Warts. Description, causes, prevention and treatment of warts. Can warts go away on their own? Do warts disappear on their own?

How warts. Also, here you can find out about reasons for their occurrence, prevention, and actually methods of treating warts. So…

Warts (wart, verruca, plural verrucae) - rounded elevations of the skin that occurred as a result of strong growth of the surface layers of the epithelium and the underlying papillary layer of skin. Warts are also benign skin growths that occur as a result of infection human papillomavirus (HPV).

Warts come in different sizes - from 1-2 mm to 15 mm, depending on the type and location of its formation. It is also possible for several warts to merge, which can form quite large tumors of a conical or hemispherical shape, with a wide base. Over time, the color of the wart, initially the same as the color of the skin, becomes brown and even black, although to a large extent, this color is due to dirt, which easily sticks to the rough surface of the wart.

Types of warts

There are 4 main types of warts: common, flat, genital warts and senile warts.

— Ordinary , or common warts . They are dense keratinized papules with a diameter of 1-10 mm. Most often they form on the back of the hands. Most of them go away on their own, without any treatment, within two years.

— Plantar warts or plantar verrucae) - a type of common warts, - appear in places where shoes are pressed, especially on very sweaty feet. First, a small shiny, subsequently keratinized papule or plaque of a yellowish-gray color with a rough, uneven surface. The formation is usually single, but 3-6 or more warts are found. Small elements can merge to form a “mosaic” wart. Very dense, keratinized, gray-dirty plantar warts are characterized by severe pain that prevents walking. Sometimes this type of wart causes temporary disability.

— Flat, or juvenile warts (plane warts) – clearly demarcated papules with a smooth surface, 1-5 mm in diameter, rising 1-2 mm above the surrounding skin. The name itself suggests that this type of wart usually occurs in children and young people. Flat warts look like round or irregularly shaped flat nodules, which are usually located on the back of the hands, shins, and also on the skin of the face. The color is light brown, pink or flesh. The appearance of flat warts is promoted by skin irritation (they often occur along the course of scratches, cuts, etc.).

— Genital warts or condylomas - tiny pink nodules (skin growths), which, merging, form a papillary growth of soft consistency on the base, in the form of a stalk, flesh-colored or reddish in color.

This type of wart appears on the male and female genital organs. They can be transmitted through sexual contact, especially if there are small cracks or injuries in the groin area and genitals. If they are not removed, they can grow to a large size and cause significant health damage. Often condylomas accompany the development of other infectious diseases of the genital organs. According to statistics, this type of wart appears most often in women with an increased likelihood of developing cervical cancer.

The photo is not presented due to the possible negative impact on the human psyche. Thank you for understanding.

Senile warts or keratomas - the most common benign skin tumor. Synonyms: Seborrheic keratosis, seborrheic wart, basal cell papilloma. Senile warts usually develop in middle and old age from the epidermis. Its pathogenesis is unclear, but it is believed that this lesion develops from cells of the basal layer of the epidermis or keratinocytes of the most superficial part of the hair follicle and is not associated with human papillomavirus. Elements of seborrheic keratosis are often multiple, located on the chest, less often on the face, neck, dorsum of the hands, extensor surface of the forearms, as well as on other areas of the skin. The exception is the surfaces of the palms and soles. The process never affects the mucous membranes. The number of lesions usually does not exceed 20. Their diameter varies from 0.2 to 3 cm, sometimes reaching 4-6 cm. Patients with multiple seborrheic keratosis sometimes have a positive family history, which is a reflection of a genetic predisposition.

The clinical picture of seborrheic keratosis depends on the location and timing of development of seborrheic keratosis. Early elements are flat, small spots or papules that seem to be stuck to the skin, they have clear boundaries, pink or yellow color, a warty (as if corrugated) surface and are covered with easily removable greasy crusts, which over time become more dense and riddled with cracks . The thickness of the crusts sometimes reaches 1-2 cm. Over time, the elements of classic seborrheic keratosis acquire a mushroom shape, dark brown or black color. The retention of horny masses in epithelial crypts leads to the formation of comedos, but similar black inclusion grains. The consistency of the formations is soft, the boundaries may be unclear, sometimes even jagged. In such cases, the tumor resembles melanoma. Sometimes the elements of seborrheic keratosis have a dome-shaped shape and a smooth surface with the presence of white or black keratin pearls with a diameter of up to 1 mm, which are easily distinguishable when examined with a magnifying glass.

Seborrheic keratosis develops slowly, over several decades, but does not undergo malignant transformation.

Causes of warts

So, as you and I already know, the cause of warts is the human papillomavirus (HPV), which almost every adult is infected with, and you can have several types of this virus at the same time and not be aware of their presence. Unfortunately, the prevalence of HPV infection is steadily increasing in all countries.

