Common Warts & Genital Warts
What Are Common Warts?
Common warts (verruca vulgaris), generally known as “viral warts,” are a skin condition. They are benign growths that occur when the human papillomavirus (HPV) infects cells called keratinocytes in the skin or mucous membranes.
More than 200 types of HPV have been identified to date, but the ones that cause common warts include HPV 2, 27, and 57.
Small ones may only just be visible depending on the lighting, but as they grow the surface becomes rough and bumpy, and blood vessels may appear as red dots within the yellow or white keratin. They can form anywhere on the body, but are most common on the hands and feet.
The virus spreads by direct contact; it can multiply on the soles of the feet, spread from the feet to the hands, or be passed to other people.
Treatment of Common Warts (Viral Warts)
Cryotherapy (liquid nitrogen)
The most common treatment for common warts is cryotherapy using liquid nitrogen.
Liquid nitrogen at minus 196°C freezes the wart and the surrounding normal tissue to destroy the virus-infected cells; treatment is repeated every one to two weeks.
A scab may form, in which case it is most effective to perform the next treatment just after the scab falls off. As it improves, the interval between treatments can sometimes be lengthened. Because the pain during freezing is intense, many people drop out of treatment, and there are also cases where someone is too busy, lets several months pass, and the wart grows large again.
Risks include pain lasting several days, blisters, blood blisters, pigmentation, scarring, and the wart being left in a doughnut shape.
Topical medications
We may apply salicylic acid petrolatum or attach a Speel plaster®. Although not covered by insurance, topical active vitamin D3 is also sometimes used, and sealing it with plastic wrap or a Speel plaster® is said to make it more effective.
Topical therapy may be used for children who cannot tolerate the pain, but it has to be said that its effectiveness is less certain than that of liquid nitrogen cryotherapy. It is sometimes combined with cryotherapy. As a risk, the surrounding normal skin can be eroded.
Pulsed dye laser (V Beam) (not covered by insurance)
This laser has a wavelength that is selectively absorbed by hemoglobin. Histologically, a wart is a state in which the keratin has thickened and blood vessels have increased; when this laser is applied, the blood vessels containing hemoglobin are destroyed, which damages the wart.
It therefore works less well on the type of wart that has few blood vessels. Some people are cured in a single session; otherwise it is repeated roughly once every three to four weeks. It requires fewer clinic visits than liquid nitrogen cryotherapy. Risks include pain and blood blisters.
Trichloroacetic acid application (self-pay)
Trichloroacetic acid (TCA) is a strong acid that erodes tissue. Taking care not to get it on the surrounding skin, we apply it directly to the affected area and protect it with a bandage or the like. Wash it off that night. It is a relatively easy treatment to use for children and others for whom treatment is difficult because of pain, but it still requires regular clinic visits and works less well on warts with thick keratin. As a risk, if the medication spreads to the surrounding area it can cause severe inflammation.
Electrocoagulation with a high-frequency radio-wave scalpel (Surgitron)
This method uses an electric scalpel to burn the wart away. If it goes well it can be removed in a single session, but it leaves a hollowed-out wound, and if the virus remains at the base of the wound it can recur deep down and become troublesome. It is fine for small, isolated warts, but is not a very good fit for large ones such as those on the soles of the feet. Risks include anesthetic allergy, postoperative pain, and scarring.
Vaporization with a carbon dioxide (CO2) laser
The carbon dioxide (CO2) laser has a wavelength that is readily absorbed by water. If it goes well it can be removed in a single session, but it leaves a hollowed-out wound, and if the virus remains at the base of the wound it can recur deep down and become troublesome. It is fine for small, isolated warts, but is not a very good fit for large ones such as those on the soles of the feet. Risks include anesthetic allergy, postoperative pain, and scarring.
Preventing Common Warts and Precautions in Daily Life
Common warts are a viral skin condition, and the infection can spread unknowingly in the course of everyday life. To prevent recurrence and spread to other areas, you need to be mindful of how you go about your daily life. Below, we explain habits for preventing infection and basic measures for avoiding worsening.
Lifestyle habits to prevent infection
Because the virus that causes common warts easily enters through small breaks in the skin, keeping the skin clean is fundamental. They tend to form on the hands and feet in particular, so make a point of washing these areas well. Wash your hands thoroughly and regularly at set times, such as before meals and when you get home. As for the feet, people who do sports barefoot in public settings, such as karate, judo, kendo, or yoga, need to be careful. It is a good idea to wash at least your feet right after the activity or as soon as you get home.
It is also advisable, where appropriate, to avoid touching the floor directly in places such as pool and gym shower rooms by wearing slippers. Because the infection can also spread within a household, avoid sharing items such as towels and nail clippers.
Because the virus enters more easily when the skin is broken, it is also important not to leave dryness or cracks untreated and to keep your skin in good condition.
Care to keep common warts from worsening
If you already have a wart, forcibly scratching or filing it can cause the virus to spread to the surrounding skin. Even if its appearance bothers you, it is important not to try to treat it yourself but to receive treatment based on a doctor’s judgment.
Also, when you need to cover the affected area, use a breathable material and avoid sealing it for long periods. Repeated friction or pressure can prolong the condition.
During treatment, try to keep the affected area clean while avoiding irritation. If the symptoms change or the warts increase in number, we recommend seeing a doctor promptly.
What Are Genital Warts?
What are genital warts?
Genital warts (condyloma acuminatum) are cauliflower-shaped growths that occur when the human papillomavirus (HPV) infects the mucous membranes. They can occur in both men and women and are seen around the genitals and anus.
They are transmitted mainly through sexual contact, with an incubation period said to be two to three months. More than 200 types of HPV have been identified to date, and HPV 6 and 11, among others, are found in genital warts. They can be prevented with the quadrivalent or nine-valent HPV vaccine. Please consult a gynecologist or similar specialist about the vaccine.
Treatment of genital warts
Cryotherapy (liquid nitrogen)
Liquid nitrogen at minus 196°C freezes the growth to destroy the virus-infected cells; treatment is repeated every one to two weeks. The skin of the genital area heals well, but marks such as pigmentation can remain. (In most cases they fade if you wait a long time.) Because it is the genital area, the pain of treatment is often hard to bear.
Topical Beselna Cream (imiquimod)
Beselna Cream is a topical medication made of an antiviral ingredient called imiquimod. Apply it to the affected area three times a week before bed and wash it off in the morning. As a rule, it is used for up to 16 weeks. It can cause irritation that breaks the skin and becomes painful, in which case treatment is paused. It is often combined with liquid nitrogen cryotherapy.
Electrocoagulation with a high-frequency radio-wave scalpel (Surgitron)
This method uses an electric scalpel to burn the growth away. It is considered when cryotherapy or topical therapy fails, but the virus may still remain and a complete cure may not be possible. In the genital area there is a risk of deformity from scarring. Other risks include anesthetic allergy and postoperative pain.
Vaporization with a carbon dioxide (CO2) laser (self-pay)
The carbon dioxide (CO2) laser has a wavelength that is readily absorbed by water. It is considered when cryotherapy or topical therapy fails, but the virus may still remain and a complete cure may not be possible. In the genital area there is a risk of deformity from scarring. Other risks include anesthetic allergy and postoperative pain.