Warts

Warts are benign skin hyperplasia caused by the Human Papilloma Virus (HPV). Over 70 types of HPV viruses are responsible for these lesions and each type is responsible for the appearance of warts on a specific part of the body. The warts are also known as verruca or beetle warts or carnivorous.

Dr. Michael Tsanakas
DERMATOLOGIST - VENEREOLOGIST
"Although it is a benign condition, warts cause concern to patients as they may be accompanied by intense pain, itching or bleeding, while if they are located on the legs, they can make walking difficult" says the Dermatologist - Venereologist Dr. Michail Tsanakas. “Warts are the second most common skin disease after acne. Children and young people are most often affected by the virus that causes warts, due to the immature immune system of these individuals, although their occurrence at any age is not excluded. The virus causes the rapid proliferation of skin cells resulting in the development of warts. The warts are benign bumps and take the form of a cauliflower.”
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Warts

Symptoms

Warts usually appear on the hands, feet and face. However, their appearance on any other part of the body is not excluded. Most commonly, they occur in summer, due to the non-use of footwear, as well as because of the increased contact with water, which makes the lower limbs vulnerable to the attack by HPV virus. Depending on their clinical picture, warts can be divided into:
  • Common warts (Verruca vulgaris): These warts may be round or irregularly shaped and can be white, grey or brown in color. They may be flat or form patches the size of a pea. Common warts usually develop around the fingernails, fingers and palm, but they can also appear on the knees and face in cases of skin trauma. In terms of symptoms, common warts do not present anything special or dangerous. There may be mild pain and discomfort in the patient. Usually, a wart on the arm or a wart on the foot falls into this category. The difference in their clinical picture is that the wart on the sole due to constant pressure and friction cannot grow extraplantar (outward) so it may appear flat, but has a lot of depth and is usually quite painful. The wart on the hand usually protrudes from the epidermis.
  • Flat (plane) warts (Verruca vulgaris): Flat warts are asymptomatic, slightly healed or flat lesions with a smooth surface and a light brown or blue-yellow color. Smooth warts are usually found on the forehead, dorsal surface of the hands, chin, neck and legs. They usually take the form of a straight line, as a result of spreading due to scratching of the area (Koebner effect).
  • Papular warts: Warts of this category usually occur in men and are distributed on the face or neck area. Often, these warts form small clusters on the beard of men and on the scalp.
  • Filiform or Digitate warts: These warts look like papillomas and are mainly found on the sides of the neck, underarms and thighs. They are called warty papillomas and multiply by friction or by the use of chains around the neck.
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Warts

Transmission

They are transmitted by simple contact with infected persons or objects, often at sites with minor skin continuity lesions, abrasions or other minor injuries, and can be transmitted from one part of the body to another after contact with the infected area. Therefore, the human papilloma virus (HPV) that causes warts can be transmitted by shaking hands or contact with infected objects. This is because the virus can live for several days outside the human body and therefore the possibility of transmission is increased.

It is quite common for the virus to be transmitted when swimming in a swimming pool, as HPV viruses are resistant to the chlorine contained in these pools. This, combined with the habit of people walking barefoot in such environments, leads to a high probability of infection.

Often warts are transmitted to oneself by inoculation at sites of injury. For example, warts that form in the palm area can lead to warts on the face or any other spot due to frequent contact of these areas with the hands.

Warts

Diagnosis and Treatment

The diagnosis of warts should be made exclusively by a dermatologist, who is the only expert for the correct diagnosis and choice of treatment. Usually, their diagnosis is not difficult and is done clinically and epidemiologically. Rarely, a biopsy may be needed, especially when they look like epitheliomas or skin carcinomas in adults.

Also, when a wart is found in the genital area it should be differentiated from genital warts and this can only be done by HPV - DNA Test.

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At Cosmetic Derma Medicine we apply the following treatments for warts, always taking into account the form and location of the warts, as well as the age of the patient.

Treatment using CO2 Laser

The removal of lesions with CO2 Laser after local anesthesia with xylocaine solution is the method of choice for warts treatment, as the effect is immediate and the lesions can be eliminated in a single session without leaving scars pr marks on the affected area. The use of CO2 laser is the most modern and up-to-date method applied in warts treatment. The treatment last just a few minutes, the method is completely bloodless and this treatment offers permanent results. There is no postoperative pain. At Cosmetic Derma Medicine, our medical team is specialized in the application of CO2 Laser and the treatment can be achieved in a single session, with the cooperation of specialized dermatologists and plastic surgeons.

Cryotherapy treatment (liquid nitrogen)

Warts treatment with liquid nitrogen has been practiced for over 50 years in medicine. When treating warts, liquid nitrogen is applied at a temperature of minus 196 degrees Celsius. The cooling causes necrosis of the affected tissue, resulting in the formation of a blister around the wart and the dead tissue falls off within a week or so. Treatment of warts by cooling may cause a little discomfort and pain. Sometimes treating warts with nitrogen can cause a scar. It is a safe and painless treatment and is particularly indicated for children and women during pregnancy, as it does not require the use of local anesthesia. The disadvantage of cryotherapy is that depending on the lesion it requires several repetitions.

Therapy with Cautery (electrocautery)

Electrocautery warts treatment is a method that destroys the wart using electricity under local anesthesia. During wart treatment, a small matrix is used, which is passed through by an electric current and burns the lesion as it touches it. The disadvantage of this treatment is the high possibility of post-operative pain and the risk of scarring.

