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.
Hello! Two years ago I discovered three small genital warts in my rectum outside the anus and it was confirmed at a Planned Parenthood clinic in Philadelphia. PP prescribed Imiquimod which I applied. I tried this treatment. They remained so I went through the same course of treatment again.
The warts remain but have not grown or spread to my knowledge. They do not bleed or secrete anything. I want to remove them. Do you think it is possible or advisable?
Treatment for genital warts is generally recommended. If imiquimod fails after 16 weeks of application 3 times a week, treatment options are Canthacur, laser, or photodynamic therapy. Please schedule an in-office appointment as soon as COVID 19 crisis is over.
I have a wart on my little finger not responded to salicylic acid, cryosurgey and electrocautery treatments. Do you do pulsed dye laser treatment in your office? Do you accept medicare and AARP?
Yes, we perform pulsed dye laser treatment for warts and accept both of your insurances.
Are you accepting new patients and do you remove genital warts. Is it covered by insurance bc/bs ppo
Our office does accept new patients, we treat genital warts, and we participate with and submit to Blue Cross Blue Shield PPO. Please book a new patient visit online on our website http://www.ringpfeildermatology.com with any of our dermatologists or call the office at 610.525.5250.
Hello-I currently have three warts in total, one on my left knee and right knee, and one on my index finger on my right hand. They are all relatively small, and I recently had cyrosurgery on all of them. The doctor told me I will probably need another appointment to get them completely removed. My question is—how much does cyrosurgery cost here? I would have to pay out of pocket because I have Amerigroup and live in Maryland, and go to college in Philadelphia. I’d like to get the procedure done with my first appointment as well, not just get a consultation. Is that possible? In addition, how much do electrocautery and laser ablasion cost? I desperately want these gone and have tried drugstore alternatives (gels and such) but to no avail.
Warts are caused by a virus and it is never trivial to lose them. A virus ‘hides” from our immune system and therefore can evade treatment. Each treatment has an efficacy of 37%. Combining at home and in-office treatments provides you the best chance to treat the warts. Cryosurgery, laser treatment (not laser ablation), or cantharidin application can be performed on all warts. On the knee, ablation by blade or laser, or cautery are also possible. The treatment can usually be carried out at time of first consultation. Current cost for cryosurgery or laser or cantharidin of 3 warts is $145.
Does your office treat mosaic plantar warts? I have several stubborn ones that have resisted at home OTC treatment. Thank you.
Warts are caused by a virus. They are by default difficult to treat because viruses are much smarter than humans. Treatment of warts on the sole take on average a year when you combine monthly in-office procedures with at home treatments. Many warts resolve on their own after 3-5 years. If this is not the case, if the wart causes pain with daily activities or if you have history of a lymphoma or leukemia, treatment is recommended.
skin How much it would cost for anyone of the surgeries to remove black small wart of buttocks
Consultation fee is $85 for this limited problem. This includes examination and discussion of treatment options. Pending on the diagnosis (warts are not usually black on buttocks, unless it is brown and could by a condyloma), removal is around $150 and fee for pathologist (if applicable) is another $150 to the pathology laboratory. Please note that warts do not always resolve with one treatment because they have a way of hiding form our immune system.
I have been to a dermatologist for over a year now- and they burned the wart off twice ..came right back even bigger.. then they decided to do 3 treatments of needles on the wart to boost my immune system and that didn’t work either.. so after a year my wart is now a size of a dime and on my right cheek and she referred me to a plastic surgent.. called the plastic surgent and they said they don’t really deal with small things like this..
I just want this thing removed and understand it’s on my face and rather have stitches than looking at this thing…. can you help or should i keep looking for a plastic surgent.
Excision of a wart by a dermatologist or plastic surgeon is not as straight forward as you might think. Warts are caused by a virus and this virus makes itself invisible from our immune system. Each treatment has 37% efficacy. This includes at home or in office treatments including excision. Excision does not always assure that the virus is removed after cutting the wart out but treatment will definitely be more challenging if the wart comes back around the scars after excision. Your dermatologist has attempted to activate your immune system to overcome the invisibility issue I mentioned above with 2 different methods. Quite, honestly before cutting and failing I suggest to explore other options of activating the immune system. They include topical agents such as imiquimod, fluorouracil and the superpotent green tea extract Veregen. Please discuss these with your dermatologist or schedule an appointment with one of our dermatologists.
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.
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.
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.