Common Lumps & Bumps – Warts
What are they?
Warts, otherwise known as verrucae, are the result of the skin’s epidermal cells infected by the human papilloma virus (HPV). This results in overgrowth of this cell layer and subsequent keratinization, leading to the distinctive appearance of the wart.
Warts can be flat, raised or pedunculated. They generally are skin colored but may appear brown or tan. Warts can be found on any part of the body. When they are in the groin region, they are termed as condylomata acuminata.
Why do I get them?
Warts are caused by the infection of skin cells by HPV. They can be spread by direct skin to skin contact, either from an infected person or from one part of the body to another. Minor trauma with small breaks in the epidermal layers usually facilitates spread.
Are they dangerous?
Most warts are self-limiting, benign lesions. They may persist for up to 2 years before regression. Generally speaking, warts are not dangerous. However genital lesions caused by HPV strains 16 and 18 are a known risk factor for cervical cancer.
What should I do?
Common warts on the rest of the body may be safely left alone, or, more commonly, removed for cosmetic reasons or for relief of physical symptoms such as itch or discomfort.
Genital lesions should always be removed. In addition, it is advisable for patients with genital warts to get screened for other sexually transmitted infections such as gonorrhea, syphilis and HIV. It is also advisable to abstain from sexual activities while having genital warts
How do I remove them?
Warts can be removed in a variety of ways. Topical applications containing imiquinod or salicylic acid help lyse the keratinized buildup and clear the infected skin cells. These may be obtained at a pharmacy or doctor’s clinic. This method of removal does take a fair bit of time and it may take a few months to see satisfactory results.
Warts, particularly genital lesions are quite amenable to cryotherapy. This is an outpatient procedure involving the application of a freezing agent onto the lesion in order to kill the cells infected with the HPV. Occasionally the surface layer of the wart may need to be curetted down first. Depending on the size and configuration of the lesion, this may be done in 2-6 sessions with each session 1-2 weeks apart.
On occasion, it may be necessary to completely excise a lesion. This may be done by a minor surgery or by electrocautery. These procedures may be done in the outpatient setting with minimum preparation. Depending on the site of the lesion, some local anaesthesia may need to be used. Complete removal of the lesions may be achieved in 1-2 sessions.
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