Okolonogtevaya wart: how to effectively get rid of?

Perhaps the periungual wart is the most uncomfortable education that can occur on the fingers and toes. Not only does the growth look completely unaesthetic: it can itch or even hurt, be damaged, bleed, etc. How can this problem be solved?

[1], [2], [3], [4]

Epidemiology

A papillomavirus wart is an extremely common skin problem, with a long-term history and a high probability of recurrence. Human papillomavirus infection is often hidden, occurring only in 3-9% of pediatric patients and in 28-30% of the adult population. In general, about 80% of people worldwide have the virus.

Not seen sex or racial attachment of viruses. Okolonogtevye warts can appear at any age, from children to the elderly.

Causes of the okolonogtevoy warts

The periungual wart begins to grow actively after a microtrauma of the zone near the nail, against the background of a weakened immune defense. Most often, the tumor grows in close proximity to the nail plate, but it can “climb” and under it, which causes particular discomfort.

Okolonogtevye warts - it is always a consequence of penetration into the body papillomavirus, which, unfortunately, is extremely common and is present in eight people out of ten.

Not all "owners" of a viral infection appear okolonogtevye warts. As we have said above, certain conditions are necessary for their development: for example, a sharp drop in immunity against the background of skin microdamages or systematic high humidity.

Immune protection of a person can weaken not only under the influence of various diseases or hypothermia, as many people think. Stress, serious conflict situations, overwork, lack of sleep, as well as poor monotonous nutrition and hypovitaminosis can reduce protective qualities.

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Risk factors

The papilloma virus is highly contagious, so it is very difficult to avoid infection. In addition, there are a number of factors that increase the risk of infection and the manifestation of viral infection:

• the presence of bad habits, unhealthy lifestyle;
• promiscuity;
• ignoring the observance of individual hygienic rules - for example, when visiting public baths, gyms, etc.;
• endocrine system diseases, metabolic disorders, weakened immunity;
• frequent and long-term courses of antibiotics or other drugs that adversely affect the quality of immune protection;
• hormonal disruptions, adjustment (in particular, adolescence, pregnancy).

Pathogenesis

The causative agent of periungual warts is the human papillomavirus, a DNA containing a viral infection. To date, about two hundred genotypes of this virus have been identified and described. Infection occurs by the contact-household method: the risk of infection is especially increased during various microdamages of the integumentary epithelium. The probability of infection depends on certain factors: the degree of viral load, the nature of contact with the carrier, the general state of health and the human immune system.

In the cellular structures of the basal layer of a viral infection is able to persist for a long time, does not detect itself. When favorable conditions appear, the viral replication mechanism is launched. As a result of this process, cell differentiation is disturbed, and tissues undergo morphological changes: a periungual wart is formed.

Symptoms of the okolonogtevoy warts

The periungual wart is an extremely unpleasant in appearance and sensation growth on the skin of the fingers, in close proximity to the nail. In some patients, the warts develop immediately under the nail plate, which causes additional inconvenience and discomfort. The nail at the same time can become uneven, rough, sometimes flaking and collapsing.

A recent wart does not usually hurt. But, having reached a large size, or "crawling" under the nail, it often provokes a constant pain syndrome.

Over time, the nail plate becomes brittle, destroyed, exfoliated. Often other fingers are drawn into the process, and the problem is exacerbated.

The first signs of wart formation can manifest themselves as local itching, tingling sensation, skin tension. In some cases, the temperature may rise slightly to subfebrile marks. A small nodule with a grainy surface appears on the skin, and over time it becomes covered with layers of hyperkeratosis. Any attempts to scrape, remove the growth end bleeding. In the future, education grows even more intense.

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Complications and consequences

Complications may occur in some patients under the influence of such factors:

• individual feature of the body;
• general health;
• a large number or large sizes of warts;
• lack of treatment, self-treatment, improper treatment of growths.

The main adverse effects and complications of the periungual warts are:

• pain syndrome, bleeding, frequent damage to the formations;
• the appearance of cicatricial changes, the spread of lesions on healthy tissue;
• the addition of a bacterial infection, suppuration, tissue inflammation;
• malignancy (a rare complication involving the malignancy of the periungual wart).

