Skin Papilloma

Skin papillomas are small, benign growths that appear on the skin, most commonly caused by a viral infection. While they are generally harmless, understanding their nature, causes, and treatment options can help you make informed decisions about managing these common skin changes.

Table of contents

• What Are Skin Papillomas?
• What Causes Skin Papillomas?
• Common Locations and Appearance
• Who Is More Likely to Develop Skin Papillomas?
• Symptoms and When to Seek Help
• How Are Skin Papillomas Diagnosed?
• Treatment Options
• How to Prevent Skin Papillomas

What Are Skin Papillomas?

Skin papillomas are noncancerous, benign growths that develop on the surface of the skin. When these growths appear on the skin, they are commonly known as warts or sometimes skin tags^[1]. A papilloma forms a nipple-shaped or raised outgrowth from the skin surface^[1].

These growths develop from the epithelium, which is the top layer of flat cells covering the skin^[1]. Papillomas are characterized by outward-projecting, finger-like or frond-like structures that give them their distinctive appearance^[4]. Although they occur in various shapes and sizes, they remain on the skin surface and do not spread to other locations in the body^[1].

What Causes Skin Papillomas?

Human papillomavirus (HPV) is the most common cause of skin papillomas^[1]. This is a large group of viruses with more than 100 different types, and about 10 of these types cause skin warts^[15]. Among the many HPV types, types 6, 7, and 11 are most commonly associated with papillomas^[2].

These particular HPV types are considered low-risk because they rarely lead to precancerous changes or turn into cancer^[4]. It is important to understand that the HPV strains causing skin warts are different from those that can cause more serious conditions. The strains that cause skin papillomas are generally harmless nuisances rather than health threats^[16].

Most papillomas are contagious through direct physical contact, though skin tags are an exception and are not easily transmitted^[2]. For skin papillomas where HPV is the cause, skin damage can promote their development. Scratching at or picking a wart can lead to further infection in the surrounding area, though the growth itself cannot spread to another location on the body^[1].

warts, verrucae, skin tags, acrochordons

Common Locations and Appearance

Skin papillomas can develop on various parts of the body, though certain areas are more commonly affected. They most often appear on the neck, armpits, and the area under the chest^[3]. Other common locations include the hands, fingers, eyelids, face, and groin^[2].

The appearance of skin papillomas varies depending on their type. They may present as small, raised bumps with a rough or irregular surface^[2]. Some appear dome-shaped with a rough surface, sometimes containing dark specks that look like small seeds. These dark dots are actually blocked and dead blood vessels^[6]. Other papillomas may be flat or slightly raised with a smooth surface^[6].

The color of skin papillomas typically matches normal skin tone but can range from light-colored to gray-brown or have a brownish hue^[3]. They can appear as small clusters of cells projecting from the skin either with a broad base or with a small stem^[3]. The size varies from very small, about the size of a pinhead, to a couple of centimeters in diameter^[6].

• Skin (epidermis)
• Neck
• Armpits
• Hands and fingers
• Feet
• Face
• Eyelids
• Chest area
• Groin

Who Is More Likely to Develop Skin Papillomas?

Skin papillomas and warts are very common, affecting approximately 10% of the worldwide population^[6]. They are even more frequent in school-aged children, affecting 10% to 20% of this age group^[6]. The condition is more common in children and young adults overall^[8].

Several factors can increase the likelihood of developing skin papillomas. People who are immunocompromised (having a weakened immune system) are more likely to develop these growths^[6]. Children and people with immune system problems are particularly vulnerable to developing warts^[15].

Obesity and diabetes are two significant risk factors for developing skin papillomas. Overweight people are more likely to develop papillomas due to excessive sweating, which favors their formation, especially where the body forms folds^[3]. People with diabetes can develop papillomas because of their weakened immune system, making them more susceptible to infections, microbes, and viruses^[3].

Other risk factors include people with disturbed hormonal systems, including thyroid gland disorders and pregnancy^[3]. Heredity also plays a role in the development of papillomas^[3]. People in certain occupations, such as meat, fish, and poultry handlers, are also more likely to develop warts, though the reasons are not entirely clear^[15].

All of us come into contact with HPV repeatedly through everyday activities like shaking hands or touching doorknobs, but only some people develop warts. The most likely explanation is that some individuals are simply more prone to developing warts than others^[15].

Symptoms and When to Seek Help

Papillomas of the skin typically do not cause additional symptoms beyond their physical appearance^[1]. Many people find them mainly irritating rather than painful, as they generally do not cause any discomfort^[3]. However, some people may dislike their physical appearance^[1].

When papillomas grow and multiply, they can cause certain symptoms. They may lead to itching, burning sensations, and pain when touched, especially during summer when there is intense sweating, or in winter when they can get tangled in woolen clothing or jewelry^[3]. Warts that develop on the skin may have an irregular surface, bleed, or itch, and can occur in clusters^[2].

