warts - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about warts or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Warts
Warts - Overview
Warts are benign tumors that can occur anywhere on the body but are most commonly found on hands and feet. The most common type of wart is asymptomatic; it is skin-colored and has a slightly raised rippled surface. Plantar warts on the soles of the feet often cause pain if they are near pressure points. If many plantar warts grow together, they are referred to as mosaic warts. Warts on the face tend to appear flat but may easily spread through shaving or waxing. Genital warts are skin-colored or brown and pose a significant health problem as some of the subtypes cause cervical cancer. Almost all warts are caused by the human papillomavirus (HPV), with many different subtypes being responsible for warts forming in various areas of the body. An individual can acquire warts from any object that harbors the virus such as dirty towels or shoes, but commonly people infect others through touch.
Warts - Diagnosis
In most instances, the diagnosis is made through recognition of characteristic features on physical examination. Rarely, a biopsy is needed especially if a cancerous transformation is suspected.
Warts - Treatment
Asymptomatic warts in non-genital areas do not need to be treated as the body will resolve them within 2-5 years. When warts are painful, bleeding, or even spreading, treatment is recommended. Unfortunately, there is no iron-clad treatment known to eradicate the human papillomavirus. Younger warts seem to respond to treatment faster than long-standing warts.
Most methodologies aim at triggering the body to recognize the root virus as a foreign object and resolve it with its own immune response. Treatment can be performed at home with keratolytic agents such as daily application of salicylic acid solution or tape, as well as duct tape. In addition, there are immune-system stimulating agents such as imiquimod or toxic agents such as podophyllin or glutaraldehyde.
If at-home treatments are ineffective, in-office treatments can booster the effects. They include monthly application of liquid nitrogen, podophyllin, cantharidin, trichloracetic acid, or pulsed dye laser. Rarely, chemotherapeutic or immune modifying substances are injected into the wart, or sensitization with DNCB or squaric acid is performed. Simple excision is as ineffective as any of the other methods yet may leave the virus behind in a scar, complicating treatment further. Therefore it has largely been abandoned for warts on hands and feet.
Coping with Warts
Fortunately, warts are fairly inconspicuous and most people will not notice them even while in public. Warts on the feet are usually concealed by shoes and even warts on the hand are not large enough to draw attention. Seeking immediate treatment can eliminate the wart in as little as two weeks. Genital warts often pose a strain on any relationship. Recurrences of warts are common as the human papillomavirus is not always eliminated at the time of clinical resolution of warts.
Warts - Prevention
Since the wart is caused by a virus, eliminating sources will prevent contracting the disease. Also, if a wart is spotted, avoid frequent touching or picking because the virus can shed from the skin and then pass to surrounding skin or other people. Open wounds and moist skin promote the contraction of the virus. So bandage all wounds and avoid wearing wet socks. Since the virus is most commonly transmitted from person to person, wearing sandals in public locker rooms decreases the risk of contracting plantar warts. Condoms should be used if genital warts are present.
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Hi,
I am a male with white marks, from genital wart treatment/removal, on the middle and lower shaft of the Penis. The marks are about 1cm wide. There is no other scaring, just discoloration or lack of pigmentation. Is there a treatment available to darken these spots to blend in with the surrounding skin?
There is no treatment currently available in the United States. Elsewhere, Re:Cell has shown excellent results for reintroducing color in white patches of skin and I believe it is a matter of time that it will be FDA approved.
Do you do laser surgical removal of warts?
We treat warts with a pulsed dye laser to interrupt blood supply to the virus. This does not instantly remove the wart and is no more or less effective than cryosurgery, excision or other modalities to treat a virus induced growth (wart). We do not perform traditional or laser-assisted excision of warts on hands or feet. Some warts that are not located on hands and feet can be removed by shave excision.
I have had a wart on my finger for about 8 months. I thought it would go away on its own, and it hasn’t yet. It isn’t overly noticeable, but I would rather it be eliminated if possible.
Is there anything that a doctor could do in a single session to eliminate it?