Diagnostics of the okolonogtevoy warts

Starting to diagnose, first of all the doctor will carefully examine the disturbing growth on the skin, pay attention to its multiplicity, soreness under pressure, change the shape of the nails. As a rule, experienced doctors can diagnose the periungual wart already at this stage. However, to exclude other diseases, including oncological diseases, additional diagnostic procedures may be required. Experts recommend a histological analysis to determine the structural features of the growth.

It is also recommended to consult with an immunologist and surgeon.

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Differential diagnosis

Differential diagnosis of the periungual wart is performed with the epidermal warty nevus and the basal cell carcinoma.

Warty nevus is usually a single formation and is found in childhood. It has a brownish tint, may contain hair follicles.

A basal cell tumor, or basal cell carcinoma, is found predominantly in elderly patients. This growth has an infiltrated base, and along the edges there is a characteristic peripheral thickening of small nodules. In the center there is a cavity covered with a crust: after removing the crust, a bleeding sore is exposed.

Treatment of the okolonogtevoy warts

Many people underestimate such a problem as a periungual wart - and in vain. As practice shows, over time, the disease worsens, and no healing and moisturizing ointments will not help, because the process goes too deep. Only one way out: to contact a doctor who will diagnose, exclude other possible pathologies, after which he will prescribe the necessary treatment. Most likely, it will require not only local but also systemic effects on the body.

The treatment will be more difficult if the periungual wart has already managed to penetrate under the nail plate. Most often, the surgeon recommends removing the nail and the wart itself. There is nothing irreparable in this: the plate will soon grow and will be healthy and renewed.

As a drug therapy, the doctor may prescribe various antiviral drugs, vitamin complexes, immunostimulants. Topical treatment involves the use of antiviral ointments, or agents that cauterize or destroy the wart.

• A solution of 1.5% zinc chloropropionate with 50% chloropropionic acid is used very rarely today, applying a special, pointed instrument to the periungual wart. This method is a type of chemical destruction of pathologically changed tissues.
• Nitric, acetic, lactic, oxalic acid in combination with copper nitrate trihydrate is another type of chemical effect on the wart.

Currently, most medical professionals prefer physical methods of destruction, because they do not cause toxic side effects, safe and effective.

Medicines

Depending on the situation, the doctor may prescribe such medications to the patient with periungual warts:

Malavit	Local complex biopreparation in the form of a solution for compresses. A cotton pad is moistened in a solution, applied to the periungual wart overnight. Polyethylene is applied on top and fixed with a plaster or bandage. In the morning the bandage is removed. The effectiveness of the drug due to its antibacterial and antiviral properties. Adverse reactions - allergies.
Panavir	External gel preparation that can raise the level of local immunity and fight off a viral infection, preventing the recurrence of warts. The tool penetrates well into the tissue. With regular application contributes to the disappearance of growths: the frequency of use of the gel - twice a day, for at least ten days. The product is safe and does not cause adverse reactions.
Imikvimod	Cream preparation that stimulates local immune defense. It is applied to the area of the periungual wart at bedtime, every other day. It is assumed complete disappearance of the growth in a few weeks. Possible side effects are redness and irritation in the area of application, which is not a reason to cancel the treatment.
Isoprinnosin	Tablets with immunomodulatory properties. Take the pill in an individually selected dosage, three courses with an interval of one month. Adverse reactions may be pain in the head, sleep disorders, digestive disorders. If adverse events are pronounced, treatment with the drug is stopped.
Viferon	External antiviral ointment that causes the death of papillomavirus. The composition of the ointment is represented by the synthesized protein substance interferon, tocopherol and peach oil. Such components fully provide regenerating and antiviral effects. The ointment is applied to the wart up to 4 times a day, for 1-4 weeks. Adverse reactions were not observed. Use of the drug is possible at any age.

Vitamins

It is extremely important for people who are diagnosed with periungual warts to maintain the quality of their immunity. Sometimes this step allows not only to prevent the emergence of new warts, but also to get rid of existing growths.

