Warts and moles

→ Warts are contagious skin growths, composed of dead skin cells, which affect its upper layer. These are also called warts, papillomas, skin appendages or soft fibroids. Many warts disappear in a period between 6 months and 2 years after the appearance, without the need for any treatment.

Warts appear when the human papilloma virus (HPV) invades the skin cells and creates small, mole-like spots (from which they are completely different). These spots have a rough surface, appear in the area of the skin folds (eyelids, fingers, neck, armpits, sub-mammary, inguinal), can grow rapidly, become inflamed, hurt, bleed or break (the foot that holds them skin sagging due to minor trauma).

Warts can be unpleasant to the eye or when walking and can itch. Warts are removed with the help of a dermatologist, but can also be treated with home remedies.

→ Moles, on the other hand, are also called pigmentary nevi or liver spots, being a form of benign hyperpigmentation, but which can become cancerous / malignant. Caused by excess melanin, they can be present on the skin from birth (congenital nevi) or can appear over the years (acquired nevi), stimulated by exposure to strong sunlight and hormonal changes. Red, brown or black, liver spots may be flat or prominent, smooth or rough, with or without hairs in them.

Moles that present no danger should only be removed for cosmetic reasons or if they are often irritated by combing, shaving or wearing clothing; those that can turn into skin cancer are surgically excised.

What are warts/ papillomas and nevi/ moles?

Papillomas or warts are benign skin excrescences, caused by infection of the upper layer of the skin with human papilloma virus (HPV). It is transmitted through direct (sex) or indirect contact (clothes, toilets and public swimming pools, floors, offices), so papillomas often occur in adulthood and the elderly.

Warts do not appear immediately after contact with someone contagious, but 2-6 months later. Warts can be skin-colored or hyperpigmented, most often appear on the hands and face (usually in the folds of the skin) and can look like a solid bladder or a miniature cauliflower (they look like cauliflower).

Papillomas are asymptomatic, but can become painful, become infected, bleed or rupture. But they also grow and multiply during periods of intense sun exposure or decreased immunity: so warts can affect children, adolescents and the elderly, people with AIDS, people undergoing immunosuppressive treatment or diagnosed with eczema./

On the other hand, nevi or moles are a common outgrowth of the skin, which occurs when pigment-producing cells (melanocytes) produce excess melanin (responsible for the color of our skin, hair and eyes).

Moles are oval or round spots (mostly smaller than 6 mm in diameter - the size of a pencil eraser), brown or black (but can also be pink, blue or red), flat, prominent, smooth or rough, with hairs that grow from them. Nevi can appear anywhere on the body (including the scalp, armpits, nails and fingers). They appear (in general) in childhood and adolescence and can change their appearance or diminish over time. These benign forms of hyperpigmentation are present in greater numbers on lighter skin. And monitoring them is an important step in detecting skin cancer, as some moles can become malignant - although most are not a health risk.

Types of warts vs. moles

Types of warts

The appearance of a papilloma depends on its location in the body and the thickness of the skin there. Skin papillomas can be of several types:

1. Common papillomas (common warts or warts / verruca vulgaris): are small hard, rough, cauliflower-like prominence that appear mainly in the knees, limbs (on the joints of the fingers), of the elbows and any other area with cracked skin. They may contain blood vessels that look like blackheads.
2. Flat papillomas (flat warts / verruca plana): they are not rough to the touch, but have the appearance of flattened circles, smooth, small and numerous (20-100 each). They can be pink, yellow, brown or skin color. They appear especially in the skin areas most often exposed to the sun (face and upper and lower limbs - hands, arms, thighs). They are the type who disappears most often without treatment.
3. Plantar papillomas (plantar warts / verruca plantaris): are small, strong and very painful swellings, with a relatively flat appearance and a central black dot, surrounded by white tissue. Unlike other types, it develops in the skin, not on its surface. They appear on the soles of the feet, heels and toes, due to the pressure exerted by body weight. They are the hardest to cure.
4. „Mosaic” papillomas (mosaic warts): they have the appearance of small groups of skin excrescence, being formed by several plantar warts. They are located in the upper and lower limbs;
5. Periungual papillomas (periungual warts / periungual verrucae): they grow under and around the nails of the hands and feet, deforming them and being able to affect their growth. The skin looks like cauliflower and cracks. They can be very painful and are considered difficult to treat: they can reappear and spread after treatment.
6. Genital papillomas (genital warts, venereal vegetation, condyloma acuminata, verruca acuminata): are gray-whitish or skin-colored prominences, with granular, cauliflower appearance. They appear in the genital area (vulva, vagina, penis, anus). They can cause serious problems, leading to cancer at both sexes.
7. Filiform papillomas (filiform warts / verruca filiformis): they are long and thin in shape, can hang and grow quickly. They have skin color. They appear around the nose and mouth, on the eyelashes, neck, underarms.

