Periungual warts are abnormal skin growths that occur around or under the fingernails and toenails. They pose a special risk to patients because if left untreated, they could cause malformation of the nail; the nail may even detach and fall off as it is pushed up and away from the skin. In the most severe cases, periungual warts can even lead to a fungal infection if they grow far enough to reach the nail plate. As are most kinds of warts, periungual warts are highly contagious through skin-to-skin contact.
Periungual Warts Causes
Periungual warts are caused by a strain of the Human Papilloma Virus (HPV) which enters the skin through a cut or scratch. The warm, moist environment of the epidermis provides a virtual feeding ground for the HPV virus to grow and multiply. As it does, it encourages rapid multiplication of skin cells which then form the wart. In the case of periungual warts, they are among the most common due to the fact that the hands and feet routinely come into contact with people or objects carrying the virus.
Biting your fingernails or clipping your toenails too closely is two practices that can increase susceptibility to periungual warts. These things often cause small cuts or scratches to the surface of the skin which then provides an open door to the HPV virus. Even if visual inspection does not reveal broken skin, it’s nearly impossible to bite the fingernails or clip the toenails closely without causing at least minor skin damage. With fingernail biting, there is an added risk of the virus entering the mouth and leading to oral warts.
Periungual Warts Symptoms
Periungual warts generally start out as small raised bumps that are not readily seen by the naked eye. This is especially true when they begin to form underneath the edge of the finger or toenail. However, as they grow patients will notice rough-looking bumps with non-uniform edges at the site of the wart. Periungual warts tend to take on the appearance of cauliflower as they grow and spread, and they can occur in clusters.
Left untreated, periungual warts underneath the nail can begin to push up on it and cause mild to moderate pressure. If still left untreated the pressure could become painful if the nail experiences even the slightest touch. Finally, if a periungual wart grows large enough its size could even cause the nail to permanently detach. Such instances are rare, but when they do occur they are likely to cause permanent nail damage and scarring.
Periungual Warts Treatment
For periungual warts that occur anywhere other than underneath the nail, they are easily treated with most over-the-counter medications from the drug store. Salicylic acid or other such compounds will attack the wart layer by layer until it is completely eradicated. Doctors who treat these warts most likely will use the same topical compounds or an immunotherapy ointment or injection aimed at trying to trigger the body’s immune system to fight warts.
Periungual warts that occur underneath the nail are much more difficult to attack and get rid of. In these cases, doctors will not use topical compounds such as salicylic acid for two reasons. First, periungual warts under the nails tend to grow significantly larger and deeper before they are ever noticed, so the compounds are largely effective. Secondly, the topical compounds could cause significant nail damage. Therefore, periungual warts that occur under the nails are almost always treated with laser surgery. This has proven to be the safest and most effective method of dealing with them thus far.