Cysts, Moles, Warts and other Common Skin Growths
David P. Van Dam, MD is most often able to recognize a skin growth is benign or malignant in nature before it is are removed. Benign lesions that do not have the characteristics of skin cancer, such as cysts, moles and other growths on the face, neck and body can be removed using a variety of techniques. The goal of treatment is not only to remove the lesion, but also to provide a pleasing aesthetic outcome. Methods for removing growths may include:
CryosurgeryFreezing a growth causing it to shed naturally over 1- 2 weeks. (Detailed information on cryosurgery using liquid nitrogen is provided below.)
ElectrosurgeryUsing electrical current to remove the growth and seal the wound at the same time.
LaserUsing the energy of light to remove the lesion.
Intense Pulsed Light (IPL)Another non-ablative technology that uses light energy to destroy any unwanted spot or blood vessel.
Shave Removal or ExcisionRemoval of a growth with a scalpel using local anesthesia and, sometimes, sutures to create minimal scarring.
A dermatofibroma is a common growth that develops in the second layer of skin (the dermis). These firm growths are usually found on the arms and legs of adults, but they may develop anywhere. They are usually brown or red in color and are normally less than a half-inch in diameter. There is no consistently identifiable cause for dermatofibromas but some seem to follow an insect bite that does not heal properly. Although most dermatofibromas cause no problems, some can be a nuisance due to their location on pressure areas or because of being cut by shaving.
Dermatofibromas rarely disappear by themselves, but treatment is usually performed only when requested by the patient (or when there is some question about the diagnosis). Surgical removal of dermatofibromas is performed in the office using local anesthesia. An alternative to surgery is freezing with liquid nitrogen (although more than one treatment is usually required). A scar almost always results from treatment of dermatofibromas and this should be taken into consideration when deciding what to do (or not to do) about one of these growths. Your doctor can give you an idea of what type of scar might result from treatment of your particular lesion.
Warts are common growths that are the result of skin being infected by the HUMAN PAPILLOMA VIRUS. This virus is present in the growths as well as on many surfaces touched by our hands and feet. Frequent touching and picking of warts may allow them to spread. Although some people may have a natural resistance to warts, it is advisable to avoid direct contact with warts on other people and to wear foot protection such as sandals or rubber flip-flops when you are in places where other people go barefoot.
Warts may develop on any part of the body including the face, scalp, lips, nose and genital area as well as on the hands, feet, elbows and knees. There are common warts (verruca vulgaris) which grow outward from the skin and there are flat warts (verruca plana) which are usually small, flat-topped and only slightly elevated. Some warts are pushed into the skin by pressure, such as those on the bottom of the foot. The bottom of the foot is called the plantar surface and this is why warts in this location are called plantar warts. Some warts contain a few dark specks. They are the remains of tiny blood vessels that became trapped in the rapidly growing wart.
Some warts go away without medical treatment because your immune system destroys them from the inside. There are many treatments for warts, but there is no single best therapy for all warts. Since no medicine exists which actually kills the wart virus (as penicillin kills bacteria), most warts are removed by destroying the skin infected with the virus.
This can be done with a variety of surgical techniques including freezing with liquid nitrogen, medicines applied to the warts, or with laser surgery. Sometimes medicine is injected into warts in order to remove them. The specific treatment used on a wart depends on its size, location and other factors.
Frequently, a wart will not be completely removed by one treatment and the wart must be retreated until it is completely gone. Even then, a wart may return in the same spot weeks or months after it appears to have been cured. New warts may form while existing ones are being successfully treated. When one method of treatment does not seem to be working or is poorly tolerated, a different treatment can be used. Patience and perseverance will usually result in successful elimination of most warts.
Liquid Nitrogen Treatment
Liquid nitrogen is a cold, liquefied gas with temperature of 196° below zero Celsius (-321° Fahrenheit). It is used to freeze and destroy superficial skin growths such as warts and keratoses. Liquid nitrogen causes a cold, stinging sensation while the growth is being frozen. The discomfort usually lasts only a few minutes but in some people it lasts longer. Taking Tylenol® or a similar aspirin-substitute usually relieves the pain.
After a liquid nitrogen treatment the skin becomes swollen and red and it may blister. Sometimes the blister fills with blood and turns purple or black. The blister roof or scab that forms falls off by itself in one to three weeks. All or part of the skin growth comes off with the scab, leaving healthy new skin.
- Usually, no special care is needed after liquid nitrogen treatment. Treated skin may be washed as usual and makeup or other cosmetics may be used.
- If a blister forms in the treated area and is large or painful, the blister may be punctured with a sterilized needle and allowed to drain.
- If the blister or scab is irritated, cover it with a bandage.
- If it becomes red and tender or if a red streak develops near the lesion, it may be infected. Contact our office right away if this happens.
More than one treatment may be necessary to completely remove a wart or keratoses. If the growth is not completely gone or seems to be coming back, please make a return appointment.