Types of moles

On the other hand, moles differ depending on the size, location and time of their appearance on the skin:

1. Congenital moles (present at birth):

• small congenital nevus (less than 1.5 cm in diameter);
• medium congenital nevus (has a diameter of 1.5-19.9 cm);
• giant congenital nevus (has a diameter of over 20 cm);
• congenital hairy nevus (has thick hairs on the entire surface);
• macula café au lait (light brown spot);
• lentigine nevus (light brown spot, with several dark brown spots);
• net Ota (bluish-brown spot, appears on the face - cheek, eyes, forehead);
• Mongolian spot (bluish, occurs in the lumbar region).

2. Aquired moles:

• common nevus (flat mole, with a single uniform color); most people have 10-40 on the whole body; if you are over 50, your risk of melanoma increases;
• atypical / dysplastic nevus (larger than a pencil eraser, with a strange shape, irregular edges, unevenly pigmented); has an increased risk of melanoma (people who have 10 or more such moles are 12 times more likely to develop melanoma); it occurs mainly in people with a high genetic predisposition;
• blue nevus (dermal, with deep located pigment);
• cellular nevus (dermal, unpigmented);
• Meyerson nevus (surrounded by an eczematous halo;
• Miescher nevus (dermal, soft, embossed); usually appears on the face;
• Reed nevus (intensely pigmented, round); appears on the limbs, usually;
• Spitz nevus (pink / brown in color, is embossed and can fester); occurs in children / young people, at the level of the head;
• Unna nevus (dermal, papillomatous, with irregular surface);
• nevus with halo (delimited by a white, depigmented area of the skin); most disappear over time and occur more often among adolescents;
• recurrent nevus (pigment reappears in the scar);
• agminate nevus (alomeration of small moles or freckles);
• acral nevus (occurs in the palms or soles);
• nail nevus (appears at the level of the nail).

Causes of occurence

Warts appear from the following causes:

• HPV infection: human papilloma virus is a contagious viral infection; it works by triggering the action of keratin-producing cells (keratinocytes), which are present in the skin, hair and nails; infection causes excessive and rapid growth of this hard protein on the surface of the skin, in the form of warts; some strains are responsible for cervical cancer, while others cause benign warts; the infection is made by direct contact (oral, genital and anal sex, touching the skin of an infected person) or indirectly (using the same clothes, shoes or towels, touching the same infected surfaces - toilet, pool, office, floor);
• a weakened immune system will make the body more susceptible to disease; old age, diseases such as hypothyroidism and AIDS, immunosuppressive treatment (after a transplant), a diet low in essential nutrients (but rich in salty foods, sweets, alcohol and caffeine) and stress can all affect and weaken your immunity , your body can no longer defend itself against HPV like a book; In this case, warts appear more often, are harder to heal and can spread to other areas of the body;
• bad habits: scratching a wart can lead to infection in other areas of the body; finger sucking and red nails negatively affect the skin around the cuticles (injured or cracked skin will allow the virus to enter the epidermis more easily and infect you) and can send the virus to the face; poor hygiene can also be a problem (dry your skin well after every bath, shower or swimming session, because HPV loves warm and humid environments; wear slippers when going to the pool and public showers, especially if you have injuries or scratches on your feet);
• the profession practiced: people working in the meat industry (in slaughterhouses and butchers) are more prone to warts.

Molles appear because:

• intense exposure to sunlight (acquired moles);
• hormonal fluctuations in adolescence and pregnancy (acquired nevi);
• genetic predisposition (in the case of congenital ones, present on the skin of newborns);
• immune status (nevi may occur following the administration of certain inhibitory and immunosuppressive drugs);
• advancing in age (those acquired).