Doctors advise to pay attention to such popular vitamin complexes to improve the level of immune protection:

• Multitabs Immuno-plus - contains basic essential vitamins, including vitamin D and folic acid;
• Vitrum - a classic vitamin complex with a fairly extensive trace element composition;
• Centrum - has a rich vitamin composition, has antioxidant properties;
• Complivit, Undevit - inexpensive, but no less high-quality vitamins with a basic composition that is well absorbed by the body.

In addition to vitamin-mineral complexes, experts advise to pay attention to drugs with immunostimulating capabilities. These include Immunal, echinacea extract, etc.

Physiotherapy

Physiotherapy methods can get rid of small periungual warts quickly and efficiently. For example, such methods are especially popular:

• Cryotherapy - is the effect on the formation of liquid nitrogen. The cold simultaneously destroys the viral infection and disrupts the structure of the wart tissue. This method is quite effective (estimated at about 75-90%, the risk of re-development of growth - 15%), but not suitable for use in young children, pregnant women and patients with diabetes.
• Electrocoagulation is a medical procedure involving the removal of a protruding okolonogtevoy warts using a special looped tool, through which the high-frequency current passes. The positive effect of the procedure is estimated at about 85-90%.

Home treatment

In some patients, the periungual warts disappear themselves some time after the appearance. But experts advise: if self-healing has not happened for two years, or additional painful symptoms appear, then you need to seek medical help. Contacting a doctor should be mandatory in the following cases:

• if a single periungual wart is replaced by multiple growths;
• if the wart increases in size, "crawls" under the nail, spreads, seizing other healthy skin areas;
• if the growth begins to bleed, cracks appear on it;
• if the color of the wart changes;
• if there is pain, severe discomfort.

When these signs appear, there is no talk of self-treatment of the periungual wart. This must be done by a doctor.

If the growth is single and small in size, the use of alternative methods is allowed after consultation with a medical specialist. Such consultation is necessary, first of all, in order to identify the periungual wart and eliminate the presence of oncological problems.

Alternative treatment

Any treatment of the periungual wart, even if it is a popular method, should be combined with strict adherence to the rules of personal hygiene: hands and feet should be washed thoroughly and no less thoroughly dried.

Additionally, you can try the use of such alternative medicine recipes:

• Wipe the wart with a slice of garlic cloves or onions, 2-3 times a day (once a night is necessary). The duration of such treatment is from one to 4 weeks. After falling off the growth of onion juice or garlic should be applied within a week, for the final destruction of the possible remaining roots of the tumor.
• Use a cotton swab to smear the periungual wart with acetic acid or essence. Do this up to 2 times a day, very carefully, so that the tool does not burn healthy, unaffected tissue.
• Large periungual warts are removed as follows: a pinch of flour is mixed with a drop of acetic acid. From the adhesive plaster cut out the hole in the center of the size of the build-up, after which the patch is glued to healthy skin so that it does not hurt during treatment. From above, the prepared mixture is applied directly onto the hole (that is, the wart), then this place is additionally fixed with a plaster (whole, without a hole). This manipulation is usually performed at bedtime, and in the morning the patches are removed. It is argued that such treatment can eliminate warts in 3-7 days.
• Castor oil is rubbed into the area of the periungual wart. Repeat the procedure daily, twice a day, for 8-12 weeks. As a result, the wart disappears gradually and painlessly.
• Every day for the night make soda or salt baths for the affected fingers. For their preparation take one tablespoon of baking soda, or 5 tbsp. L sea salt to 500 ml of warm water. Fingers hold in solution for about 15 minutes. After that, the solution is not washed off, the skin is soaked with a paper napkin, and a cut of aloe leaflet is applied to the wart. Fixed with plaster, which is removed in the morning. Presumably, the disappearance of the periungual wart occurs for 7-10 days.

Herbal medicine

• Fresh celandine juice is applied to the periungual wart. Coat juice should be all the growth, twice a day, until complete cleansing of the skin.
• Instead of the juice of celandine, you can use dandelion juice, but in this case, the frequency of daily application should be increased up to three times.
• Treat the periungual wart with agave juice, three times a day. At night, you can make a compress from this tool: with a juice, a small square of gauze is impregnated, applied to the growth, a small square of cellophane is placed on top and fixed with a plaster. The procedure is repeated daily.
• Fresh plantain juice is dripped onto the wart, 2-3 times a day. At night, the cake from the plantain leaf, under the plaster, can be applied to the affected skin. Treatment continues until the problem is completely eliminated.

