Warts And All

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Dr Alan Wong introduces the characteristics of warts and molluscum contagiosum – both common skin lesions caused by viruses (#warts).

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Warts are bumps that develop on the skin. They are firm and raised and may have a cauliflower surface appearance. Most people will have warts at some point in their life. They’re generally harmless and tend to go away on their own eventually, but this can take months or even years.

You can get infected with the virus that causes warts by touching another person’s wart. You can also get infected by touching objects that have the virus on them. For instance, people can catch warts by walking barefoot around pools, locker rooms, or gyms.

Treatment of warts is not mandatory. Most of them will go away on their own eventually, particularly in children. Some reasons for treatment include pain or discomfort, cosmetic reasons, or for children with immunosuppression (because of the risk extensive infection).

If treatment is warranted, options include mechanical destruction, adjustment of the patient’s immune system through medications, and observation. The most commonly employed treatments involve destroying the affected tissue by freezing, burning, applying topical acids, or surgical removal.

Of course prevention is the best cure. Patients with warts should avoid deliberately touching warts on themselves or others. Always use slippers or other footwear in public showers. The HPV vaccines have been developed for the prevention of genital warts and HPV-related anogenital cancers. However, there is currently no effective vaccine for the prevention of cutaneous warts.

Molluscum Contagiosum

Molluscum contagiosum is a poxvirus that causes a localised skin infection. The infection appears as skin-coloured, dome-shaped bumps on the skin of an infected individual.

Infection is spread by direct skin-to-skin contact and can occur anywhere on the body. Infection can also be spread by objects containing the virus such as on bath sponges or towels.

The diagnosis of molluscum contagiosum is usually made by the characteristic appearance of the lesions. In most cases, individual lesions usually go away on their own within two months and the infection often clears completely within six to twelve months. In a minority of cases, the disease can persist for three to five years. Although scarring can occur as the lesions disappear, most molluscum contagiosum lesions do not resolve with scars.

Again, as with warts, treatment is not mandatory. Treatment options include scraping off the bumps (curettage), using medicines (liquids or creams) such as those used to treat warts, freezing the bumps (cryotherapy), or putting a chemical on the bumps like cantharidin.

Potential advantages of successful treatment include limiting the spread of lesions to other sites, reducing the risk of transmission to others, soothing itchiness when present, and the prevention of scarring that can result from lesions that become inflamed, traumatized, or secondarily infected. Treatment may also reduce psychological stress over the appearance of lesions. However, depending on the chosen therapy, treatment can be time consuming or can result in adverse effects such as pain, irritation, dyspigmentation, or scarring.

Dr Alan Wong is a registered medical doctor in the US, Canada, United Kingdom, Australia and Hong Kong. He practices at Southside Family Health Centre.

This article appeared in Playtimes February Issue 2017.

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