When do I have to go to the doctor?

Warts can disappear on their own (in periods between 6 months and 1-2 years) or can be removed by treatment: although they are common, they can cause shame or embarrassment, being an aesthetic or functional inconvenience. But others can last for years on the skin or reappear periodically. You need to see a dermatologist urgently if:

• genital or facial warts;
• you have papillomas that change their appearance, do not disappear and continue to grow, despite treatment;
• you have painful warts, which irritate, bleed or break by rubbing with clothes / jewelry;
• you have inflamed or infected papillomas, which contain pus;
• you confront with warts after the age of 45;
• you find that your warts spread easily to other areas of your body;
• you removed a wart, but it reappeared in the same place;
• you want to get rid of an unsightly wart;
• you want to protect your family and loved ones by eliminating papillomas that can also infect them.

The specialist doctor is the only one who can determine your risk of skin cancer, the existence of a problematic mole on your skin, its monitoring in time and a suitable treatment, in case of malignant melanoma. Symmetrical (round, uniformly colored) moles with clearly defined edges and no larger than 6 mm do not raise questions.

A dermatologist can clinically examine the moles (in the case of a patient who has few and common moles) or will do a digital dermatoscopic examination (in the case of people at risk). The latter consists of scanning the whole body for moles, checking them individually and saving images with them, to compare them later and see if a mole has changed its appearance (dermatoscopic map). Dermatoscopic examination performed annually can detect malignant melanoma or other skin cancers in time, increasing the chances of effective treatment.

A visit to the dermatologist is required if:

• you were born with large congenital moles (over 5 cm in diameter);
• you have over 50 moles on your body, of which 20 have a diameter greater than 2 mm;
• you have a new nevus and you are over 40 years old;
• stay in the sun for a long time or go to the solarium in excess;
• you are allergic to the sun or have often suffered sunburn (which has filled your skin with spots and freckles);
• you have red, pink, white and blue moles, mixed with black nevi;
• you want to get rid of a mole that causes you discomfort (being in an area often touched by the comb, razor blade, zipper, jewelry etc.) or is unsightly;
• you have a family history of malignant melanoma;
• you have a nevus that meets one or all of the 5 characteristics related to melanoma - ABCDE (asymmetrical shape of the two halves of the mole, irregular edges, uneven color, diameter greater than 6 mm, changes in size, color, height and symptoms - suppurates, bleeds, eats or hurts); a suspicious mole will be removed for biopsy.

Treatment

Treatment focuses on eliminating the symptoms and the presence of warts, not on the definitive cure (HPV cannot be eliminated from the outside, the infections being resolved in 70-90% of cases of the immune system). Wart removal treatments aim to irritate the skin, to trigger the body's defense system. Doctors do not recommend home treatments without consulting a specialist, as papillomas can be easily confused with moles or manifestations of skin cancer. However, pharmacies sell over-the-counter patches, solutions and creams for warts. Find out below what treatment methods exist against papillomas!

