Warts are small skin growth caused by an infection in the outer layer of the skin with a virus called “Human Papilloma Virus” A wart is a growth that develops on the skin. It can grow inward or outward, cause a lot of problems or not have much of effect.
DO’s and Don’ts for prevention of warts:
Do try to get-rid of them at the earliest
Do not try to remove the wart by your own.
Do maintain good self-hygiene & keep your hand & feet dry
Do not pick or scratch your warts
Do keep your skin intact, if the skin has been cut or opened the virus is more likely to enter
Do not share towels, clothing, socks, or soaps with others
Do cover warts with a plaster or bandage
Do not walk barefoot in public places, if you have a plantar wart
Do wash your hands regularly
Do not shave or do electrolysis where the wart are located
Do get warts evaluated promptly
Do not share your sports gear
Do check children’s feet frequently for warts
Do not bite your fingernails or the cuticles
Do consult the dermatologist
Do not try home-remedies
Do wear waterproof shoes or sandals (flip-flops) in public showers and pools or in a locker room
Do not have sexual contact if you have warts in the genital area
Each type appears on a different part of the body and has a distinct appearance. The most common type of warts is mentioned below:
1.Common warts or Verruca Vulgaris: Common warts are most often on the back of hands, foot involving mainly fingers and toes, but can appear elsewhere.
2.Plantar warts: Plantar warts grow on the soles of the feet. Unlike other warts, the pressure from walking and standing makes them grow into your skin. Multiple plantar warts in a large cluster called mosaic warts. Plane warts or Verruca plana: Flat warts tend to appear on children’s faces, men’s beard areas, and women’s legs.
3.Filiform Warts: They appear as thread-like and spiky or tiny brushes involving around the mouth, eyes, and nose or chin and can be irritating due to their involvement of sensitive areas of the face.
4.Genital Warts: They appear as small, scattered, skin-colored bumps or like a cluster of bumps (cauliflower) on your genitals.
5.Periungual Warts grow around and under the toe or fingernails. They can be painful and affect nail growth.
Treatment: includes simple measures to limit the spread of infection, prevention, medication, and interventional treatments. Many people with a good immune system don’t require treatment as the lesions resolve spontaneously without medical intervention.
However, it justifies treating as it is a contagious disease; and can spread from one area to another in the same individual.
Medication: Topical treatments are regarded as first-line therapy. Topical cream such as retinoic acid cream, salicylic acid preparations, 5-FU, podophyllotoxin cream (anogenital warts). diphencyprone (DCP) and imiquimod irritate the skin and encourage your immune system.
Oral immunomodulators such as levamisole and zinc sulfate are used which have an effect on the immune system for any kind of warts. Antiviral cidofovir ( topical or intravenous or intralesional ) are used in very severe involvement of warts.
Occlusion: duct tape occlusion involves covering the wart with a small piece of duct tape for a period of 2 months. This therapy can be used for common or plantar warts, and in combination with topical therapy enhance the results.
Interventional therapy is advised if medical therapy fails to work or our body immune system does respond to the infection to heal on its own.
Intralesional immunomodulator, interferon is used to boost your immune system to fight against HPV, typically for genital warts. Intralesional cytotoxic agent bleomycin may stop infected cells to replicate. These intralesional therapies are used in recalcitrant warts.
Chemical cautery using high concentrated trichloroacetic acid, silver nitrate, phenol, cantharidin, formic acid. Cantharidin liquid is often used in young children, as it doesn’t cause pain. After application blister is formed underneath it, lifting it off the skin.
Photodynamic therapy: topical or systemic aminolaevulinic acid is taken up by dividing cells, metabolized to protoporphyrin, and then photoactivated to produce damage effect on the cell in the infected area of wart.
Cryotherapy: involves freezing the wart with liquid nitrogen. Freezing causes a blister to form under and around wart which in due time lifts the wart away from the skin. The procedure is a little painful, probably need more than one session. It usually works well but can cause discoloration and scarring in dark skin.
Surgery is usually only considered if the above treatment doesn’t work. There are different surgical options for removing warts, usually done after giving local anesthesia and are mentioned below:
Curettage is scraping off the wart with a sharp knife.
Electrosurgery: This is using a small probe with an electric current to cauterize the skin tissue. It works well for common warts, filiform warts, and foot warts.
Excision: surgical excision using a sharp blade and closure.
Laser surgery: by using ablative lasers such as co2 and erbium YAG laser to destroy warty tissue.
However, this laser surgery by co2 is a modest and effective method to remove or cauterize the warts.
We at Clear Skin Centre provide the most common practice treatment to remove the wart in the globe:
1. CO2 laser
4. Radiosurgery by Ellman RC
We at Clear Skin Centre use the simplest and cheapest way to remove warts, by electrosurgery using the advanced technology Ellman radiofrequency device; though co2 laser is an advance but costlier treatment. The procedure is done on an outpatient basis with the highest safety measures. We recommend the earliest intervention, with the appearance of a single lesion of the wart, as to avoid spreading from one area or person to another.