Problem with skin warts most often occurs in children of school age, although they also occur in adult patients. Although it is an infection, skin warts are primarily an aesthetic problem, but while in certain patients skin warts will withdrawn by themselves, at others they can persist despite treatment, or return again and again.
Viral warts (papillomavirus ) are the very common disease of the skin. Common believe is that they affect about a quarter of school-age children, while in the total population their frequency ranging from seven to 10 percent. Warts on the skin are a contagious skin disease that occurs due to infection with human papillomavirus (HPV). Skin warts are benign skin changes that in many patients, especially in children, withdraw after two years.
There are about 60 types of human papillomavirus. They are ubiquitous which means that most of the population has it on the skin, but changes in the skin do not appear in all patients. Doctors believe that warts will never appear on the skin in about 50 percent people infected with HPV.
It is well known that HPV cause skin warts, but the mechanism of action of the virus and its specific role are not fully understood. The virus probably enters the skin cells – keratinocytes – through an often unobservant breach on the surface of the skin, and then leads to the proliferation of keratinocytes and the appearance of skin warts.
What are warts on skin?
Viral warts represent benign epithelial tumors of the skin (Verruca) or genital warts resulting from infection of keratinocytes HPV. They occur mainly on the hands and feet, and rarely on the face, shoulders, and knees. Warts are contagious, but it does not mean that Warts are contagious, but it does not mean that they will occur in every person infected with HPV. There are several types of warts, which type will occur on skin surface highly depends on the type of virus that causes an infection.
Some of the most common types of skin warts are:
- Verruca Vulgaris, which usually causes HPV 2, they are mainly located on the hands, fingers and around the nails. They are hard spherical in shape, brown, or skin color
- Verruca plantaris most often caused by HPV 1, appear on the feet, especially on parts exposed to increased pressure. Whitish color and enclosed in the surface of the skin, often very painful and can have black spots caused by capillary thrombosis
- Verrucae planes, caused by HPV 3, 10 and 28, commonly found on the upper surface of the hands and the limbs, in the form of painless, light brown flattened skin surface
Types of warts and what they look like
In the picture below you can see all types of warts and how they look like
How does HPV spread?
The virus can be spread by direct contact with infected skin to an uninfected person, but also indirectly, because HPV is resistant to the environment. Thus, the risk of infection increases among people who like to walk barefoot (the pools, the bathrooms, shower cubicles and similar places where the humidity is increased) and in those whose skin is drier and more prone to cracking of the skin. At an increased risk are people who sweat a lot, because the HPV activity favors the moist environment (especially in the folds between the toes or around the nails).
How do skin warts occur and what causes common warts?
There are many different causes of warts on the body, but a mechanism for the occurrence of skin warts has not been fully elucidated. It is not known why papillomavirus, which is found on the majority of infected, leads to the appearance of skin warts only on some persons. It is believed that these persons have a certain genetic predisposition. They are more susceptible to warts on the skin, and the state of their immune system plays an important role, so warts appear more frequent in people with the weaker immune system.
The virus can enter the proliferative cycle immediately after infection, in some cases never, or it can be latently present in keratinocytes and (re) activated after a certain period, usually when a person is exposed to a stress situation or the decline of the immune system. Generally speaking, the incubation period of the virus usually lasts from two to six months.
Furthermore, although it is considered that the papillomavirus the only human virus, that the carriers of the virus are only people, yet it is unclear why the skin warts relatively often occur at people who professionally often come into contact with meat (veterinarians, butchers, workers in fish markets). The most likely cause is the fact that the cuts and wounds at these people are more frequent, but that’s not accurately identified.
How much are warts contagious?
It is believed that the main source of infection with HPV is the natural skin peeling which helps to spread the virus. The most common way of transmission of infection is direct contact with the infectious and non-infectious skin, especially if the skin is dry and cracked. HPV virus is resistant to the environment, so it can be also easily transferred at swimming pools, sports centers, showers, and tubs, or by using other people’s towels. A higher risk has a person who lives in large families and groups, as well as children in kindergartens and schools.
However, this disease is not very contagious, skin warts themselves are often more aesthetic than a serious health problem. Opinions are divided among the doctors, so some recommend to start with therapy as soon as possible to reduce the risk of spreading of infection, while others suggest that the disease is not very contagious and that you don’t have to start the treatment of warts because warts often disappear within two years.
Can I cure skin warts?
In many cases, warts go away on their own, and there are different ways of removing them. If they do not bother you, you can wait for warts to eventually subside spontaneously, though they may persist for several years. We should bear in mind that the removal of warts from the surface of skin does not necessarily remove the virus itself. The virus can remain, persist in the skin around the lesion themselves, so a new wart can appear after a few years, in case of a decline of the immune system.
However, there are no reliable data, whether new warts appear in patients who had already had warts due to the presence of a virus or reinfection. Due to the impossibility of complete removal of the virus, at patients in which warts keep coming back, there is doubt about the effectiveness of treatment and will to continue warts treatment.