1. Electrocautery and curettage: the dermatologist makes local anesthesia, then heats the tissue with electricity, burning the wart and scraping it completely.
2. Photodynamic therapy (PDT): uses certain photosensitizing chemicals and light to destroy wart cells. It is done in two stages: injection of the photosensitive agent at a certain wavelength; after 1-3 days, return to the office to treat the area with light.
3. Laser therapy: is a therapeutic option indicated for large warts, resistant to other methods. It works by the local application of high-energy light, which will affect the blood vessels in the papilloma and lead to cell destruction, atrophy and its fall.
4. Cryotherapy (tissue freezing): the wart is removed by applying liquid nitrogen on it, which destroys the cells and leads to the formation of a bladder, whose healing will lead - over time - to the disappearance of the papilloma. Pharmacies sell cryotherapy sprays to use at home, which should not be used on the face and which are not as effective as a treatment at the doctor's office.
5. Surgical excision: has a high rate of recurrence of warts, leaves a scar after healing and is recommended in very few situations. It can be recommended by the doctor in patients for whom other treatment methods have not worked.
6. Local chemical treatment: the removal of warts is done with the help of caustic substances, which are applied topically or injected into the lesion, by the dermatologist (5-fluorouracil, bleomycin, trichloroacetic acid, cantharidin).
7. Immunotherapy: the host's immune system does not notice the wart. But if stimulated locally, the local immune cells will activate and act. For this purpose, immunomodulatory substances (Candida antigen, Trichophyton or smallpox, imiquimod, tuberculin products) are injected into the lesion.
8. Local treatments with salicylic acid: for the treatment of warts at home, you can buy patches, gels, creams or solutions from the pharmacy. They remove layers of tissue, kill cells or stimulate the immune system. Most contain salicylic acid and are applied daily, on the wart soaked in water and (if you want to increase their effectiveness) lightly rubbed with pumice stone for a few weeks.
9. Home remedies:
   → aromatherapy: 2 times / day, apply lemon, tea tree, cypress or lavender oil over the wart; if you are treating a small child, dilute 1 drop of essential oil in ½ teaspoon of carrier vegetable oil; avoid cypress oil in the first 20 weeks of pregnancy;
   → homeopathy: take granules, cream or tincture of thuja;
   → an adhesive tape applied directly to the wart and changed every few days can cause it to fall off;
   → apple cider vinegar can also be an effective treatment, destroying the wart tissue just as salicylic acid does; the method involves covering the wart with a piece of cleansing disk soaked in vinegar, then bandaging the area; the bandage is left overnight or even 24 hours and the diskette is replaced every night; the area may swell or throb, the wart may blacken in the first 1-2 days (a sign that the cells are beginning to die) and the growth will fall in 1-2 weeks; you can prevent recurrence by still using vinegar in that place for a few days;
   → garlic contains compounds with antiviral activity and can stop cell development; in the morning and evening, put crushed garlic juice over the wart or apply a dressing containing a thin slice of garlic in the evening;
   → propolis tincture can be another effective way to remove warts; in the morning and in the evening, the growth is swabbed with a gauze soaked in tincture, avoiding the surrounding skin; to speed healing, propolis can be administered internally - 6 drops to 1 cup of water (consumed throughout the day) or 3 drops on a piece of bread (consumed before / after meals, 2 times / day);
   → castor oil can also be used; swab the wart for 2 weeks, morning and evening, wait 10 days and repeat the procedure for 15 days;
   → squeeze a drop of sap from a dandelion or celandine stem daily on the wart;
   → anoint the wart in the morning and evening with 2-3 drops of calendula tincture or thuja tincture;
   → in the morning and in the evening, put lemon juice over the wart;
   → onion is also a natural remedy, but should only be used soaked; twice a day, swab the wart with onion leaves that have been covered with salt overnight; soak 2-3 medium onions in food vinegar for 24 hours, then use one sheet of onion to cover the problematic wart (tying it with a sterile gauze) for 3 hours;
   → in addition to external treatment, consume tea / tinctures of echinacea, burdock, dandelion root or clover.

Most moles are not dangerous and should not be treated. If you have a mole that bothers you, that has not changed its appearance and that a dermatologist has declared normal, then you can remove it by using:

1. Surgical methods (performed by a specialist):
   → a scalpel excision;
   → a destruction by radio / electrosurgery;
   → a laser cauterization.
2. Natural remedies (tried with the consent of the doctor):
   → at the level of moles can be applied daily fresh juice of cauliflower, pineapple, apple, grapefruit, lemon, onion (apply them with a piece of cotton wool, leave them to act for a few hours and repeat for 3 times / day, 3 weeks); they discolor the area and can eliminate the nevus; lime citric acid can be effective in combination with a little moringa powder (Moringa oleifera); and 1 drop of grapefruit seed extract can be applied to the treated mole;
   → garlic contains enzymes that break down melanocytes and can discolor nevi; disinfect the mole with sanitary alcohol, grease it with almond oil (to protect the skin), then apply over it half a clove of peeled garlic (with the inside on the skin); glue a patch over it and let it act overnight; repeat the procedure daily for a week until the mole falls / discolors;
   → apple cider vinegar can also discolor or remove moles; soak a piece of cotton wool in a tablespoon of apple cider vinegar and cover the mole with it for at least 1 hour / day; repeat the procedure until the desired effect is obtained; if vinegar irritates your skin, stop using it;
   → mix 1 tablespoon of castor oil with 1 tablet of finely ground aspirin or 1 tablespoon of baking soda; apply the mixture on the mole in the morning (after waking up) and in the evening (before going to bed), massage well and do not rinse; repeat the procedure for 1 month;
   → baking soda can be used and mixed with a little water to form a paste (which is applied to the mole, left to dry and then covered with a patch, overnight); treatment lasts about 3 weeks;
   → you can also try to apply thin slices of radish, small pieces of banana peel (with the inside down) or potato-based poultices over the nevus you want to remove;
   → finely grind a few flax seeds (in a mortar), mix them with flax seed oil and honey (until you get a homogeneous paste) and apply the result over the mole, every day; bee honey can be put as such on the treated area, left to act for 10-15 minutes, then washed the mole with warm water;
   → try to massage the moles with nuts oil and dandelion root;
   → tea tree oil is effective; in the morning, massage the area with a cleansing disk soaked in oil and in the evening fix on top, with a patch, a piece of cotton wool soaked in oil; in about a month you can see a positive result.