Homeopathy

The use of homeopathic preparations to eliminate the periungual warts has a number of features. For example, such tools can be used both to get rid of a single growth, and from its multiple manifestations. Homeopathy can be easily prescribed to both adults and children, since such drugs are safe. Homeopathic remedies can be used both independently and in combination with other types of treatment - for example, medicines or alternative methods.

What means are we talking about:

• Antimonium Kundum - is prescribed for the removal of hard, keratinized periungual and subungual warts.
• Kaustikum - used for large soft growths, located on a broad base, as well as bleeding warts.
• Thuja - used to eliminate multiple neoplasms, as well as with frequent repeated growth of warts.
• Hepar sulfur - suitable for getting rid of flat periungual warts.

The doctor will prescribe the exact dose of each of these drugs, based on constitutional features and other signs of the disease.

Surgical treatment of periungual warts

The surgeon’s help is usually resorted to with a significant size of the periungual wart, with the suspicion of its malignancy, or with an uncomfortable position.

Surgical excision always involves the capture of not only damaged tissue, but also a small amount of healthy ones. This helps prevent re-formation of warts in this area. The main advantage of this method over laser removal or treatment with liquid nitrogen is that the resulting material can be sent for histological analysis. Such a study is necessary to study the structure of the growth and exclude the process of malignancy.

The technique of operation may be different, depending on the location and size of the wart. Most often, the removal is performed with suture material applied: the surgeon treats the skin, injects an anesthetic, excises the growth and surrounding healthy tissue. Since deep skin layers and blood vessels are affected, suturing must necessarily follow.

Wound healing after such an operation occurs within 1-2 weeks and largely depends on the patient’s general state of health, on the individual characteristics of his body, as well as on the quality of postoperative care.

Perhaps the only drawback of surgical removal of the periungual wart is the formation of a scar, or scar. Its size depends mainly on the initial scale of the intervention, as well as on the qualifications of the operating doctor. In general, the surgical removal of such growths is quite a standard medical procedure, which is considered one of the most radical methods of getting rid of pathological tumors.

Laser wart removal

Laser removal is the most common, safe and reliable way to get rid of the periungual wart. The entire removal process occurs due to evaporation and tissue coagulation, which avoids bleeding and damage to healthy tissues.

Laser removal does not require special preparation for the patient. At the same time, post-procedure care is also quite simple:

• within 2-3 weeks after removal, do not expose the skin to ultraviolet radiation;
• until complete skin cleansing, one should not visit a bath, and even a pool;
• it is impossible to remove the formed crust by yourself, to treat the place of the wart with aggressive liquids.

As a rule, the laser procedure is a one-time, it is not required to repeat it. With a significant size of growth, preference is given to its surgical removal.

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Prevention

For people who want to avoid the appearance of periungual warts, there are a number of recommendations:

• Do not walk barefoot on public beaches, in baths and swimming pools - be sure to wear rubber slippers.
• It is important to prevent damage to the skin, and if scratches or cracks appear, you should immediately treat them with any disinfectant solution.
• High humidity of hands and feet should be avoided: shoes should be of high quality and dry, and when working in conditions of high humidity (for example, when cleaning, washing, washing) you should wear protective gloves on your hands.
• If there is at least one wart, it should be removed as soon as possible to prevent further growth of the growths.
• It is necessary to get rid of the bad habit of chewing on nails and tearing the hooks and cuticles: this is an important condition for preventing the appearance of periungual warts.

Forecast

Sometimes periungual warts are prone to self-healing. However, one should not hope for such an outcome, especially if the growth has existed for more than 2 years, or it starts to disturb with pains or intensive growth. It is important to remember that the tumor cannot be damaged, injured, and also try to get rid of it yourself, without first talking with the doctor. In order to avoid complications, it is recommended to contact a dermatologist or surgeon as soon as possible.

In general, the periungual wart has a favorable prognosis, subject to timely and complete treatment.