In most cases, infection occurs through direct contact with skin and mucous membranes affected by HPV. Less commonly, infection occurs through household items (nail files, manicure scissors, etc.). Infection is also facilitated by microtrauma to the skin, but the main reason for the appearance of warts on the body is a weakened human immune system, which is unable to control HPV.

You can “purchase” warts for yourself in the following way:

- in personal contact with a person who has warts;
- when using the same things with it, for example a towel or dishes;
- if you do a manicure or pedicure with instruments not treated with an antiseptic;
- if you walk barefoot in a bathhouse, swimming pool or sauna where there was a person infected with the papilloma virus;
- condylomas may appear during sexual contact with an infected partner;
- Wearing tight shoes can cause plantar warts to appear.

A favorable condition for the appearance of warts is a weakened state of the body, which can be caused by lack of sleep, poor immunity, and poor nutrition.

The most important rule for preventing warts is to healthy image life. Moreover, initially in the spiritual plane, and then in the physical. Support your immune system, which weakens due to lack of sleep, stress, etc.

- avoid stress. Remember that your health is worth more than work, or other sources of constant discomfort;

— when going to a public bath or sauna, be sure to wear personal shoes. By the way, it’s generally better to avoid going to the pool, because... in it you can not only catch HPV, but also a “bouquet” of various infections and viruses, and “expensive” swimming pools are not immune from this. I believe that this is due to the desire of a modern person to earn more, cutting expenses to the maximum;

— when working with cleaning products that can damage the skin, use gloves;

- wear shoes only from natural materials, such as natural fabric or leather, and avoid wearing synthetic shoes, especially for children and teenagers;

- in your personal life, have no more than one sexual partner. Not only will this reduce your risk of HPV, but it will also promote a healthy mind, and where there is a healthy mind, there will be a healthy body.

Now we know what warts are, what they are like, what they look like, what are the reasons for their appearance, and how to prevent the appearance of warts. All that remains is to figure out what to do if you already have a wart. More on this below.

General principles for treating warts:

- None of the currently known methods of treating warts eliminates the cause of warts - the human papillomavirus (HPV).

— Relapse is possible after any method of wart removal. Moreover, the probability of relapse is approximately the same after any method and is about 30%.

— Unfortunately, none of the known methods of treating warts is 100% effective. It is in the range of 60 - 95%.

— Most wart removal methods can cause scars on the body. In this case, as a rule, the following pattern is observed: the higher the effectiveness of the method, the higher the likelihood of scar formation.

— Warts can behave completely unpredictably: they may resolve on their own without any treatment, or they may not respond to the most effective treatment methods. Warts resolve spontaneously in approximately 20% of cases within 2 months, in 30% of cases within 3 months, and in 50% of cases within 2 years. Warts in children are more likely to resolve on their own. With warts in adults, in people with reduced immunity, as well as with persistent warts, spontaneous resolution is observed less frequently.

— Taking into account the possibility of warts disappearing on their own, the possibility of relapse after treatment, as well as the possibility of scarring, in some cases the decision to observe rather than treat is quite reasonable. This does not mean that warts do not need to be treated. Necessary, but not always. When deciding on observation, the acceptability of warts for the patient (whether they cause physical and psychological discomfort) is very important.

— Treatment of warts should begin with inexpensive and safe methods, although not the most effective. If they do not help, they move on to reserve methods - more aggressive and expensive. It is unwise to immediately start treatment with reserve methods (for example, laser), since this carries a high risk of scarring and there is no advantage in reducing the likelihood of relapse.

Medical ways to get rid of warts

The most correct decision when warts appear is to consult a dermatologist, who will prescribe medications that enhance immunity, calm the nerves and vitamins. In addition, only a doctor can help you correctly determine the method of getting rid of warts. These methods include:

— Cryodestruction (consisting of freezing warts with liquid nitrogen). Liquid nitrogen is applied to the wart using a swab attached to a wooden stick or using a special cryoapplicator. Freeze the wart for 10-30 seconds. In this case, the wart becomes white and dense, and after about an hour, a blister forms in its place, which lasts 5-7 days, gradually drying out. The crust finally comes off after two weeks, leaving a light pink spot. For plantar warts, a longer course is needed - several freezing sessions with an interval of 2-3 days.

