of the skin. No clotted capillaries.
  • Palmoplantar syphilides- multiple painless neoplasms, skin exfoliations along the periphery. The reaction to syphilis is positive.
  • Corn- usually painless, can only cause pain when pressed vertically.

The doctor must also differentiate other types of warts from various diseases. If another pathology is suspected, he may prescribe additional diagnoses (for example, detection of antibodies to viruses, computed tomography or MRI).

Warts treatment

Warts are treated for aesthetic purposes and to improve the patient's quality of life. It can only be prescribed by a doctor after an examination and a diagnosis diagnosed accurately. Independent attempts to get rid of the wart are unacceptable, since a patient with no medical education and the necessary equipment is unable to accurately determine the disease, and complications after this "treatment" occur much more frequently than recovery.

There are several ways to treat warts. All of them are usually performed under the supervision of a doctor, and some of them - only in the clinic's treatment room.

Chemical treatments for warts

Chemical treatments

Salicylic milk collodion and salicylic adhesives are used to get rid of the wart. The percentage of medications and the method of use (prolonged use of dressings, applications, etc. ) depend on the prevalence and location of the neoplasm.

Zinc and 2-chloropropionic acid solutions can also be used. In this case, a chemical composition is applied to the pre-treated surface, which remains on the wart until the color changes (depending on the type of wart). The procedure is repeated several times after 7, 14 and 21 days. Before each procedure, the tissue is removed mechanically.

Another chemical method is a combination of nitric, acetic, oxalic, lactic acids and copper nitrate trihydrate. In this way, only relatively small neoplasms are treated - up to 5 mm. The solution is also to change the color of the wart. After 3-5 days, the patient comes for a follow-up visit, if necessary, he is prescribed a second procedure in 1-4 weeks.

Treatment of a wart with liquid nitrogen

Cry-destruction

This method consists of freezing the wart with liquid nitrogen: a moistened cotton swab is pressed against the damaged skin (with capture of the surrounding tissue for a few mm) for 1-5 minutes. Some injuries require multiple treatments every four weeks to be destroyed.

The main disadvantages of cryodestruction are its pain and delayed effect compared to other methods, in which only one procedure is often sufficient for removal.

Electrocoagulation

Under the influence of an electric current, the wart is removed in layers. This operation is performed under local anesthesia.

This method is more effective than freezing, but it has a significant disadvantage: electrocautery generally leaves scars at the site of the wart removal. For those patients looking to correct a cosmetic defect,Skin after laser removal of warts on the legthis method will not be the most suitable.

Laser destruction

The laser also removes warts in layers. The light guide comes in contact with the skin for several seconds to three minutes, depending on the size. Then, the scab that appears is excised and the lower part of the wound is treated with a laser again. The patient is then instructed on how to deal with the wound. The operation itself is performed under the influence of local anesthesia.

Radio wave surgery

Radio wave surgery is one of the most modern and gentle methods of removing some benign neoplasms, including warts.

The method is based on the generation of electromagnetic waves with different frequencies: from 100 kHz to 105 MHz. During the procedure, the tissues resist the passing waves, which is why the molecular energy is released in the cells, which heats theskin. Under the influence of heat, the cells actually evaporate - a precise cut is obtained. At the same time, no mechanical force is exerted on the affected tissue.

Advantages of this method:

  • security;
  • rapid healing of wounds;
  • good cosmetic effect - scars and scars are excluded;
  • relative absence of pain - local anesthetic is applied before mini-surgery;
  • exclusion of secondary infection due to automatic disinfection of the electrode when the device is turned on.

The effectiveness of this method is recognized worldwide, however, it is quite difficult to find a clinic that uses the radio wave surgery method.

Which treatment method to choose

All of the above methods have several disadvantages:

  • In the first few weeks, the operated area looks unattractive - scabs, darkening of the tissues. This should be taken into account if warts are found on visible parts of the body (for example, on the face).
  • Unpleasant odor and some degree of pain during surgery.

In addition, each of these methods has contraindications, which you need to know in a preliminary consultation with a dermatologist.

But the main disadvantage is thehigh probability of recurrence, especially if the warts are widespread, extensive. With each of these methods, doctors do not fight the root cause of the disease, but its consequences, since todayHuman papillomavirus is not curable.

Therefore, therapy is directed to:

  • or destruction of neoplasms that appear at the site of the virus introduction;
  • to stimulate the antiviral immune response;
  • or a combination of these approaches.

Most of the time destructive treatments are used. Its efficiency reaches 50-80%.

Childhood is generally not a contraindication for surgical treatments. Therefore, many of them (including radio wave surgery) are also used to treat warts in children. An exception is the chemical removal of warts due to the possibility of adverse reactions to the substance.

What to do after the operation

Be sure to follow your doctor's advice after any of these operations.

After removing the tumor by any of the methods presented, the doctor usually prescribes treatment of the removal site. It is forbidden to remove "scabs" on your own, wet the wound and expose it to direct sunlight.

If a patient constantly suffers from warts, he should consult an immunologist - drug therapy may be necessary, which will increase the resistance of immunity to the manifestations of human papillomavirus.

Forecast. Prevention

If the patient does not have immunodeficiencies, the warts may disappear on their own, but this will take a long time - from several months to several years. Therefore, in 65% of cases, warts regress independently within two years. If after two years the wart is still in place, it is recommended to remove it. It is recommended to remove multiple growths immediately.

With normal immunity and the correct method of removal (depending on the size and type of the wart), it is possible to remove the pathogenic tissue and achieve a good cosmetic effect. With reduced immunity and other predisposing factors, the human papillomavirus remaining in the body causes relapses.

There is no specific disease prevention. But is infection inevitable?

You can reduce the likelihood of a virus by following a few rules:

  • Avoid walking barefoot in public places where skin lesions and viral infections (swimming pools, public showers, gyms) are possible.
  • Choose quality shoes, change them frequently. Try to keep your feet dry. Heat and humidity are excellent breeding grounds for the human papillomavirus.
  • To avoid periungual warts, go only to certified nail technicians and make sure they use sterile instruments.

For the prevention of anogenital warts, according to the WHO (World Health Organization), the quadrivalent vaccine against human papillomavirus is also highly effective. There are currently no vaccines available to prevent other types of warts.

If you find a wart, don't try to cauterize, cut or pluck it yourself - so you can contribute to the inflammation and spread of the virus through your skin. After this "removal", instead of a mole in the morning, you can wake up with ten.