Treatment with topical use of chemical agents

Wart treatment can be achieved by using chemical caustic agents. They are applied to the affected area and gradually destroy the warts. The disadvantage in treating warts with topical agents is that a period of time needs to elapse before the lesions are eliminated, and they often have the side effect of causing irritant contact dermatitis.

Treatment with surgical removal

Treating warts surgically has a high success rate. This method is applied as a treatment for warts in very large lesions. The operation is performed under local anesthesia, but it causes some discomfort and full healing of the area takes several weeks. The risks associated with surgical warts treatment are the possibility of infection or scar formation.

Treatment for children

Treatment of warts in children should be done with special care by a qualified dermatologist. At our clinic we have extensive experience in treating warts in children of all ages. Laser and cryotherapy are preferred. Topical caustic chemicals should be avoided in treating children's warts, as they can cause burns on children's sensitive skin. In case of large sized warts, we proceed to surgical wart treatment in collaboration with the plastic surgeon.

Alternative warts treatments

Numerous methods have been described for treating warts, however with questionable results. Among them are aromatherapies, herbal remedies, phytotherapies, homeopathy, hydrotherapy. Because it is a skin infection caused by a virus, the only responsible person to suggest an effective warts treatment is a Dermatologist – Venereologist. The specialized doctors of Cosmetic Derma Medicine can suggest the appropriate case-by-case treatment.
Warts

Types

Depending on their location, warts are classified into the following types:
1

Plantar warts

Plantar warts appear as a clearly excoriated circular lesion with a rough supra-vertebral surface. They are skin-colored, and if the thick coating is removed, black spots are seen which are pathognomonic for the disease. Plantar warts usually develop at the sites of greatest pressure on the foot.

In women, plantar warts prefer the anterior part under the toes. In some cases, plantar warts may flock together creating plaques with a "mosaic" appearance.

Plantar warts are usually extremely painful if not treated and cause difficulty and severe pain when walking. Due to the pressure from walking they usually do not develop in the form of bumps but in the form of hard nodules. A differential diagnosis must therefore be made in the case of a foot wart from a possible foot callus.

2

Palmer or Periungual warts

It is the most common location of warts. Palmer warts are very common. They can be located on the palm or even the back of the hands. Often hand warts are located around the nails so they are called periungual warts.

Palmer warts are a common manifestation of children who can touch infected objects with their hands and do not yet have a strong immune system to protect them. Toe warts often occur in people who, because of their work, have frequent contact with water, e.g. housewives, hairdressers. Palmer or Periungual warts often experienced by these people cause severe discomfort and pain that makes it difficult for them to work.

A finger wart can occur either around the nails or on the palmar surface. Often finger warts are also found between the fingers with severe pain or even bleeding. Due to the prolonged wetting of the skin, it becomes more vulnerable and palmer/periungual warts develop.

3

Facial warts

The face is a frequent manifestation of warts. Face warts usually occur in children and are mostly asymptomatic. Facial warts are smooth and flat and often multiply due to scratching.

Facial warts are often an aesthetic problem for the patient. Special care is required by the dermatologist to properly diagnose and treat facial warts and to distinguish them from possible hyperplasias and nevi.

4

Warts on genitals

These warts are similar to the well-known genital warts but they might not have been transmitted through sexual intercourse, but through transmission from hand warts.

Warts

FAQ

How can I protect myself from warts?

Although in some cases warts can disappear on their own, the virus is highly contagious, and following the rules below is essential for prevention:

  • Frequent hand washing
  • Avoid contact with bare feet in the sand and around swimming pools
  • Avoiding swimming pool use by infected persons to prevent transmission of the virus
  • Use of personal towels and utensils
  • Immediate treatment on appearance to prevent transmission of the virus to healthy people

Why is the CO2 Laser ideal for the treatment of warts?

At Cosmetic Derma Medicine, the treatment of warts is mainly done with CO2 Laser, as it completely destroys the lesion, even in a single session, with the lowest recurrence rates. The advantages of CO2 Laser treatment are:

  • Atraumatic & bloodless method
  • No scarring
  • Penetrates deeply, destroying the root of the problem
  • May require as little as one session for complete healing and the patient leaves the doctor’s office fully healed
  • Associated with the lowest rate of recurrence compared to other methods

What should I watch out for after treating warts?

After laser warts treatment, the patient should not wet the area for twenty-four hours. It is recommended to use a topical antibiotic cream at the site of removal for 5 days.

In case of foot wart, we recommend avoiding standing for 3-4 days and we suggest placing the foot in an immobile position for the first 24 hours after treating a large foot wart.

Why should I choose Cosmetic Derma Medicine for the treatment of warts?

Cosmetic Derma Medicine Medical Group is the largest and most specialized medical group in the field of Dermatology and Plastic Surgery, with 14 clinics in Greece and Cyprus.

Thanks to the latest generation of equipment, it is possible to treat warts with CO2 Laser, Cryotherapy, Cryotherapy, Transfusion or Surgical treatment. The high rates of successful treatment of warts in a single visit prove the effectiveness of the use of CO2 Laser, in combination with the specialized medical staff of Cosmetic Derma Medicine.

The Dermatology Department and Plastic Surgery Department of the clinic, headed by the Dermatologist & Venereologist Dr. Amalia Tsiatoura and the Plastic Surgeon Dr. Anastasios Vekris, provide the full range of treatment for even the most challenging cases of warts. Our medical team is at the patient's side 24/7 for whatever is needed.

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