Warts - symptoms and treatment

22 August 2020

what is lez? We will analyze the causes, diagnosis and treatment methods in an article by a dermatologist with 37 years of experience.

Definition of the disease. Causes of the disease

Wartsare irregular light gasoline lesions of the skin in the form of a localized overload of the upper layer of skin (epidermis) with papules (nodules) or plaques.

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

Warts are very similar to other skin growths. Usually, a person can not accurately determine his disease, therefore, 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 in the localization that is most characteristic of it.

Type HPV	localization of preferred	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, occasional plantar, palmar and mosaic warts
3, 10	Shins, hands, face	Flat warts
7	Hands, fingers	Butcher Warts
5, 8, 9, 12, 14, 15, 17, 19-24	Face, arms, front torso	Verruciform Epidermodysplasia

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

Also contributes to the appearance of warts:

(including HIV infection);
warm and humid environment;
need for professional contact with meat and fish ("butcher warts").

Some types of human papillomavirus are transmitted by parents.

But toads and frogs, despite the horror stories we are so often afraid of in childhood, can not be infected - this is one of the most popular myths about this disease, which has no basis.

If you find similar symptoms, consult your doctor. Do not treat yourself - it is dangerous to your health!

Wart symptoms

Symptoms will vary depending on the type of wart.

Common wart:

Dense round papule of normal color, 1-10 mm and more.
The surface of the papule is covered with cracks, layers.
If the papule is on the finger, the pressure disappears and is distorted. The same goes for palm drawing.
Simple warts are located separately or in several parts - they usually appear at the sites of greatest injury (hands, fingers, knees).
When viewed with a dermatoscope, the doctor may see small brown spots - thrombosed (blocked) capillaries. Patients often refer to these points as "roots. "This is the main sign for a doctor: it can be used by a dermatologist to distinguish a wart from other similar diseases (for example, molluscum contagiosum and keratoma).

Plantar link (horny):

The main symptom that usually causes a patient to see a doctor is pain when pressing and walking.
Such warts are usually placed on the feet.
When you contact a doctor, as a rule, a keratinized, uneven plaque of the usual color is visible, although in the first stage you may see an even and smooth papule. With keratinization, capillaries can only be seen if the keratinized layer of skin is removed.
The heel skin pattern is distorted.
Plantar warts are usually solitary, but there are also 2-6 warts;
these warts are often confused with corn (especially dry) - this is the description of the problem that patients usually come to see.

Flat wool (new):

Looks like a round, clean, smooth papule of normal color, pink or brown in size 1-5 mm in size.
Appears on hands, shin, very often on face.
There are always some such warts - they are located in groups.

Verruciform Epidermodysplasia (lyth plaque):

Large, round, numerous neoplasms of normal pink or brown color.
Most often appear on the face, arms, in front of the torso.
Can be confused with keratoma, herpes and skin cancer.

Wart pathogenesis

When it enters the body, the human papillomavirus can be dormant for a long time - a person usually does not even know it exists. When favorable factors for the virus appear, it begins to "multiply" in the epithelium, leading to tissue changes.

Unlike other viruses, the human papillomavirus does not destroy epithelial cells themselves - they die naturally, in the process of keratinization and inflammation.

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

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

Classification and developmental stages of warts

There is no universally accepted classification for warts. However, there are some common types:

Common wartis the most common type (70% of warts are just that). Such neoplasms are not felt and only cause aesthetic discomfort to a person.
Plantar Wart- appears on the soles of the feet, is painful, and therefore requires treatment. Skin trauma due to uncomfortable, tight and clumsy shoes contributes to the appearance of such a lesion.
Flat warts- most often appear in young people, teenagers. This is due to the unstable hormonal background of youth, which affects the whole body. Usually 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 that can occur on the face and hands. If there is no discomfort, such warts should not be treated - healing in older people can be much slower than in young people, due to a slow metabolism.

Other authors distinguish some more from these types of warts:

Mosaic warts(HPV 2, 4) - neoplasms of the palms and soles. They appear as concentrations of hyperkeratosis, d. m. th layer thickness (usually in the front), covered with deep cracks.
Cystic warts(HPV 60) are a very rare type of foot growth. It is a soft cracked joint. Upon opening, a yellowish-white discharge looks similar to cottage cheese.
Formal wartsare thin corn results near the mouth, nose or eyes.
"Butcher" warts(HPV 7) - appear on the hands and fingers of people who are in constant contact with meat and fish. They appear as hypertrophic neoplasms similar to cauliflower but with normal color.

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

For example, anogenital warts - tumor-like neoplasms that appear on the genitals (especially in places where the skin passes into the mucosa) are a common disease. They are usually caused by HPV types 6 and 11.

Wart complications

The main reason why wart patients go to the doctor is an aesthetic defect that can affect the patient's quality of life, his self-confidence and develop very complex. Complications include cracking of the wart surface and increased infection, and in some types of warts, pain while walking.

Skin warts usually 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 growth yourself. In this regard, inflammation and aesthetic defects in the form of scars can occur, as well as further spread of the virus through the skin, which is why a person may wake up with some new ones in the morning after self-removal of a wart.

