Part 1: Spine, or palmoplantar wart
It has been proven that certain types of human papillomavirus (HPV) can lead to the development of tumor diseases. It is also known that the types that cause the formation of palmoplantar warts are not oncogenic. That is, they do not cause the formation of malignant neoplasms that give metastases. It would seem that there is nothing wrong. However, this opinion is not always correct.
Palmoplantar warts: to treat or not to treat?
Definitely yes! After all, papillomaviruses are very contagious. Therefore, if the formations are often injured, then the viruses quickly spread to healthy areas of the skin, leading to even greater growth of warts.
In addition, the constant presence of the virus in the body weakens the functioning of the immune system. The baby can endure any diseases more severely and longer: colds, sore throats, pneumonia and others.
Although in fairness it is worth noting: according to statistics, self-healing of palmoplantar warts occurs in 25-27% of cases 15-20 weeks after infection. However, you must agree that the recovery rate is small. Is it worth risking your child's health? I think no. It is better to get rid of such “decorations” in a timely manner.
Palmoplantar warts: how to treat?
Unfortunately, today there is not a single 100% effective method that provides a complete cure for HPV. Therefore, even after seemingly successful treatment, there is always a risk that warts on the soles and/or palms will grow again.
Official medicine offers two main directions in the treatment of palmar-plantar formations:
- Conservative method: medications are prescribed.
- Surgical method: a minor operation is performed to remove the warts.
Which one is better for the baby? In fact, there is no clear answer to this question, since everything depends on the age of the child, the number and size of formations. The decision should be made only by the doctor in each specific case individually.
So, let's talk about the methods in a little more detail.
Mode of application
Oxolin is suitable for a home method for removing condylomas, spines and other types of benign tumors caused by HPV. To cleanse the skin of unwanted growths, the instructions advise applying the drug to problem areas 2-3 times a day until complete recovery.
The duration of therapy depends on the type and size of tumors. The course of treatment of papillomas on the legs and feet with oxoline takes from 2 to 4 weeks. The patient will need the same amount of time to permanently get rid of genital warts in intimate places. Patients who want to remove palmar and plantar warts must use the drug for 2-3 months.
To remove a wart with oxolin, you need to:
- Before each application of the drug, steam the neoplasm in hot water and soda.
- Remove the softened surface of the wart using a pumice stone or a manicure file.
- Lubricate the skin tumor prepared for the procedure and the healthy epidermis around it generously with oxolinic ointment.
- Allow the product to absorb and do not wash it off for 3 hours. If desired, the treated area can be sealed with a bactericidal plaster.
- After 6-12 hours, treat the wart again.
Use of medications: ointments and cauterizing liquids
Surgery is painful and frightening for most children. And due to their age, not all children can have formations on their soles and/or palms removed.
First, it is recommended to get rid of such “decorations” with the help of medications. And here the pharmaceutical industry comes to the rescue, in its arsenal there is a wide selection of tools.
Keratolytics
Products that soften the surface of the wart, break down keratin (a protein with mechanical strength) and promote exfoliation of the skin on the treated area. As a result, the process of skin cell renewal is stimulated, which leads to its restoration.
- Uroderm is an ointment. The instructions do not indicate that the product should not be used in children.
- Salicylic ointment is an effective medicine. However, according to the instructions in the drug reference book, Vidal is contraindicated for use in childhood.
Preparations with cauterizing properties
Promote the coagulation of skin proteins and mummification (intravital drying) of altered cells.
- Mountain celandine - balm (dark solution). Contains extracts from herbs: celandine, string, gentian, golden rhododendron and goose foot. The drug is not recommended for use in children under five years of age.
Do not confuse Mountain Celandine with SuperClandestine - a chemical preparation that has nothing in common with a natural product, but contains sodium and potassium hydroxide (a clear solution).
- Solcoderm is a solution for external use in children over five years of age. Apply to skin formations with a special applicator only by a doctor. It is unacceptable to use the drug independently at home.
- Verrucacid is a liquid for external use that is not used in children under seven years of age, so the product is not suitable for children.
Note to mom
Carry out all procedures at home with drugs that have cauterizing properties, avoiding contact of the solution with the mucous membranes and healthy areas of the baby’s skin. In addition, it is advisable to process the formations in a well-ventilated area, since the liquids have a pungent odor.
Antiviral ointments
- Riodoxol is available as a 0.25% or 0.5% ointment. The percentage of ointment that is used in a child is determined by the doctor. The instructions do not indicate that the drug is contraindicated for use in children.
- Viferon ointment. The main active ingredient is synthetic interferon, which not only fights viruses, but also stimulates local immunity. Prescribed from the age of 12 months.