However, it is worth noting that freezing (for example, using liquid nitrogen) is usually carried out in beauty salons and is quite expensive: from 600 to 3000 rubles. for the removal of one wart - accordingly, if there are more than one formations on the skin, then the cost of removal should be multiplied by their number. Many people “kissed by warts” have repeatedly noted that it would be great to have some kind of drug for home and inexpensive removal of warts using the cryodestruction-freezing method. Until relatively recently, the prospect of having a “cryo-jar” at home seemed like something fantastic - but now, fortunately, there are drugs that, at home, affect warts using the cryodestruction method. Below we talk about one of these means for cryodestruction at home - the drug Veruclin.

— Electrocoagulation (removal of warts with electric current). The wart is “cut off” with a thin metal loop under a high-frequency current, which helps to avoid bleeding and at the same time disinfect the tissue. This leaves enough material for histological examination - if there is a suspicion of oncology, for example. The operation is performed under local anesthesia. After exposure to current, a small crust forms, which will fall off in a week (it is better not to wet it or cover it with cosmetics during this time, so that there is no scar left).

— Laser coagulation (wart removal with laser). The wart is removed layer by layer using a laser under local anesthesia. A small depression remains at the site of the wart, which smoothes out in 2-3 weeks. If we are talking about a plantar wart, then you need to take into account that during these 2-3 weeks you will have to take care of your foot - walk as little as possible.

— Surgical excision of warts. The method is used only when the warts are large enough (or several have merged into one). Under local anesthesia, all excess is cut out with a scalpel and sent for examination. The skin is sutured with a cosmetic suture, after which only a thin, light, flat scar will remain.

— Chemical methods . They are used relatively rarely. This is the lubrication of a wart with a fairly caustic acid or alkali: one-time, or as a course of treatment. At the same time, there is a high risk of damaging surrounding tissues or introducing infection, and this is also a painful method of combating warts. An exception may be the treatment of warts with salicylic acid. It can be bought at the pharmacy in liquid form, as an ointment (in combination with something else) or as a special patch. For some types of warts this works quite well. The main thing to remember is that only the wart needs to be removed, and not the flap of skin on which it grew - that is, only the wart needs to be lubricated, and only the wart needs to be covered with a special plaster.

Important! Before using the following remedies against warts, consult your doctor, because... Self-medication is always life-threatening!

Salicylic acid. Of course, before trying this or that method of getting rid of warts, you should consult a dermatologist. Moreover, the use of salicylic acid is not indicated for everyone. This remedy should not be applied to warts that have formed on the face or genitals, as well as to those warts from which hairs grow. Salicylic acid can be purchased at the pharmacy in the form of an ointment, liquid, or patch. One prerequisite for its use is to apply the product directly to the wart itself. Salicylic acid is also used to treat acne and excessive sweating of the feet. Some doctors do not recommend this method for those who are sick or have circulatory problems - it is better for such people to be treated under the supervision of a doctor.

Trichloroacetic acid. A product that can be used to cauterize warts and remove calluses. It is also applied to the wart itself and left until completely dry.

"Ferezol" is a drug that has a pronounced bactericidal property due to which it is used to remove warts, papillomas and condylomas. You should also consult a doctor before using it.

"Papillek"- a drug without side effects that eliminates warts.

"Veruclyn"- the same pharmacy drug announced above for cryodestruction of warts at home. Perhaps one of the most modern today pharmaceutical drugs to fight warts at home. The principle of action of the product is exactly the same as in a procedure from a beauty salon: the product quickly and effectively freezes the wart. The result is like after a cosmetic procedure, but you don’t have to go anywhere and pay 600 - 3,000 rubles for one wart. It is enough to apply a drop of “Veruclin” directly to the wart with a special applicator and hold the applicator on the wart for 40 seconds. The wart will freeze and fall off on its own after two weeks. The cost of the drug is several times less than the medical procedure: one bottle costs just over 700 rubles, and it is enough to remove 12 warts. Those. the cost of removing one skin lesion is only 60 rubles. In some cases (large formation), re-application is necessary after two weeks. The product is approved for use not only in adults, but also in children.

Important! There are many more medical supplies and methods for removing warts, but I will not mention them in the article, because... they mostly leave scars on the skin and can also be hazardous to health.

- Every day, lubricate the wart with wormwood infusion several times.

- Strong (for 1 glass of boiling water - 3 tablespoons of wormwood, boil for 2 minutes, leave for half an hour covered) is also used for daily lubrication of warts.

- Rub the warts with raw garlic 2-3 times every day. The course of treatment can be continued until the warts disappear, which usually takes from two weeks to a month, in some cases longer.

- Squeeze juice from or. Apply it to the wart every day. Continue treatment for about 3 weeks.

- You can add baked garlic and butter.

— If the warts are located on the legs, then simply lubricate them with oil tea tree two to three times a day. This oil can be purchased in pharmacies and is not expensive. You should not dilute the oil because the skin of the feet is thicker and thus less sensitive compared to the skin on other parts of the body. However, if you think that you have really sensitive skin and there is a high chance of getting irritation, you can dilute the oil using aloe vera gel or water. A fifty percent dilution will be sufficient.