The hot and humid areas of the body, such as the throat, armpits, under the chest, eyelids, and groin, are more prone to developing papillomas due to increased friction of the skin at these specific body parts^[3]. If papillomas are injured due to friction or irritation, there is a risk of bleeding^[3].

While lumps and lesions naturally cause concern, a doctor can perform tests to confirm whether growths are benign or not^[1]. It is important to receive a clinical opinion on any lump or skin lesion, because if a lump turns out to be a more severe type, early intervention is important^[1]. Although most papillomas present no cause for concern, a person might still want to address or treat them if they cause pain, irritation, or concerns about appearance^[1].

How Are Skin Papillomas Diagnosed?

Diagnosis of papillomas is performed by a specialized clinical dermatologist, as it can be very easy to misinterpret them for something else, such as other types of warts^[3]. A healthcare professional might be able to diagnose HPV infection and warts by simply looking at them^[10].

During a medical visit, patients typically report a small rough bump on the skin that may or may not cause discomfort^[8]. When examining skin papillomas, doctors look for characteristic features. Warts vary in appearance based on their type, and may appear dome-shaped, flat, rough, bumpy, smooth, or thread-like, with colors ranging from skin-colored to brown, grey, or black^[6].

In cases where the patch appears unusual, and always at the discretion of the specialized clinical dermatologist, it may be sent for biopsy after removal to rule out any concerning changes^[3]. Papillomas should not be neglected because in some cases they can develop abnormalities and potentially develop into skin cancer^[3].

Treatment Options

A papilloma is often harmless and does not require treatment^[1]. Studies indicate that about half of warts go away on their own within a year, and two-thirds within two years, so watchful waiting is definitely an option for new warts^[15]. Most HPV infections do not cause any problems and are cleared by the body within two years^[7].

However, if you prefer not to wait, several treatment options are available. Some experts recommend immediate treatment to reduce the amount of virus that might spread into nearby tissue and possibly lower the risk of the wart coming back^[15].

At-Home Treatments

You can treat warts at home by applying salicylic acid, which is available without a prescription. Before applying the salicylic acid, soak the wart in warm water, file away the dead warty skin with an emery board or pumice stone, and then apply the medication. This process should be repeated daily or even twice a day^[15]. Salicylic acid works by removing layers of a wart a little at a time^[10]. However, it is important to note that salicylic acid is not for use on the face^[10].

Professional Medical Treatments

If over-the-counter medications do not work, several professional treatments are available. Cryotherapy, or freezing with liquid nitrogen, is a common method^[10]. The treatment involves applying extreme cold to destroy the tissue.

Prescription medications that can be applied directly to warts include imiquimod, which helps the immune system fight HPV, and podofilox, which works by killing genital wart tissue^[10]. Trichloroacetic acid is a chemical treatment that burns off warts and can be used on various body areas^[10].

Modern removal methods include CO2 laser treatment, which is considered the most modern and effective approach. Laser papilloma removal leads to complete elimination of existing lesions. The treatment is extremely accurate and targeted, with the laser beam directed perfectly to eliminate the papillomas without leaving scars on the skin^[3].

It is strongly recommended that papillomas be removed immediately to avoid future irritation that could result in their multiplication^[3]. Warts can be stubborn, but many treatment options can help get rid of them^[6].

How to Prevent Skin Papillomas

Although you cannot fully protect yourself against HPV, there are several steps you can take to reduce your risk of developing skin papillomas and prevent their spread if they have already appeared^[7].

Vaccination

Vaccination with vaccines such as Gardasil can provide protection. This vaccine protects the body from certain papillomaviruses, including HPV6 and HPV11, which are the types most commonly associated with skin papillomas^[3]. The HPV vaccine protects against the types of HPV that cause most cases of warts, though it does not protect against all types^[7].

Personal Hygiene and Care Practices

Several practical measures can help prevent the occurrence and spread of papillomas. Avoid scrubbing the body with a sponge during bathing in areas where papillomas are present^[3]. Do not wear necklaces if you have papillomas on the neck, as they can irritate the growths, cause bleeding, and promote spreading^[3].

It is important not to remove hair in areas with papillomas using a razor^[3]. Avoid scratching at or picking warts, as this can lead to further infection in the surrounding area^[1]. Although papillomas are not easily transmitted from person to person, they can multiply in the same patient’s body if injured^[3].

Lifestyle Measures

If papillomas appear due to obesity, weight loss is recommended to stop their spread^[3]. Managing underlying health conditions, particularly diabetes, is also important, as people with diabetes are at higher risk of developing papillomas due to their weakened immune system^[3].

While these measures can help reduce risk, it is important to remember that some people are simply more prone to developing warts than others, regardless of preventive efforts^[15].