Warts, Moles & Birthmarks
Warts are a common skin condition resulting from infection by one or another strain of human papillomavirus (HPV). There are several types of warts that can affect individuals of any age, but some types are more commonly found in children and some more often found in adults. Many types of warts, especially those usually found on children, disappear on their own. When troublesome, warts can be treated with medications or otherwise removed.
Patients with weakened immune systems, such as those with HIV or other immune disorder or those who have had organ transplants, are particularly susceptible to warts. Since warts are contagious through direct skin contact, strict personal hygiene can help to prevent their spread. This includes avoidance of shared personal items, such as towels or razors.
Warts appear as small skin growths, flat or slightly raised, on the surface of the skin. They can vary in coloration. Usually warts can be diagnosed by a simple medical examination, but occasionally a biopsy may be necessary to distinguish them from particular kinds of skin cancer.
Different types of warts appear on different parts of the body and vary in appearance.
Some of the most common varieties of warts are:
- Common warts, which usually appear on the fingers or toes
- Flat warts, common on face, arms or legs
- Plantar warts, which grow on the soles of the feet
- Filiform warts, which grow on the face or neck
- Periungual warts, which grow around or under toenails and fingernails
While most varieties of warts are benign, they may be itchy, painful or embarrassing. Most can be treated through the application of medications like salicylic acid or cantharidin or through cryotherapy, a process of freezing with liquid nitrogen.
In especially resistant instances, warts may require laser surgery or surgical excision with a scalpel. In most cases, treatment is permanent and warts do not return.
Moles & Birthmarks
Moles are growths on the skin that are usually brown or black; they may be located, alone or in groups, anywhere on the body. A birthmark is a colored mark that appears soon after a baby’s birth. Although many moles and birthmarks are completely benign and pose no health risk, some people choose to remove them because they consider them unattractive. Regularly using a strong sunscreen, and monitoring birthmarks and moles for changes, is highly recommended.
Most moles and birthmarks are harmless. However, some atypical moles have the potential to be or become malignant. Atypical moles may be asymmetrical, or have irregular borders and uneven coloring; they can be located anywhere on the body, including areas not exposed to the sun.
Types of Moles & Birthmarks
There are many types of moles and birthmarks, including the following:
- Congenital mole (dark and irregularly shaped)
- Atypical mole (irregular color and undefined borders)
- Cafe-au-lait spot (light-brown patch)
- Mongolian spot (flat, bluish and irregularly shaped)
- Hemangioma (reddish-purple patch or raised dots)
- Salmon patch (reddish patch, usually on the upper eyelid)
- Port-wine stain (dark red and flat)
Diagnosis of Moles & Birthmarks
A thorough physician-performed examination of the skin is necessary to determine whether a mole or birthmark needs immediate treatment or simply to be checked on a recurring basis. When a mole is diagnosed as atypical, it may need immediate treatment. A patient with an atypical mole may have a personal or family history of melanoma, which increases the possibility of malignancy.
A mole should be examined by a physician if it is:
- Larger than 6 millimeters
- Itching or bleeding
- Rapidly changing color, size or shape
- Located in a difficult-to-monitor area (such as the scalp)
Most birthmarks are benign, but some have the potential to become malignant or may indicate systemic disease. A large congenital mole that is present at birth has a greater risk of becoming malignant; this is especially true if the mole covers an area larger than the size of a fist. Café au lait spots can indicate a number of rare systemic diseases, such as Maffucci syndrome or Gaucher disease.
Treatment of Moles & Birthmarks
Depending on its depth, location and color, as well as factors that include the patient’s skin type and age, treatment for a benign mole or birthmark includes:
- Laser or pulsed-light therapy
- Surgical removal
If a mole is irregular and needs to be evaluated further, either the entire mole is removed, or a small tissue sample taken, in order to biopsy it. If only a small section of tissue is taken and it is diagnosed as malignant, the entire mole will be removed, along with a margin of normal skin around it. Cutting into a malignant mole will not cause cancer to spread. If the malignancy is caught early enough, this may be the only treatment needed.
A melanoma that has spread beyond the skin requires more aggressive treatment, which may include:
- Surgery to remove affected lymph nodes
- Radiation therapy
- Biological therapy to boost the immune system
- Targeted therapy (attacks vulnerabilities in cancer cells)