Warts, milia and skin tags

Advanced cosmetic procedures to get rid of unsightly skin blemishes and growths

Milia

Milia cysts are usually very uniform, they are pearly-white to yellowish, domed shaped small spots that measure about 1-2 mm in diameter. They are most often found on the face and are particularly prominent on the eyelids and cheeks, behind the ears or on the jaw line but may occur elsewhere. There is normally no sensation with milia but they can become itchy and are very common. They are benign, keratin-filled cysts that can occur in all ages, from infants to the elderly.

They are harmless but unsightly and tend to be more permanent in adults. They can be removed with a needle but to cauterize them with an electric current will prevent them from returning without leaving any scar. This sounds really bad but it isn’t. Although milia are found in the outer layers of skin, they are difficult to remove without the proper tools. Do not try to remove them at home, as you may leave a scar.

They especially affect middle-aged women and are sometimes due to certain products on the skin and can sometimes be a result of using heavy creams, makeup, sunscreens, hair gel, and hair spray and products that contain mineral oil and wax. They can also be hereditary but are not infectious or down to poor hygiene. Excessive sun exposure can also increase the chances of getting milia as sun damage thickens the top layer of the skin.

Warts

wartWarts commonly appear on the fingers and around fingernails. They often have a cauliflower-like appearance, but this depends on the type of wart. Typical types of wart are: common, plane, plantar -often called verrucae.

Let me explain the different types of warts:-

  • Common warts usually appear on the hands, but can be anywhere. They are normally not painful but can be if they are repeated rubbed.
  • Flat warts are generally found on the face and forehead. They are very common in adults and can also be found on the body.
  • Plantar warts are found on the soles of the feet and are referred to as Verrucae. They can be very painful. Many of them on the foot may cause difficulty walking or running.

Warts can be caught by physical contact or contact with a contaminated object for example a hand towel or work surface. After you have been infected, it can take weeks, or sometimes even months, for the wart to appear on your skin. Warts are generally small, usually painless growths on the skin caused by a virus called human papillomavirus (HPV). They can be disfiguring and embarrassing and sometimes they itch or hurt particularly on the feet where they are commonly known as Verrucae. They can spread from one part of your own body to another and may spread from one person to another, but this is uncommon. Treatment is available if you do not like how the wart looks or if it is painful. Warts normally will last about 2 years before they give up the ghost and disappear!

The first treatment is a home treatment mainly for warts on the hands.

First, use a nail file or emery board to file the wart when your skin is damp, for example, after a bath or shower or washing the affected area in warm water. This helps remove dead tissue. Do not use the same emery board/file on your nails since it is now infected but wash thoroughly before re-using. Afterwards, you can use Cryospray 58 – liquid cryogen or Askima Skin Freeze – these are available from the chemist and are applied with cotton bud for 20 seconds. You are causing a 3rd degree burn and it will go white with a red line around it. You need to wait for the wart to die down. Do not repeat this treatment unless necessary. Don’t use this on anything but a common wart since other areas may be too sensitive.

The next treatments are provided by a clinic and there is a combination of one or two treatments available– or sometimes both together.

You can have the warts burnt off by Electrocautery. This is where a fine needle, attached to a short wave diathermy machine, is inserted a number of times into the offending wart. The cauterisation will stop the blood supply and the feeling from the nerve endings to the wart therefore preventing it from growing anymore or remaining in situ.

The laser wart removal treatment uses a laser to target and destroy the wart/verrucae without damaging the healthy skin surrounding it. The laser cuts off the blood supply to it therefore safely preventing the wart from surviving.

Although laser treatment alone can stop the blood flow to the wart and is used very frequently for this purpose, it is also used in conjunction with the Electrocautery treatment and I feel that the two treatments together will clear the wart quicker than one alone. Purely this is my own opinion, but something I feel quite strongly about.

Verrucae

Veruccae appear on the feet. They look flat and thick and hard around the edges. They have smallish black dots in the middle and often feel sore. They are highly contagious and are sometimes passed on at swimming pools due to people walking around barefoot.

Whilst most verrucae will go away, on their own given enough time, they may leave some scarring behind and infections can re-occur. If you are suffering with verrucae, they can be effectively treated to remove the offending objects and restore soft skin. Laser treatment is the most common removal method and targets only the verruccae not the surrounding area as does electro-cauterisation or a combination of both.

Both these methods will stop the blood supply to the verrucae causing it to die away. I feel that the electro-cauterisation will also kill off the roots to it, which to my mind is important.

How will I feel during verrucae removal?

You may feel mild discomfort during your treatment and if so, anaesthetic cream can be applied to help numb the area. Electro-cauterization can create a little discomfort but I think the laser is just fine. You will be OK though with anaesthetic cream – you can buy some from Boots called Emla. It’s only a small tube but you could apply it 1 hour before, cover over this with something like cling film, and do not rub in the cream – just place it over the verrucae.

Stubborn verrucae may need more than one treatment but, even if previous attempts have failed, it is very rare for it not to work with laser and electro-cauterization.

Aftercare includes thorough drying after bathing. Skin that is left damp may fester and cause infections. Rub rather than scratch if itching is a problem. Nothing very special here but do keep the area extremely clean.

Skin Tags are fibro epithelial polyps or acrochordons

Skin tags are small flesh-coloured or brown growths that hang off the skin. They are very common fibrous skin conditions that are mainly found on areas where there is friction or rubbing. Necklines, underarms, bra lines, inner thighs are most commonly affected. They are not infectious but do seem to spread on individuals. They are usually only a few millimetres in size, although can be as big as 5cm.

To have them removed professionally is by far the better option and once they are gone, they are gone for good. Most professionals will use a short wave diathermy or electrolysis machined which to my mind is the better way. A very fine needle, placed in the needle holder, is attached to an electric current which is momentarily flashed on and off. The current is applied to the stem of the tag and once the nerve endings and the blood supply are destroyed then all feeling ceases.

Unless you have masses of them then usually a half hour treatment is sufficient. You will have a tiny scab from where they have been removed or you could have a black bobble which will fall off in the next few days. Either way it’s not as bad as having them. It takes a little time for the new skin to colour up so if you’re going in the sun soon you may have little white specks where the tags were remove from.

It can feel slightly uncomfortable when they are being removed but you can always put some anaesthetic cream on to numb the area. Smaller tags will be removed totally and larger ones will fall off in their own time.

How are skin Tags Removed and does it hurt?

To have them removed professionally is by far the better option and once they are gone, they are gone for good. Most professionals will use a short wave diathermy or electrolysis machine which to my mind is the better way. A very fine needle, placed in the needle holder, is attached to an electric current which is momentarily flashed on and off. The current is applied to the stem of the tag and once the nerve endings and the blood supply are destroyed then all feeling ceases.

Small tags will fall off immediately but larger ones will take longer and usually come off in a couple of days. The larger ones also turn black/brown before falling off.

Some people find it uncomfortable to have skin tags removed wheras others tolerate it very well. It’s all up to the individual. If you are one of those who find it unpleasant, then there is always an a aesthetic cream that can be applied beforehand and will numb the area.