What wart treatments are available?
Treatments, whether it is a physical method or implementing of certain preparations, chemical substances, remove skin warts from the skin surface, but not completely removes the virus. There are no official recommendations, nor opinions about which method is the best or most efficient in the long run and how should you start treatment. Many dermatologists believe that, in relation to the final outcome, does not matter which type of therapy will be used as the first therapy and which as a second choice if the first one proves to be ineffective.
Physical methods of wart removal include cryotherapy, electrocoagulation, surgical and laser removal. All these methods are more or less painful. Besides cryotherapy, which can be applied by patients themselves at home, all the other methods of wart removal apply a doctor.
Chemical substances used for wart removal from the skin are keratolytic, salicylic, lactic or trichloroacetic acid in various pharmaceutical forms (solution, gel, cream).
Studies have shown that the placebo effect is much important for the treatment of skin warts, also it is found that taking a placebo solution helps in removing warts, in average, around 27 percent of cases, and in some studies up to 70 percent.
Safety precautions when using keratolytic in skin warts treatment
A large number of preparations for the treatment of skin warts containing salicylic or lactic acid, which have a strong catalytic effect and cause peeling of the skin. Relatively often is used Vaseline with salicylate in a concentration of up to 30 percent. Salicylate concentrations depend on the structure and the level of keratinization of warts, while Vaseline softens the wart and enable to remove warts easier.
Patients should be advised that all keratolytics are carefully applied only on the wart and to protect the skin around it with the cream, Panthenol for example. Keratolytic is best to be applied to clean and dry wart with previously removed a layer of dead skin.
It is believed that keratolytics affect helps in the removal of the virus itself as they can cause a local inflammatory reaction and the activation of the immune response to some extent to eliminate the virus. This therapy is applied daily, for one to four weeks.
What makes cryotherapy so effective?
Cryotherapy is a natural wart removal method that has long been reserved for dermatological surgery. It is based on the incineration of skin warts with liquid nitrogen (Liquid Nitrogen Treatment) by freezing at a temperature of -96 ° C. On the place of wart occurs a bubble which fell off in 10-15 days.
This procedure is quite painful, but apart from removing of the wart, leads to the disappearance of the virus and is quite effective. However, it is often necessary to repeat the treatment several times, at intervals of two to three weeks.
In addition, there are pharmacies and medical products based on the principle of cryotherapy which removes warts. These products mainly include dimethyl ether, propane or isobutane, who manage to freeze warts at -57 ° C. It is believed that the efficacy of these preparations is equal or close to cryotherapy conducted with liquid nitrogen.
The treatment is applied once, and if skin warts do not disappear after 14 days, it should be repeated. These products are not intended for the removal of genital warts and they should not be used either on the face, around the eyes or on the chin.
Does HPV virus cause genital warts?
HPV causes genital warts, but these are different types of viruses than those that cause skin warts. Genital warts are caused virus types that have a higher affinity for mucous tissues and these are preferably HPV types 6 and 11.
Special attention should be given to HPV types 16, 18, 31 and 45 which are proto-oncogenes and increase the risk of cervical cancer. Therefore, to all women, especially those who have had at some point a manifestation of HPV infection, it is advisable to take a regular Pap test.
Otherwise, genital warts cause about 30 different types of HPV. Unlike warts on the skin, which can be, but do not need to be treated, removal of genital warts is recommended because it is a very contagious infection.
However, it is believed that 70-100 percent of people at some point in life is infected with the virus, but many do not know they have been infected because they never get the disease manifestations. It is believed, too, that for most people the immune system is capable to deal with infection without a problem, and that only 20-40 percent of people carrying the remains of the virus.
What should be expected during wart treatment?
Patients should be cautioned that redness and mild inflammatory reaction around the warp are normal and expected. Methods of laser and surgical removal carry a slightly higher risk of scars than other methods. When using keratolytic treatment for wart removal, burning feeling on the skin and skin peeling are normal reactions.
However, if ulceration appears on the skin or infection occurs, be sure to contact your doctor. In this case, the doctor usually recommended local antibiotic therapy. Also, if you experience bleeding from the skin on warts or wart becomes painful, you should visit a dermatologist to exclude the possibility that it actually was not a warp than about skin cancer.
Similar considerations apply to warts that appear around or under the nail and cause deformation of the nail. it is necessary to consult a doctor if warts persist despite the use of preparations for their removal.
Are there effective natural solutions for removing skin warts?
Phytotherapy shows a particular efficiency in the treatment of skin warts. Thus, for example, garlic is known a folk remedy for warts. In addition, in the remedies prepared based on the principles of traditional medicine are also used bark extracts of Betula pendula and Salix Alba, rhizomes of Sanguinaria canadensis and essential oil of Thuja occidentalis plant.
It is also well known the use of pure juice and tinctures of the Chelidonium majus plant. Keratolytic resin (Collodium keratolytic) can also effectively eliminate warts.