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Wart/Syringoma/Milia Removal


What is Wart?

warts-face-241x300A wart is typically a small growth that appears on a person’s hands or feet and looks like a solid blister or a small cauliflower. They may also appear in other parts of the body.

Warts have a rough texture and are caused by viruses, particularly one of several kinds of HPV (human papillomavirus). The virus causes keratin, which is a hard protein on the top layer of the skin, to grow too fast. Warts are not the same as moles. Moles are dark and may become quite large, while warts are nearly always small and have the same color as the person’s skin.
In this article we shall look at various types of warts, but not genital warts. Click here to read article called “What are genital warts? What causes genital warts?”

The appearance of a wart can vary depending on what part of the body it is, as well as how thick the skin is. A wart that is located on the sole of the foot is known as averruca.

What are the different types of warts?

How how can you get rid of a wart

Experts say there are several different kinds ofwarts. According to the National Health Service (NHS), UK, a survey of 1,000 children with warts found that:

  • 74 per cent of them had common warts
  • 24 per cent of them had verrucas
  • 3.5 per cent of them had plane warts
  • 2 per cent of them had filiform warts
  • Common warts (verruca vulgaris) – these have a rough surface. They are firm and raised and may have a cauliflower surface type look. They are thickened bumps called papules or plaques. Common warts may appear in any part of the body, but are more common on the knuckles, fingers, elbows and knees. Often they have tiny dark spots which are from blood vessels that have clotted.
  • Verrucas (plantar warts) - these appear on the soles of the feet, sometimes the heel and toes. They usually grow back into the skin because the weight of the person pushes onto the sole of the foot. They can be painful. It is common for verrucas to have a black dot in the middle, with a surrounding hard, white area. The dark dot is the wart’s blood supply.
  • Plane warts (verruca plana) - plane (plana) means flat. Plane warts are round, flat and smooth. They are generally yellowish, brownish or skin color. They are also known as flat warts and are more common among young children. They are usually found on the hands, legs and face. Adults can have plane warts, but this is unusual.
  • Filiform warts (verruca filiformis) - these are long and can usually be found on the eyelids, neck and armpits
  •  Mosaic warts – these grow in clusters. Palmar warts are mosaic warts that grow on the palm of the hands and feet.

When should you see your doctor?

If you are sure it is a wart tell your doctor next time you see him/her. Most warts do not need to be treated medically. Most warts disappear on their own. If you are not sure and wonder whether it may be something else, go and see your doctor to have it checked.

You should definitely see a doctor if the wart causes pain, bleeds easily, changes appearance, spreads easily to other parts of your body, or comes back. If you want the wart removed for cosmetic reasons see your doctor. Podiatrists (foot specialists) can give people advice about verrucas.

What are the causes of warts?

filiform-thumbDifferent HPV (human papilloma virus) strains cause warts. The wart-causing virus can be passed on by close skin-to-skin contact, as well as through contact with towels or shoes.

The wart-causing virus can be spread to other parts of the body in the following ways:

  • If somebody scratches or bites a wart
  • Sucking fingers
  • Biting fingernails can cause warts to spread on the fingertips and around nails
  • Shaving (face or legs)

A person whose skin is damaged, wet, or comes into contact with rough surfaces is more likely to catch the infection. For example, a person with scratches or cuts on the soles of his/her feet is more likely to catch verrucas in and around public swimming pools.

As we all have different immune systems some of us may develop warts when we come into contact with HPV, while others don’t. The risk of catching warts from another person is fairly small, but it exists. Genital warts are much more contagious.

How are warts and verrucas diagnosed?

Warts and verrucas are generally easy for doctors to identify just by looking at them. The doctor may ask whether any other family members have warts. Occasionally, he/she may take some tissue from a wart and examine it under a microscope.

What is the treatment for warts?

wart+on+finger1The majority of warts clear up without any treatment. How long it takes for them to clear up varies considerably from person to person. They tend to clear up faster among young children. Some warts may take several years to clear up. Less commonly, warts may clear up without treatment within weeks.