- Oxolinic 3% ointment. The drug is contraindicated for use in children under 3 months.
To achieve a better effect, as well as to avoid the development of viral resistance to antiviral drugs, it is sometimes advisable to alternate ointments every 10 days.
Cryotherapy products
The virus is killed and the wart is removed by freezing the modified tissue at a temperature of minus 57 degrees.
Cryopharma is an aerosol containing propane and dimethyl ether. The product can be used at home. Contraindicated for use in children under 4 years of age.
The following drugs are only a part of the drugs approved for the treatment of palmoplantar warts in children. But don’t rush to immediately go to the pharmacy for a miracle cure. It is better to consult a doctor who will prescribe the drug and also recommend a regimen and duration of treatment in accordance with the child’s age, number and size of formations.
Human papillomavirus infection of the skin (papillomatosis, or warts) is caused by human papillomaviruses (HPV). The HPV group is the DNA-containing papovaviruses ( Papovaviridae
) size 40-50 nm.
More than 100 types of HPV are known, of which more than 40 can cause damage to the anogenital tract (genitals and anus) and the appearance of genital warts.
Warts are one of the most characteristic clinical manifestations of HPV infection. The histological picture is characterized by proliferation of the epidermis with impaired keratinization, vacuolization of cells and hypertrophy of the papillary dermis [1].
There are vulgar, flat, plantar, filiform and genital warts.
Types of warts
Vulgar (simple) warts
account for up to 70% of all skin warts and occur mainly in school-age children. These are round papules the size of a pinhead to a pea, with an uneven, keratinized surface, grayish, yellowish-brown or flesh-colored, which can merge with each other. The favorite localization is the hands, but they can appear on the face, red border of the lips and, extremely rarely, on the mucous membrane of the mouth. Usually among the warts there is the largest one - the “maternal” one. When the mother's wart is removed, all the others often disappear as well.
Flat (juvenile) warts
are less common (4%) and are observed mainly in children and young people. They are small in size, have a smooth surface, the color of normal skin or are slightly yellowish, and rise above the skin level. The shape can be round or polygonal. Flat warts are characterized by multiple rashes of elements, mainly on the back of the hands and feet, face, and oral mucosa. Flat warts can be localized on the skin of the penis, cervix, and rectum.
Palmoplantar warts
common among adults and young people and occur in 34% of skin warts. They appear in the form of dense formations with horny layers. Plantar warts are the most difficult to diagnose: they must be distinguished from calluses, calluses, and horny syphilitic papules of the soles.
Palmoplantar warts are most often observed on areas of pressure from ill-fitting shoes and can cause pain when walking. In patients with excessive sweating of the hands and feet, warts spread quickly and are difficult to treat.
Filiform warts
They are soft papules, flesh-colored to dark brown, often pedunculated. They are often located on the neck, skin of the eyelids, in the armpit, groin area, and under the mammary glands. Their size is usually 1-4 mm, but sometimes reaches 3 cm or more in diameter.
A pronounced tendency to autoinoculation (self-infection) proves the viral origin of filamentous warts, and the frequent combination with diabetes mellitus, obesity, pregnancy, and menopause indicates that they are hormonally determined.
Genital warts (genital warts)
are usually localized in the intergluteal folds, on the skin of the perineum, and external genitalia. The appearance of genital warts is promoted by secretions that occur during inflammatory diseases of the genital organs. Sexual transmission is also possible. At first, genital warts appear as soft, papule-like, pointed nodules that tend to coalesce into tumor-like conglomerates with a surface resembling a cockscomb or cauliflower (giant genital warts). In genital warts, the hyperplastic epidermis retains its typical structure, although keratinization is disrupted (parakeratosis). Typically, condylomas are caused by HPV types 6-11; their malignant degeneration occurs rarely.
Causes of warts
HPV is transmitted through contact from people or animals suffering from diseases caused by HPV, as well as through contact with a virus carrier who does not have clinical manifestations of the disease. Intensive reproduction of HPV occurs in the superficial layers of the skin. Another type of infection spread is autoinoculation (self-infection). For example, warts in the periungual area are observed mainly in people who have the habit of biting their nails, and the appearance of flat warts on the cheeks, chin and legs can be caused by shaving, hair removal, and cosmetic peeling.
The “gate” for virus penetration is microtrauma of the skin (abrasions, cracks). Infection can occur in swimming pools, baths, and gyms. People who cut meat, fish and poultry often suffer from warts on the hand and forearm (“butcher’s warts”).
The incidence of warts has not been studied, but, according to various sources [2, 3], they occur in 10% of children and adolescents, most often in the age group of 12-16 years.
