LASER REMOVAL OF WARTS

Warts (Viral verrucas) are caused by viral infection due contact through micro-injuries of the epithelium in susceptive persons especially in childhood and young grown-up age. For the formation viruses belonging to family of HPV (Human Papilloma Virus) are responsible. The virus enters the epithelial cells through minutes injures if it finds reduced resistance for the eventual weakness of the immune system and infects epithelial cells forcing them for increased fission so starts formation of veruccas. Verrucas start to grow slowly and after a while they can be observed, they often prone to spead through by using lymphatic circulation of the skin. Generally they appear on hands and feet (verruca vulgaris), on bodies (molluscum contagiosum), rarely on outer genitalia and surround anus (condyloma acuminatum). Characteristically they bulge and they often have rugose surface sometimes they are painful, and have same colour as skin, they are located deep in skin, where their so-called "root" is to be found.

Viral verrucas around anus and genitalia (condylomas)

Viral verrucas around anus and genitalia are called condyloma. This infection is a classic, cauliflower-like wart and may appear in form of condyloma acuminatum, but in most cases it is a flat wart-like deformation without clinical symptoms. Mainly it spreads through sexual contact; the morbific is also in this case the human papilloma virus (HPV). Transmission time cannot be determined (it can be 1-8 months, and can stay hidden for a long time). Seeable condyloma must be always treated for they continuously grow and spread and they also might indicate a cancer preventive stage. We carry out operations of verrucas around the anus with CO2 laser.

Treatment options

Viral warts may be treated with verruca paints, creams or excision. Methods include curettage with Volkman's spoon, electrocautery, freezing with liquid nitrogen or vaporization with laser. The latter is used in our clinic as an outpatient procedure. According to our twelve year experience the outcome of laser removal is very good. The average time for healing is 3-5 weeks depending on the size of the wart. It is important to know that besides the removed visible warts there might be small warts invisible even with magnifier glass that may become apparent after further growth for a few weeks. It is therefore necessary to keep the follow-up appointments strictly, to be able to remove the warts that have developed since surgery. This new procedure however is free. We observe the patient for twelve weeks after surgery and consider him or her healed if no new wart develop. Should new warts develop, they are removed as mentioned above, and the three months observation period starts again. Getting rid of viral warts may try one's patience due to the need for long observation period and repeated follow-ups, therefore always requires the long-term cooperation between patient and doctor.

One day surgery

"One day surgery" means, that patients can leave the outpatient center on their own feet, accompanied by a helper, within 24 hours of surgery (usually after few hours of observation), and continue the healing process in the familiar confines of their own home. "One day surgery" requires strict professional, social, and various other preconditions that are discussed at the stage of the consultation when the need for surgery becomes clear. (I.e.: good general health, absence of serious systemic disease, patient must take responsibility for arrangement of transportation, home care, must have phone to contact the clinic or the surgeon if necessary, etc).

Examination and consultation

The procedure is preceded in by examination by the specialist. Following the examination, the doctor informs the patient about the results of the examination, surgical anesthesia, the recommended surgery, possible complications, and postoperative wound care at home. The procedure may be performed immediately following the examination and discussion, or at a later time. Before surgery, the patient has to sign a consent form, which authorizes the clinic to perform the surgery.

Charge for examination and consultation: 10.000 HUF > Euro

The procedure

Surgery is performed with local anesthesia, by injecting 1%-s Lidocaine immediately under the wart. The principle of the procedure is to lift the wart along with its root from the skin with the laser. The removed wart is always sent to histology and the patient is provided with a written report at the first follow-up. A "hole" remains on the site that will fill with granulation tissue and epithelialize in 2-6 weeks depending on the size of the wart.

Possible complications

No doctor can guarantee a complication-free surgery. Complications can arise even following the most carefully performed procedures. The early complications: postoperative bleeding, inflammation are however rare and always treatable. Oozing of blood at the first dressing change on the day after surgery may occur after removal of unusually large and deep-rooted warts. This usually stops after soaking in lukewarm water and application of a larger dressing. In case of inflammation the area surrounding the wound becomes red, hot and tender. If you experience any sign of complications call your doctor day or night who will make sure the problem is treated. Among the possible later complications, scar hypertrophy (keloid) deserves mention. This is the consequence of a genetic predilection to abnormal wound healing and increased scar formation that is prominent, red and may be associated with itching and burning sensation. This is an essentially benign but esthetically bothersome lesion. If during follow-up visits we notice the tendency to this type of wound healing we can stop or reverse the abnormal process with injection therapy. This involves administration of long-acting anti inflammatory injections directly into the scar, three times, two weeks apart. Early recognition of abnormal wound healing is very important since it can only be successfully treated within three months of surgery. This is another reason in addition to learn about histology results to keep the follow-up appointment.

Postoperative care

The procedure is followed by observation for 15-20 minutes in clinic, then the patient may leave. On the first postoperative day the dressing placed by us needs to be removed the wound rinsed with lukewarm water, then covered with a band aid. Laser wounds heals with granulation that is normally associated with discharge and should not cause concern. Rinsing of the wound in the shower should be done at least twice a day. It is important not to leave the dried crust on the wound because it prevents secretions to drain and the wound may become inflamed. Powder or ointment should not be applied to the wound. The time for full recovery is 2-6 weeks and greatly depends on the size and depth of the wart.

Fees

Charge for examination and consultation: 10.000 HUF > Euro
Surgery with local anesthesia: 4.000 - 12.000 HUF / piece. > Euro

The price decreases by the number of warts removed. More...

Charge for histology examination: 5.000 HUF / piece. > Euro

(One biopsy is satisfying on one surgical surface.)

Price is only informative, depends on the size and location of warts. Special e.g. mosaic wart, which is more warts connected to each other and so its removal is not considered to one!

It is important to emphasize that the above fees include not only removal of the already present warts, but the total cost for the entire process of curing the infection independent of the duration of treatment and the number of further procedures required.

If surgery follows the initial consultation, the consultation fee is waived.

Appointments: Monday - Friday, 8 am - 8 pm.
Telephone: + (36 1) 266 7766

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