Some treatments may cause the skin around the wart to become irritated, others may cause pain, and even blistering. The type of treatment depends on where the wart is located and how many of them there are:

  • Surgical Excision – this is less common for warts. Warts treated with surgery often come back. Surgery has a higher risk of scarring. However, sometimes a doctor may recommend surgery, which will generally be performed under local or general anesthetic. Surgery may be recommended if other treatments have not worked. If the wart is very big it will be cut out. Smaller warts may be scraped off using a curette.
  • Laser treatment – a precise laser beam is used to destroy the wart. Laser treatment is usually recommended for warts that are hard to treat.
  • Electrocautery – an electric current is used to burn off the wart.


  • Some people who have many warts, especially on their face, may find their self-confidence is affected.
  • Some treatments may cause pain and irritate the skin around the wart.
  • Although scarring is possible, it is unusual.
  • It is harder to successfully treat warts if the patient has a weakened immune system.
  • People with weakened immune systems are at a higher risk of their warts becoming malignant. Even so, this is rare.


  • Do not touch other people’s warts.
  • Do not use towels, flannels or other personal items of people who have warts.
  • Do not share shoes and socks with a person who has verrucas.
  • Do not scratch your warts or verrucas. If you do they will most likely spread.
  • Wear sandals when going into and out of communal showers.
  • Wear sandals when walking around communal pools.
  • Cover your wart/verruca with a waterproof plaster (band aid) when you go swimming.
  • There are special socks you can buy to cover verrucas.
  • Wear gloves in the gym if you have warts on your hands.
  • Do not brush, comb, shave, clip areas that have warts.
  • When filing or cutting your nails do not use the same utensil on the infected nail and then on the healthy nails.
  • Do not bite your fingernails if you have warts near them.
  • Keep your hands as dry as possible.
  • Wash your hands thoroughly after touching a wart.




Notice tiny solid skin bumps under your eyes? No, it’s not acne or whiteheads. It’s called syringoma. It sounds intimidating especially since it ends with ‘-oma’ suggesting its tumor-like nature. So is it actually a tumor? Well I’d like to say no but it really is a kind of tumor.

What is syringoma?

Syringomas are benign tumors of eccrine origin commonly found around (usually below) the eyes . Eccrine simply means sweat glands and the sweat glands around the eyes are the common sites of transformation into syringoma.

So how do you treat syringoma?

Syringoma-3Treatments for syringoma include using creams or having the dermatologist do any of the following:

Excision: the dermatologist will use a small scalpel to cut and take out the syringoma one by one. This might take a long time and may hurt especially if it is deep which is why anesthesia is sometimes needed.

Electrodessication and curettage: the curettage part simply means that the syringoma will be scraped down; this is followed by electrodessication which will dry/burn the area using electric current. The 2 techniques will be repeated alternately until the doctor is satisfied that the syringoma plus a little of the normal skin area is clear.

Who’s At Risk

Syringomas can appear at any age, though they usually occur after puberty. Syringomas can develop in people of any race and of either gender, though females are more commonly affected.

Syringomas sometimes run in families. Up to 18% of people with Down syndrome have syringomas. People with diabetes mellitus are more likely to have a type known as clear cell syringomas.

A less common condition, eruptive syringomas, is more commonly seen in people with darker skin.

Signs and Symptoms

The most common locations for syringomas include:

  • Upper cheeks
  • Lower eyelids
  • Armpits
  • Chest
  • Abdomen
  • Forehead
  • Genitalia (penis or vulva)

syringomaSyringomas typically appear as small (1–3 mm) flesh-colored-to-yellowish bumps. They usually occur in clusters on both sides of the body and in an evenly distributed (symmetrical) fashion.

Eruptive syringomas appear as multiple lesions that all develop at the same time, usually on the chest and abdomen.

Self-Care Guidelines

Any new skin growth should be examined by your doctor in order to obtain a correct diagnosis.

When to Seek Medical Care

See a dermatologist or another physician if any new growth develops on your skin.

Treatments Your Physician May Prescribe

If the diagnosis of syringoma is suspected, the doctor may want to perform a skin biopsy.The procedure involves:

  1. Numbing the skin with an injectable anesthetic.
  2. Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a “punch biopsy”). If a punch biopsy is taken, a stitch (suture) or two may be placed and will need to be removed 6–14 days later.
  3. Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).