Treatment methods
Therapy for HPV infection is reduced to treatment aimed at removing areas of altered epithelium along with viruses. For this purpose, along with surgical methods, podophyllin, podophyllotoxin, liquid nitrogen, laser, electrocoagulation, acids and mixtures of acids are used.
Surgical methods
Cold treatment (cryodestruction).
The advantage of the method is the ability to treat extensive lesions. Side effects include pain during treatment, the formation of erosions and ulcers, and the occurrence of hyperpigmentation (darkening) of the skin.
Coagulation
using electrosurgical instruments or laser. In recent years, this method has been increasingly abandoned, since the smoke can be potentially dangerous, more for the doctor than for the patient. A high risk of HPV infection for a surgeon through smoke generated by tissue evaporation has been proven. A mask of any density is not effective. Unfortunately, unpleasant localizations of warts when infected through smoke are the pharynx, larynx, respiratory tract, mouth and nose.
Surgical excision
effective, but has a certain relapse rate. 63-91% of patients are cured.
Local drug treatment
In modern conditions, local drug treatment is most preferable.
Podophyllin
(podophyllin). A resin obtained from plants that has a cytotoxic effect. Usually a 10-25% solution is used on an outpatient basis 1-2 times a week for no more than 5 weeks.
Podophyllotoxin
(podophyllotoxin) is the most active substance in podophyllin. It is the active ingredient of several well-known old drugs, including those prepared in pharmacies.
Oxolinic ointment 3%
(unguentum oxolini 3%). Has virucidal activity. To remove genital warts, apply 3% ointment 2-3 times a day for 2 weeks to 2 months. Wax paper is placed on top. In general, this treatment method is complex and not effective enough.
Feresol
is a mixture of phenol (60%) and tricresol (40%). Condylomas are treated with a break of 1 week. The mechanism of action of this drug is a chemical burn, so its use is possible only in medical institutions and not in all patients. At the same time, effectiveness is balanced with safety, since there is always a risk of under-treatment or excessively deep or extensive exposure, including scarring.
Trichloroacetic acid
at a concentration of 80-90% it is a weak destructive chemical that causes the formation of local necrosis. Recommended for mild cases and pregnancy. Unfortunately, the relapse rate with this treatment method is quite high.
Various mixtures of organic and inorganic acids
, produced by pharmacies (nowadays rare). They have a coagulating effect on altered tissues. Treatment of condylomas with such drugs is carried out using a special applicator, which allows the drug to be applied locally to the formation, preventing it from spreading to surrounding tissues. The procedure is painless. The break between sessions can be 1-4 weeks, the scab disappears on the 3-5th day.
Apparently, the best known method of combating HPV infection, both in terms of simplicity and effectiveness, is modification of the acid treatment method
- in the form of finished preparations containing both salicylic and lactic acids.
Salicylic acid has a keratolytic effect and has antimicrobial activity. Lactic acid causes chemical destruction of warts.
In practice, salicylic acid has been used for many years in different concentrations - from 15 to 60% (most often 15-26%; without lactic acid). According to numerous data [4], the effectiveness of such treatment reaches approximately 60-75%.
To treat warts in modern conditions, special varnishes are used in the form of elastic collodion, into which a combination of salicylic and lactic acids is introduced. This varnish is used to remove calluses, warts, etc. When applied to the skin, the varnish hardens in the form of a thin film, which is quite strong and prolongs the medicinal effect.
If necessary, the film from the skin can be removed by intense mechanical action or easily - with gasoline. The varnish has the ability to penetrate deeply into the skin, which has a positive effect on the effectiveness of treatment.
This varnish can be made ex tempore, according to a doctor's prescription. But currently there is a ready-made dosage form in the form of Collomac varnish.
Collomak
is a modern multicomponent drug that contains active ingredients: keratolytics - salicylic (20%) and lactic (5%) acids, emulsifier polidocanol 600 (2%), as well as special fillers that form the basis of the varnish dosage form, a film-forming substance ( ethylcellulose 5.5%), plasticizer (dibutyl phthalate 1%), solvents (acetone 6.65%).
Polidocanol, a component of Collomac
, plays another important role: it causes sclerosis and obliteration of small veins and arteries at the base of the papilloma.
Collomak
applied to a wart or callus, after which the horny layers are easily removed.
If necessary, this treatment is repeated several times. To avoid damage to the surrounding skin when applying Collomac
, it is protected with indifferent zinc paste.