Warts are caused by human papilloma virus. They are benign and most will resolve on their own after several years. They can be transmitted to others through frictional skin to skin contact. Treatment is indicated when warts cause symptoms or are actively growing or spreading. There is no effective treatment for warts, yet. In office and at home procedures are tailored to encourage the immune system to fight the human papilloma virus from the inside. In areas of thickened skin such as on fingers, toes, palms, soles, elbows and knees several treatments are usually needed to remove a wart.
My son (18 years old), has been battling a wart on thumb for the past year. It is on the end of the thumb coming up under the egde of the nail. It has been treated with TCA, cryo, and an in office mixture with duck tape. It inmproves, then reoccurs. It appear to be enlarging in size. It interfers with some of actions with his thumb. He is becoming frustrated. To make things worse he is in college in Phila. making regular treatment intervals difficult. Any reccommendations? Do you take insurances?
Unfortunately, there is no miracle treatment for warts, yet, because viruses stay under the radar of our immune system. In addition to the first line treatments your son had, other topical, oral vitamin supplements, laser treatment, empirical oral immune boosting prescription medications, desensitization treatments, hypnosis and others can be tried. Treatments should be carried out in regular intervals. Also, warts that persists under the nail may need a biopsy. We participate with most insurances.
I have recently noticed a wart on my face, just below the eye.. I want to have it removed… Can you help me???
I recommend you make an appointment with one of our dermatologist…This can probably be taken care of during your initial visit.
I was recently diagnosed with Pearly Penile Papules (PPP), the doctor said they are very common and that I should just leave them alone. Well I want them to be removed effectively with no scars, it really bothers me! What would you recommend?
Pearly penile papules are benign enlargements of glands that are located on the lips, the nipples and the genital area. I suspect that your doctor recommended to leave them alone because there is no specific treatment to shrink these glands. Treatment is limited to attempts to destroy these glands. The best treatment )(CO2 laser) only resolves about 50% of these papules. All treatments leave minute scars behind. Unless there is a method to specifically and successfully target these glands, I also recommend not to treat.
I have a wart on the back of head (on the scalp). Would this be removed on the first visit and what type of treatments are available?
The wart can be removed during the first visit if the diagnosis is correct, and the wart is small enough to be removed. For warts larger than a pencil eraser, treatment with liquid nitrogen(cryosurgery) might be a good option. A wart is caused by a virus and thus far, science has not yet come up with a specific treatment for this virus. Treating the wart attempts to destroy the housing of the virus. It sometimes fails and repeat treatments might be needed.
Hi
I Am a male and I have the HPV Virus and i have genital wart in the back of my shaft and in the middle on my penis I wanted to know is there any way you can help me get rid of them and treat the virus.
Treatment is available for genital warts. Treatment will remove the wart, which is the housing for the virus. About 20-30% of people will not loose the virus when the wart is treated. The HPV will then stay in the skin and can produce a wart later in life. A condom must be used to protect others when you have or had HPV in the genital area.
Hello,
I got condylomas near the anus from my infected husband. One of them is very dark and big(around 1.5 cm). Is it a sign of malignancy and should it be removed or treated? Does homeopathic remedies effective?
Thank you.
Condylomas should be treated because they are caused by a virus that may spread when traumatized. Trauma with natural skin friction is not entirely unusual in the perianal area. The size is not necessarily a sign of malignancy however, I recommend a biopsy with your description of size and color. If the growth is a malignancy, you can discuss various treatment options with your dermatologist.
I have recurring flat warts on my face around my cheeks, eyelids and orbital bones. I have had them cauterized in the past and they have grown back. Flat warts run in my family so I dont expect them to not grow back despite my efforts. I have also gotten the Guardasil vaccine. What are the chances I can have them removed on initial visit? What is expected of post cautery care?
Treatment is always best if it can be properly planned. As you know, flat wart treatment is not straight forward because there is no cure, yet. In office treatments include cryosurgery, electrocautery or laser ablation and pulsed dye laser treatment. At home measures for treatment and prevention are topical retinoids and immune stimulators, as well as treatments to prevent the occurrence of dark marks at sites of in-office treatments. This type of planning takes place during the initial evaluation. If there are very few spots, and hyperpigmentation is not anticipated, treatment can take place at the initial visit.