How to prevent warts and moles?

To reduce your risk of getting warts or giving them to others, follow these tips:

• do not touch other people's warts;
• after touching a wart of your own, wash your hands thoroughly;
• do not use the towel or other personal items that do not belong to you (shoes, socks, nail polish);
• do not use the same nail, scissors or file used on an infected nail and the rest of your healthy nails;
• do not scratch the warts and do not bite your infected nails;
• do not shave, comb or mow in areas with warts;
• wear slippers at the pool and public showers;
• when you go swimming, cover your warts with waterproof patches and always keep your skin as dry as possible;
• when you go to the gym, cover your warts with gloves or socks;
• increase your resistance to infections through a healthy diet; eat 2-3 cloves of raw garlic and foods rich in beta-carotene and vitamins C and E daily.

To prevent excess moles and prevent skin cancer, follow these tips:

• choose a diet full of fruits and vegetables rich in potassium and citric acid (cabbage, spinach, potatoes, tomatoes, mushrooms, large beans, bananas, avocados, grapefruit, oranges, lemons, cashew nuts);
• if you are in the category of people at risk (see the section When should I go to the doctor? above), do a dermatological check-up per year, before the summer season;
• always monitor your moles on your body; so, if their appearance changes or if new ones appear, you will know in advance and go to the doctor quickly;
• always protect your skin during sun exposure; wear glasses, hats, thin and long clothes (covering your arms and legs) and apply sunscreen with an SPF of at least 30; tan looks good on the skin, but it is a form of skin burnt that activates pigment cells and can cause them to grow uncontrollably;
• regardless of season, use protective sunscreen on the face, because the sun ages the skin prematurely and can cause the appearance of moles;
• avoid prolonged exposure to the sun (stay in the shade between 10:00 and 16:00);
• NEVER got o the solarium.

Did you know that…?

• in the past, among the home remedies indicated for warts was rubbing them with a dry, dusty frog?
• there are more than 100 different strains of human papilloma virus, some of which can only cause warts, others can cause cancer (cervix, neck, tongue etc.)? Most people who have become infected with HPV do not know they are infected.
• warts can go away on their own without treatment and leave no scars? Obviously, there are many treatments that are just as effective in avoiding the marks left on the skin.
• even though they are still called “liver spots”, moles do not have anything to do with the liver? The name probably comes from their brown color.
• most of us have 10-40 moles on our body? Most appear by the age of 40-50.
• hormonal changes in adolescence and pregnancy determine moles to become larger and darker in color?
• of all the types of moles, dysplastic and congenital nevi come with an increased risk of skin cancer?
• congenital moles present in 1 of 100 people? The risk of developing melanoma is slightly higher in their case than in nevi acquired during life, especially if we talk about large congenital nevi.
• the so-called “red moles” are not nevi, but cherry angiomas? They occur more often on white skin and can be caused by sun exposure, liver problems, hormonal disorders, age and genetic inheritance. If they have irregular edges and texture, are rough to the touch and exceed 6 mm in diameter, require a dermatological consultation.
• the protective sunscreen should not be applied to the beach for the first time after you arrive, but in the room, 30 minutes before going out? Reapply is done every 60-90 minutes and every time you return from the water. Don't forget to cover the top of your soles and ears - areas forgotten by many people.