You can protect the surrounding skin with adhesive tape by cutting a hole in the middle. The duration of treatment is determined depending on the effectiveness of the drug. For adults, the maximum dose of Collomac
is 10 ml/day, which corresponds to 2 g of salicylic acid;
for children - 1 ml, which corresponds to 0.2 g of salicylic acid. It is not recommended to exceed this dose and treat several areas of the skin and mucous membranes at the same time. During pregnancy, the use of Collomak
is permissible only when applied to a limited surface (no more than 5 cm).
When using the drug in the maximum daily dose in adults and children, the duration of treatment should not exceed 1 week. Positive experience with the use of Collomac
allows us to recommend this drug for widespread use in gynecological and dermatological practice in the treatment of warts, including genital warts [5].
Modern local drugs for the treatment of HPV have undoubtedly made a big step forward compared to the methods used previously. This progress is a consequence of perfecting finished dosage forms from previously known ingredients. In combination preparations, the effective properties of their predecessors - single preparations - are preserved and enhanced and the disadvantages are eliminated, primarily excessive resorption and fairly extensive local irritation.
This is exactly how we see the emergence of modern combination drugs for the treatment of HPV, which are now undoubtedly the drugs of choice.
Surgical treatment of palmoplantar warts in children
There are several methods. However, when it comes to children, you should weigh the pros and cons more carefully in order to make the right decision.
When is removal of palmoplantar warts indicated in children?
In children under five years of age, it is generally not recommended to resort to surgical treatment of spines.
In older children, palmoplantar warts are removed in several cases:
- There is severe pain.
- They interfere with walking or performing certain movements with the hand (for example, while writing).
- A tear appeared.
- The formations have grown to large sizes.
- Black dots appeared on the surface of the warts, or the formations began to bleed.
- Near the main focus there are subsidiary ones - the result of the spread of papillomavirus to a healthy area of skin.
Removal methods
A visit to the surgeon is an unpleasant event for a child. And adults should first prepare mentally for the upcoming visit.
However, if the doctor nevertheless recommended surgical treatment, it is better to “arm yourself” with some knowledge.
Cryotherapy
The essence of the technique
The wart is exposed to liquid nitrogen, the temperature of which is minus 196 degrees. This destroys the affected cells and improves local immunity.
Need for pain relief
The procedure is painful, so the doctor suggests local anesthesia. And if a small tumor is to be removed from a teenager, then it is possible to carry out the procedure without pain relief, since the exposure time is short.
Efficiency
When a wart is removed in the first six months from its appearance, the effectiveness is about 87%, if more - about 39%. Therefore, sometimes you have to repeat sessions.
Duration
One exposure or treatment lasts from 10 to 30 seconds.
If the formation is large, then during one session the removal is carried out in several impacts, between which a break of about one or two minutes is taken to assess the effectiveness of the treatment.
If the wart is small, then one exposure is usually sufficient.
Care and healing
The wound heals with the formation of a crust, which falls off on its own after 10-14 days. It is recommended to treat the wound locally with an antiseptic for the first 4-5 days.
After the procedure, moderate pain persists locally for several days.
Consequences
Deep processing may result in scarring.
Laser coagulation
The essence of the technique
The affected area is cauterized layer by layer, so the depth of treatment is controlled. In addition, the laser beam seals the vessels at the site of exposure, preventing the development of bleeding.
Need for pain relief
The procedure is painful, so local anesthesia is performed.
Efficiency depends on the laser coagulation method. For example, when treated with a carbon dioxide laser - 70%, with an erbium laser - 75%, with a pulsed dye laser - 95%.
As you can see, relapses are possible, and sometimes repeated sessions are required.
The duration of the procedure depends on the size of the formation, but usually ranges from 1-2 to 10 minutes.
Care and healing
The wound heals within 7-10 days with the formation of a crust, which disappears on its own after 10-14 days. The wound is treated with any disinfectant solution in the first 4-6 days.
Consequences
The procedure usually leaves no traces, but if the impact was deep, scarring may occur.
Radio wave therapy
The essence of the technique
High-frequency waves generate thermal energy, which disrupts the structure of only the changed cells in the wart, without affecting healthy tissue. In addition, the vessels are cauterized in parallel, so bleeding does not develop.
Need for pain relief
The procedure is low-painful, since radio waves prevent painful muscle contraction and stimulation of nerve endings. Therefore, it is believed that the administration of local anesthetic by injection is not necessary in most cases. However, much depends on the age and pain sensitivity threshold of the child, so pain relief is usually carried out.
As an alternative to injections, you can use a cream or spray that contains an anesthetic to reduce discomfort during the procedure.
Efficiency - 95-97%.
The duration of the procedure is usually from 10 to 20 minutes.
Care and healing
A small and painless wound is formed, which becomes covered with a crust. After 7-10 days the crust falls off on its own.
