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Warts HPV Human Papillomavirus Memphis Dermatologist

George Woodbury Jr. M.D. (10/26/2023)

















Warts – also called Verruca Vulgaris – are a common skin problem bringing patients to a Memphis Dermatologist such as myself – now with over 30 years with Rheumatology and Dermatology Associates, Cordova TN. Warts are due to skin infection with Human Papillomavirus – also called HPV – so let’s take a look at what warts are, how we diagnose warts and options for wart treatment.















A wart is a type of skin infection with a virus that a person picks up from another person who has a wart. Verruca vulgaris or warts are actually due to a type of skin HPV infection, for Human Papilloma Virus, a type of DNA virus that spreads between people. Certain strains of or types of Human Papillomavirus lead to infections of the cervix, the entry area to the uterus, and lead to the development of cervical cancer.































Many Dermatologists diagnose warts simply by visual inspection, though if we are unsure whether a given lesion is a wart, or feel that it could be a type of Skin Cancer, we sometimes remove the lesion after a shot of local anesthetic, a Lidocaine shot, to get the lesion diagnosed by the Dermatopathology Laboratory. This type of test is called a “wart excision,” which is a type of “skin biopsy.” It generally takes one week to several weeks to get the results back from the laboratory.

















If a Dermatologic Surgeon like myself sees a lesion that appears to be a wart but suspects a type of Skin Cancer, called a Squamous Cell Skin Cancer, or a Squamous Cell Carcinoma, and the laboratory diagnoses the lesion as a Squamous Cell Skin Cancer, then further surgery may be needed, to help to ensure that the edges of the specimen sent into the laboratory are clear of cancer. Sometimes, we use a special type of tissue processing called Mohs Surgery or Mohs Micrographic Surgery.

































What are the types of HPV or the types of Warts?


The most common type of Wart is what’s called Verruca Vulgaris, or Verrucae Vulgares. These growths can occur on any part of the body, as raised bumps, especially common on the hands and feet, or the arms and legs. The virus can be spread through shaving so that one wart can easily become five warts or even ten warts.
















Another common type of Wart is called a Plantar Wart or Verruca Plantaris, meaning that the lesion occurs on the bottom of the hand or foot. It’s a high priority to get this type of lesion treated, because they’re often painful when walking, and they are also prone to spread to other areas of the hands and feet.
















Warts that develop beside the fingernail or toenail, making them into “Periungual Warts.” Sometimes, these periungual warts can grow underneath the toenail or fingernail, making them more difficult to treat, and at higher risk of growing back or ‘recurring.”


























What populations are at higher risk of the wart virus?


Anyone can develop a Wart, but people with family members with Warts are definitely at higher risk of this infection. Furthermore, people who have close contact with other people, such as athletes, people living in dormitories, and people in prisons, seem to be at higher risk, as well as people who are barefoot in communal showers or people who have sex with more than one sexual partner, possibly through increased skin-to-skin contact. I’ve certainly had many young people coming for treatment of Warts after participating in ballet, TaeKwondo, karate, or kickboxing.



















What can be done for Wart prevention?


It’s generally a good idea to be careful not to touch another person’s wart – because the infection can spread from person to person. It helps to be careful about being barefoot at the gym – such as by wearing flip-flops and by carefully washing one’s feet after being on the gym floor.
























Genital HPV infection is the most common STD or Sexually Transmitted Disease in the United States, and certain genital HPV infections can lead to cervical cancer in women, penile cancer in men, anal cancer, and oropharyngeal cancer. Fortunately, the Gardasil9 vaccination or shot helps to cut down on the risk of infection with high-risk strains or HPV types for this type of cancer. This vaccine protects against HPV types 16, 18, 6, and 11, 31, 33, 45, 52, and 58. There are however over 100 types of HPV – so this vaccination cannot prevent all risk of development of warts. It is recommended by the Centers for Disease Control to administer two vaccination shots for both boys and girls beginning between the ages of 9 and 12.


















It also helps to get a wart infection treated promptly before the infection can spread. I’ve treated many patients, for instance, who transmit warts all over their legs by shaving again and again, without replacing their razors. So, one wart left untreated can easily become ten warts!


What can be done for Wart Treatment?




















The most common approach used by Dermatologists is what’s called Cryotherapy, the application of liquid nitrogen, a very cold liquid that causes the wart or warts to blister and then heal. This treatment often has to be done on more than one occasion. Sometimes, we use a topical resin called Podophyllotoxin or Podophyllum, or even a blistering agent called cantherone or cantharidin.




















Another Wart Treatment option used by Dermatologic Surgeons is to cut out or “excise” the wart tissue to get it evaluated by the laboratory. Even this treatment often has to be done more than once, because the wart tissue can sometimes grow back. Sometimes, we cut out the wart – particularly deep or thick warts – then follow up with a cryotherapy treatment several weeks later. Dermatologists often prefer to use cryotherapy first, because it often has a lower risk of leaving a scar.

























Nonsurgical options include prescription imiquimod cream, prescription Condylox Gel (podophyllotoxin), over-the-counter salicylic acid products (such as Wart-Off or Compound W), and prescription Tretinoin Cream or Gel (Retin A Cream or Gel). Sometimes we use a series of injections with interferon, or even a series of injections with Candida Antigen. Some Dermatologists use different types of laser therapy or laser treatments for Warts.



















Be aware that I am also President of Big River Silk™ Skincare, an organic skincare company that distributes a helpful moisturizer containing an Alpha Hydroxy Acid or AHA called Glycolic Acid – called GlycoShea Hand&Body Lotion and GlycoShea Facial&Neck Lotion. The GlycoShea Lotions can be used as an antiwrinkle cream because of their skin-smoothing Glycolic Acid. Check us out at https://www.Bigriversilkskincare.com.


























So if you or a family member or friend, has a suspicious lesion, or any type of growth that may be a Wart of Verruca, consider seeing a Dermatologist. My own Memphis Dermatology practice since 1993 has been with Rheumatology and Dermatology Associates, 8143 Walnut Grove Road, Cordova, TN 38018 (1-901-753-0168). Or you can find a Dermatologist closer to you by going to the American Academy of Dermatology website, www.AAD.org, then plugging your zip code into the “Find a Dermatologist” tab. Don’t delay. Get examined today!




















George Woodbury, Jr., M.D.

Board-certified Dermatologist at Rheumatology and Dermatology Associates

8143 Walnut Grove Road

Cordova TN 38018

1-901-753-0168


President of Big River Silk Skincare Inc.



10/22/2023

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