Warts? Are you sure?
That’s what I often hear when I tell my male patients what the troubling tiny bumps under their beards could be. Black, big circular skin tags — they don’t look like what most imagine warts to be. But the reality is that warts come in all shapes, sizes, and textures.
What causes beard warts and how do you get rid of them?
The science behind it
Warts are benign epidermal growths caused by the human papillomavirus (HPV). The skin under your beard gets exposed to HPV when it breaks, which could happen due to cuts or scratches from shaving, especially if you’re sharing the razors. Poor hygiene contributes to the issue. One of the most common hotspots of the virus is children’s nail beds. Children end up transferring the virus when they touch your face — or scratch it in case their nails are longer. The incubation period of the virus is nine to 90 days, which means that warts may show up a long time after you’re exposed to the virus.
Warts can lead to precancerous lesions, though that is very rare. It happens when you’re exposed to a more damaging HPV variant, whereas common warts are harmless. Consult a dermatologist to make sure you’re clear of a possible cancer scare.
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Treating beard warts
Dermatologists find it challenging to treat beard warts due to the Koebner phenomenon, which was first identified in 1876 and is sometimes called auto-inoculation. It refers to the condition in which HPV spreads to other parts of the face due to continuous shaving, thus starting a vicious cycle of warts emerging on clean skin while you’re treating current ones.
Beard warts can be flat or filiform. Flat warts are small, smooth, may not be visible, and aren’t painful. They are commonly seen in children too. Moreover, they grow in clusters — numbering 20 to 200 — and normally go away on their own. Filiform warts, though, are spiky, fast-growing, and more visible around the nose and mouth.
In addition, warts can differ in shape (dome or round), texture (rough or smooth), and colour. If you feel a bump rising under your beard or notice a slight discolouration of your skin, visit your dermatologist without delay. In most cases, they can identify the warts on physical examination. Otherwise, they may take a skin biopsy to confirm HPV.
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Getting rid of warts
Home remedies aren’t always the solution to skin problems. Some men use salicylic acid-based OTC medications along with face masks made with apple cider vinegar to aid their wart treatment. Others apply local choona, which is more likely to harm than heal.
Going to a dermatologist should be your first step. Depending on the depth of the wart, treatment options differ.
Cryotherapy (freezing) is one of the most commonly used methods. It involves inserting liquid nitrogen in the wart to dry the skin out so it sheds over time. Though this method is highly effective, it can lead to scarring.
Electrodesiccation, in combination with topical treatment, is done to battle stubborn cluster warts. This is an often-used technique in which specific skin lesions are electrified. A trained dermatologist uses an electrode to touch the skin directly, heating the warts up. As your skin gets dehydrated, a dry coagulum is formed, which helps remove flat warts.
Electrofulguration is used for warty lesions and works in a similar way to electrodesiccation. The main difference is that in the former, the electrode is kept 1-2 mm away from the skin, which results in a spark over the area. This leads to dehydration and carbonisation, thereby reducing the lesions.
Either of these treatments, in addition to a CO2 laser (for deeper tissue warts), is the way to tackle beard warts. It takes multiple sessions, and your dermatologist may add a chemical peel to completely exfoliate the area and remove all remnants of the virus.
Some organic compounds can help too. Vitamin A consists of a compound called tretinoin, which, when applied to the skin, helps reduce warts. While this treatment may turn out to be more tedious, it has better results than cryotherapy and leaves no scarring.
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How to prevent beard warts?
If you recently developed beard warts, retrace your shaving routine. If you had gone to a barbershop, time to switch salons. If you used a friend’s razor, avoid doing that in the future. If you used only your own, sterilize it or replace your set. It’s important to maintain proper hygiene standards to reduce all risks of exposure.
If you have children around, make sure their nails are clean and trimmed. Even better if you use personal clippers for each family member to avoid cross-contamination. Consult your dermatologist about home remedies. Warts are an easy, treatable skin disorder but you need the proper skin sherpa to help you navigate the ups and downs of treatment.
Dr Deepali Bhardwaj is a dermatologist, anti-allergy specialist, laser surgeon and internationally trained aesthetician. She tweets @dermatdoc. Views are personal.
(Edited by Humra Laeeq)