In most cases, local treatment of the wound with an antiseptic is not required (with rare exceptions), since tissue sterilization occurs during the procedure.
Consequences
As a rule, no scars are formed.
Or maybe it's better to combine?
Did you successfully get rid of the thorn and it never bothered your baby again? Congratulations! However, no child is immune from relapse (return of symptoms of the disease) after removal of formations by chemical or surgical means, since the papillomavirus often remains in the child’s body for a long time.
What to do? The question is not rhetorical. There is an answer: improve the functioning of the baby’s immune system.
The best thing is to provide your child with a nutritious diet without preservatives and dyes, and also to take more walks in the fresh air. After all, our body is a self-regulating system that will find the right solution itself.
But such measures do not always lead to the desired result, so it is necessary to intervene in the body’s functioning artificially.
If necessary, the doctor prescribes medications according to age:
- Vitamins - for example, Vitamins or Alphabet. Read more about vitamins for children in our articles and
- Antiviral agents that also improve the functioning of the immune system. It is believed that interferon drugs (for example, Viferon) and Groprinosin (Isoprinosine) have good effectiveness against HPV.
- Immunostimulants - for example, Lykopid.
Warts on the legs: causes and etiology
In order to determine the answer to the question of how to treat warts on the legs, you must initially understand that these epidermal growths are always a consequence of the activation of HPV in the human body. Anyone can become a carrier of the papilloma virus through direct contact with an infected person or using common household items, but skin manifestations may be absent even if several forms of HPV are present in the body. What provokes the formation of plantar warts, and what patient pathologies can this process indicate:
- Decreased immunity, which can occur against the background of serious inflammatory and infectious conditions, overwork, poor nutrition and neuro-emotional stress;
- Damage to the integrity of the epidermal cover of the feet: cracks and microcracks, punctures, burns, etc.;
- Impaired tissue trophism, which can result from pathological conditions such as diabetes mellitus, atherosclerosis, varicose veins;
- Dry skin, tendency to skin hyperkeratosis;
- Excessive sweating of the feet, which may be associated with disturbances in the sebaceous and sweat glands;
- Prolonged wearing of uncomfortable shoes that compress the foot.
Errors and misconceptions, or Do conspiracies and rituals work?
Mark Twain in one of his works gives advice from his (many familiar) literary character Tom Sawyer. This tomboy and “generator” of ideas believed that to get rid of warts it was enough to spin a dead cat over your head and then bury it in a cemetery.
What to say? Whatever method is strange, it can lead to the desired result. Because when the functioning of the immune system improves, self-healing sometimes occurs, which may coincide with the moment of your desire to get rid of spines in such an original way.
In fact, conspiracies and rituals do not affect HPV. Moreover, some methods sometimes involve traumatizing the wart (for example, pulling it with a thread) or lubricating it with excessively aggressive media (such as rubber glue).
Such interventions can lead to relapse (the spine often grows again with the formation of new warts), since the formation grows deeply into the skin. Whereas in such methods only the top is removed, and the virus is easily spread with pieces of tissue to neighboring areas of the skin. In addition, there is a risk of infection.
Perhaps it is not worth experimenting, bringing the child even more inconvenience and emotional discomfort.
"Grandma's Remedies" from Nature's Pantry
You will find many recipes on the Internet using garlic, acetic acid and other ingredients. Not all of these methods are suitable for use on children, as they may cause burns to children's delicate skin.
Still, there is one method that dermatologists recommend for painless removal of spines in older children: the use of celandine, which also has antiviral properties and promotes tissue healing.
Fresh celandine juice is used. Moreover, to extend the period of use, you can mix freshly squeezed celandine juice with alcohol (alcohol extract) or glycerin at home.
The method has a significant drawback: only celandine that blooms from May to August-September can be used for treatment. Therefore, this method is not entirely suitable for a city dweller. In this case, you can use the pharmaceutical drug Mountain Celandine.
special instructions
Treatment of warts with oxolinic ointment should not be accompanied by discomfort at the site of application of the drug. If itching, burning, swelling and other side effects occur, the patient should wash the skin under running warm water and soap and stop further use of the product.
At what age can oxolinic ointment be used?
The ointment can be used from the first days of life. Treatment with oxolin for condylomas and growths in children under 12 years of age should be carried out under the supervision of a specialist. Allergic skin diseases are a contraindication to the use of this drug for warts in childhood.
Oxolinic ointment during pregnancy and lactation
The drug should be used with caution to remove condylomas and other benign tumors during pregnancy and breastfeeding. Women who experience the formation of warts during pregnancy or lactation should be treated with the drug with the permission of a doctor.
