Papillomas are caused by types of the Human Papillomavirus (HPV) i.e. the virus that causes warts and genital warts. However, papillomas are not equally infectious. This means that they do not get easily transmitted among individuals. Papillomas can proliferate and spread in the same person (autoinoculation) after rubbing or injuring an area.
The main HPV types responsible for causing papillomas are HPV types 6 and 11. They are basically low risk viruses. Thus, papillomas are not particularly associated with an increased risk of developing skin cancer, although in rare cases the development of malformation on a papilloma as well in situ skin cancer have been described.
Thus, papillomas are often found in the neck, face and mainly on the eyelids, the armpits, the chest and the groin area. As they grow or proliferate they can often cause various discomforts. Thus, patients with papillomas report pruritus (itching) and burning sensation at the site of localization. Many times papillomas are injured and bleed, causing concern to the patients. Scratching or rubbing can result in inflammation of the papillomas. In this case edema (swelling) and pain is observed. In several cases the inflammation following injury of papillomas may require the use of topical or systemic antibiotics.
Sometimes papillomas become very large in size and form warts or molluscum. In cases of a large sized skin lesion (molluscum), there is pain, while the injury of papillomas can lead to increased bleeding. Treatment is performed surgically and consists of its surgical removal or ligature and excision by laser.
Papillomas and body weight
It has been observed that papillomas most frequently occur in overweight or obese people. This is probably due to the more intense sweating and creation of skin folds that favor the development of human papilloma virus. In these cases the loss of body weight decreases the occurrence of new papillomas.
Papillomas and pregnancy
Papillomas often first occur or proliferate during pregnancy. Both the weight gain and hormonal factors may play a role in the occurrence or proliferation of papillomas in pregnancy. During pregnancy an increase of the size of papillomas is commonly observed. This should not cause a concern to pregnant women. It is advisable to treat papillomas postpartum (after birth).
Papillomas and endocrinopathies
Papillomas often occur in people with diabetes. In these cases, they should be treated immediately, as the inflammation risk of papillomas is higher in diabetic patients. Moreover, hypothyroidism and adrenal disorders can lead to an increase of papillomas. Polycystic ovarian syndrome, as well as pituitary adenomas that cause acromegaly, are often associated with papillomas.
Papillomas and cutaneous (skin) injury
Injury favors the spread of papillomas. Thus, rubbing with a sponge during bathing, as well as with towels causes proliferation of papillomas. Shaving of the area favors the formation of papillomas, as the razor cuts some papillomas during shaving and transfers them to new areas where the virus is inoculated. Moreover, neck chains because of the friction exacerbate the problem of papillomas on the neck region.
Papillomas – association with warts and genital warts
Papillomas are caused by the same group of viruses that cause warts and genital warts. Therefore, it’s not a rare phenomenon the coexistence of papillomas, warts or genital warts.
Papillomas – heredity
There is a hereditary predisposition for the occurrence of papillomas. Therefore, when a patient has papillomas, other individuals in his/her family may present them as well. The type of heredity, however, has not been elucidated yet.
The following measures prevent the occurrence of papillomas:No scrubbing with a sponge or towels after bathing
Avoid the use of chains and necklaces in the neck
Avoid shaving the area that is affected from papillomas
Avoid touching the area and frequent hand washing
Reduce your body weight if you are overweight
Immediate destruction and removal of papillomas with laser as soon as they are identified.
Vaccination against HPV with the multivalent Gardasil vaccine reduces the risk of papillomas, as it protects against HPV types 6, 11, 16 and 18.
Removal of papillomas with CO2 laser
The removal of papillomas with laser is the most modern and effective treatment of papillomas, which results in complete eradication of existing lesions, without causing marks and scars on the skin. The use of CO2 laser is painless, non-invasive and immediately after the removal the patient can return to his/her daily activities.
The laser beam is directed with millimeter precision to the point of interest without at all affecting the surrounding healthy tissue. In Cosmetic Derma Medicine we recommend laser removal of papillomas, since all papillomas are ablated and destroyed even in just a single session. In our clinic, laser papilloma removal is exclusively carried out by a physician dermatologist using the latest generation of CO2 laser. Laser removal of papillomas enables us to also intervene in sizable papillomas, such as molloscum.
Removal of papillomas with cryotherapy (liquid nitrogen)
The removal of papillomas can also be performed with the method of cryosurgery. Liquid nitrogen, either by direct spraying or with the use of a probe tip, freezes the papilloma, causing it to shrink and fall. This method is one of the oldest and best known techniques of papilloma removal. But it has one disadvantage: papillomas do not immediately disappear, thus requiring few days for their eradication. Some cases of papillomas may require more than one session. The papilloma is freezed down to -196οC. This leads to stopping vasculature and its perfusion causing its necrosis. However, the removal of papillomas with this freezing method leads to great damage of the surrounding tissues and consequently to the formation of scars and marks.
Removal of papillomas with diathermy coagulation
With this method, the removal of papillomas takes place by the application of electricity and heat (electrocautery of papillomas). It is a quite painful method which can result to post-surgical scarring and is not currently recommended.
Surgical removal of papillomas
Surgical removal of papillomas can be applied in very large papillomas and stalky molluscum. It is usually performed by shave excision of the lesion, without requiring sutures. The surgical removal of papillomas with the above technique does not cause scarring and is easy, rapid and painless. In Cosmetic Derma Medicine surgical removal of papillomas is performed where required, both by the Dermatologists and the Surgeons of our clinic.