If syringoma is diagnosed, no treatment is necessary because it is a benign condition. However, many people find syringomas cosmetically disturbing and want to have them removed.

Though there is a risk of scarring, destruction of syringomas is fairly simple and may include:

  • Burning (cauterization) with an electric needle
  • Cutting out (excision) with a scalpel, scissors, or flexible razor blade
  • Carbon dioxide laser treatment
  • Procedure to rub out the lesion (dermabrasion)
  • Freezing (cryosurgery) with liquid nitrogen



What is Milia?

mh_capd_fig2-1.tifA milium is a white papule, 1–2 mm in size, composed of laminated, keratinous material and situated as a solid cyst in a pilosebaceous follicle. Milia are fairly common on the brow, glabella, and nose in newborn infants and in such infants tend to disappear quickly and spontaneously. There may be few or many, and they may develop later in infancy, in childhood, and in adolescence. In older children and adolescents, they tend to macules may be sparse or numerous and resolve without residua over a period of several weeks to several months.

What are milia and what do they look like?

A milium is a small, raised bump on the skin. It is a type of tiny skin cyst filled with a protein called keratin. Many are usually found together and so they are called milia (the plural of milium). As can be seen in the picture, milia are usually each about 1 or 2 millimetres across and are pearly-white or yellowish.
They are most often seen on the skin around the cheeks, nose, eyes and eyelids, forehead and chest but they can occur anywhere on the body.

What are the types of milia and what causes them?

There are different types of milia. We do not fully understand what causes all of the different types.

  • Neonatal milia. These are milia that are seen in young babies soon after they are born. They are very common and are usually found around the nose area but may also occur on the scalp, cheeks, upper body and inside the mouth. They are thought to arise from sweat glands that aren’t fully developed or mature. Around half of all babies develop neonatal milia. In fact, because they are so common, they are actually considered as normal in newborn babies.
  • Primary milia. These are milia that can occur in both children and adults.
  • Secondary milia. These are milia that develop in an area of skin, anywhere on the body, that has previously been damaged or injured – for example, after a burn or a blistering rash. The milia develop as the skin heals and it is thought that damage to the sweat glands may be an underlying cause. Secondary milia also sometimes develop after certain skin creams have been used – for example, corticosteroid skin creams.
  • Milia en plaque. Milia of this type are rare. The milia develop on an inflamed, raised patch of skin known as a plaque which may be several centimetres across. The cause for milia en plaque is not fully understood. It usually occurs behind the ears, on an eyelid, or on the cheeks or jaw area. This type of milia tends to particularly affect middle-aged women.
  • Multiple eruptive milia. These are crops, or patches of milia that develop over a period of weeks or months. The crops usually appear on the face, the upper arms and the upper trunk. Milia of this type are also rare.

Do milia cause any symptoms?

Milia do not usually cause any symptoms but, in some people, they can become itchy.

miliaHow are milia diagnosed?

Milia are usually diagnosed by their typical appearance and generally no investigations are needed. However, in a few cases, if the diagnosis is uncertain or if milia en plaque are suspected, your doctor may suggest a skin biopsy. During a skin biopsy, a small piece of skin is removed so that it can be examined under a microscope. There are different ways that a skin biopsy can be carried out. For example, by shaving away a small piece of skin or by using a special instrument to punch a tiny hole in the skin.

Is any treatment needed?

Milia are harmless and, in most cases, they will eventually clear by themselves. In babies, they clear after a few weeks but, in some people, milia can persist for months or sometimes longer. Secondary milia are sometimes permanent.

How Are Milia Treated?

There is no treatment necessary for infant milia. The cysts will usually clear up within a few weeks. In older children and adults, milia will go away within a few months. If it causes discomfort, then there are some treatments that can be effective for eliminating these cysts.

Treatments include:

  • de-roofing, or using a sterile needle to pick out the contents of the cyst
  • destruction of the cysts using diathermy (extreme heat), curettage (surgical scraping and cauterization), or cryotherapy (freezing)
  • medications, such as topical retinoids (creams that contain compounds of vitamin A

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