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

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 neoplasm cells.

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

Molluscum contagiosum- most often appears on the body and genitals, less often on the hands and feet. It is a hemisphere with an impression on the surface; when pressed from the sides, a white "swarm" is released.

epidermal wart nevus- most often solitary, a person has from birth. It rises above the surface of the skin, often covered with hair.

Basalioma- a tumor in the form of a nodule, covered with a crust in the center. Typical of the elderly.

Palmar-plantar wartsshould be distinguished from the following diseases:

Keratoderma- large areas of keratinization and inflammation of the skin. No clotted capillaries.

Palmar-plantar syphilis- numerous painless neoplasms, the skin peeling along the periphery. The reaction to syphilis is positive.

Callus- usually painless, can only cause pain when pressed vertically.

The doctor must also distinguish other types of warts from a number of diseases. If another pathology is suspected, it may prescribe additional diagnostics (for example, detection of antibodies to viruses, CT or MRI).

Treatment of warts

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 an accurately determined diagnosis. Independent attempts to get rid of a wart are unacceptable, as a patient without medical education and the necessary equipment is not able to accurately diagnose the disease, and complications after such "treatment" occur much more often than cure.

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 treatment room of the clinic.

Chemical treatments

Milk-salicylic colloid and salicylic fragments are used to get rid of the wart. The percentage of drugs and the way they are used (long-term plaster coating, applications, etc. ) depend on the spread and localization of the neoplasm.

Zinc and 2-chloropropionic acid solutions may also be used. In this case, a chemical composition is applied to the preset surface, which is left 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 and copper nitrate trihydrate. In this way, only relatively small neoplasms are treated - up to 5 mm. The solution is also left to change the color of the wart. After 3-5 days, the patient comes for a follow-up appointment, if necessary, he is recommended a second procedure in 1-4 weeks.

Cryodestruction

This method consists of freezing the wart with liquid nitrogen: a wet swab is pressed against the damaged skin (by trapping the surrounding tissue by a few mm) for 1-5 minutes. Some lesions require several treatments four weeks away to destroy.

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

Elektroagulimi

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

This method is more effective than cryodestruction, but it has a significant disadvantage: electrocaution often leaves scars at the wart removal site. For those patients seeking cosmetic repair,this method will no longer be appropriate.

Laser destruction

The laser also removes warts in layers. The light guide contacts the skin from a few seconds to three minutes, depending on the size. Then the cavity that appears is excited, and the lower part of the wound is treated again with laser. The patient is then instructed on how to treat the wound. The operation itself is performed under the influence of local anesthesia.

Wireless radio surgery

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

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

The benefits of this method:

security;

rapid wound healing;

good cosmetic effect - scars and wounds are excluded;

without relative pain - apply local anesthetic before mini surgery;
exclusion of secondary infection due to automatic electrode disinfection when the device is switched on.

The effectiveness of this method is known all over the world, however, it is quite difficult to find a clinic that uses the radio wave operation method.

Which treatment method to choose

All of the above methods have some drawbacks:

In the first two weeks, the operated area looks attractive - crust, darkening of the tissue. 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 pain during the operation.

In addition, each of these methods has contraindications, which you should learn about in a preliminary consultation with a dermatologist.

But the main disadvantage is the high probability of recurrence of, especially if the warts were widespread, wide. With each of these methods, doctors do not fight the root cause of the disease, but with its consequences, as of todayhuman papillomavirus is not curable.

Therefore, therapy is directed to:

or destruction of neoplasms appearing at the site of presentation of the virus;

or to stimulate the antiviral immune response;

or a combination of these approaches.

Destructive treatments are most often used. Their efficiency reaches 50-80%.

Childhood is usually not a contraindication to 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 you need to do after the operation

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

After removing the tumor with any of the methods presented, the doctor usually prescribes treatment of the removal site. It is forbidden to remove the "crust", moisten the wound and expose it to sunlight.

If a patient is constantly suffering from warts, then he should consult an immunologist - perhaps drug therapy will be required, which will increase the immune resistance to the manifestations of human papillomavirus.

Forecast. Prevention

If the patient has no immunodeficiencies, then the warts can go away on their own, but this will take a long time - from a few months to a few years. So in 65% of cases, the warts independently regress within two years. If after two years the wart is still in place, then its removal is recommended. It is recommended to remove multiple increments immediately.

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

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

You can reduce the chances of a virus if you follow a few rules:

Avoid walking barefoot in public places where there is a possibility of skin damage and virus infection (swimming pools, public showers, gyms).

Choose quality shoes, change them often. Try to keep your feet dry. Heat and humidity are excellent bases for the spread of human papillomavirus.

To avoid periungual warts, only go to a certified nail technician and make sure they use sterile instruments.

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

If you find a wart, then do not try to care for it, cut it or pick it yourself - this way you can contribute to the inflammation and further spread of the virus through the skin. After such a "removal", instead of a wart in the morning, you can wake up with ten.