- Rub the new growth carefully so as not to damage it with clean chalk, and sprinkle a little more chalk on top. Tie it so that no moisture gets in. Walk with the bandage for 24 hours.

— Keep the raw onion in vinegar essence and tie it overnight. Do this several times until the wart comes out from the root.

- Grind a clove of garlic to a paste, add a drop of lemon juice, add flour to make a dough. On the lesion with the wart, stick a patch with a hole in the middle for the nodule. Place garlic dough on the wart and cover it with a larger plaster on top. Keep this bandage for a day or two, replacing it with a new one if necessary. When warts fall off, lubricate the skin with Vishnevsky ointment and bandage it. Apply the ointment until the wounds are completely healed.

— Instead of the garlic dough in the above recipe, you can use a piece to remove warts. Make dressings constantly, replacing a piece of Kalanchoe with a fresh one. Usually, after such procedures, warts disappear completely.

- Every day, lubricate the warts with juice or juice from sour apples several times. Without rinsing, let dry. The acidic juice causes the wart to significantly decrease in size and disappear after 10 days.

—Green liquid soap purchased from a pharmacy can be used to bandage a wart. Moisten a piece of bandage with soap and secure it to the wart with an adhesive plaster.

- Juice from fresh rowan berries can also help the disappearance of warts. The juice should be applied to warts 2-3 times a day.

— Fresh green tomato juice is used to lubricate warts.

— Horseradish juice mixed with salt is used for compresses on warts.

- Remove warts with dry ice. To do this, keep a piece of ice on the wart for as long as possible, repeating the procedure several times.

— Hot water (Hyperthermia). The method is extremely simple and consists of immersing the hands or feet affected by warts for 30 minutes at maximum hot water temperature that a person can tolerate (usually 45 - 48°C). Procedures are carried out 2-3 times a week. The mechanism of action of hyperthermia is presumably associated with redness of the skin (due to dilation of small blood vessels) with subsequent activation of local immunity. The primitiveness of the method often causes ridicule among patients. However, hyperthermia is sometimes very effective. The method is more preferable for plantar warts.

- Bandage a banana peel to the wart, with the inside of it. When the wart begins to turn black on top, this is a sure sign that its roots are dying. During this period, do not try to cut off the top layer from it; it is important that the wart falls off completely - this way you will increase your chances of protecting yourself from the reappearance of a wart in the same place.

- Warts on the genitals. You can use tea tree oil to treat genital warts as long as there is no exposed or irritated skin. Dilute tea tree oil 50% with water. Use cotton swab or gauze bandage for treating warts. Remove excess moisture. Leave the bandage on overnight. Just continue to do this procedure every night until the warts are completely gone.

Important! I would like to note that in no case should you use spells, magical methods, etc. when fighting warts, because Even if it helps, it will definitely harm another person, and this is due to the fact that the dark forces plan to destroy a person, and not to heal.

Probably, many of us were scared by our parents that picking up a toad was dangerous - warts would definitely come out. And some especially impressionable children avoided these amphibians on the tenth road. But it is not a fact that this helped them subsequently avoid the occurrence of warts. We will try to consider the causes of its occurrence, as well as treatment options, below.

What are warts?

Warts are in the form of papillae or nodules. Most of them are benign in nature, although there are known cases of warts degenerating into malignant tumors. As a rule, they are dense and dry. In structure they can be single or consist of many nodules and have clear boundaries. Dimensions: from a pinhead to 1-2 cm. Sometimes small warts can merge into islands the size of a nickel.

They do not hurt, except for those that are in places of constant pressure or are subject to other mechanical stress. They can form on the hands, soles, head, face, and genitals. They are mostly gray-yellow in color, sometimes dark brown.

What are they?

There are four main types of warts:

1. Ordinary (vulgar) usually appear on the hands. They have an uneven, villous surface, with a keratinized top layer. These also include plantar warts. People who sweat a lot are more likely to find them in themselves. In places where shoe pressure is applied, such growths are very painful.
2. Flat warts They mainly appear in children and young people, which is why they are also called juvenile. They rise above the surface of the skin by only 1-2 mm. Their surface is smooth, color from pink to light brown. Favorite “habitat” is the face, hands, legs.
3. A completely different type of wart from the previous ones - genital warts. If they are ordinary and dry, then condylomas are fleshy, icicle-shaped growths on a stalk. As they grow, they can form growths similar to cauliflower. Condylomas on the genitals are very dangerous. They are the ones that most often can develop into malignant ones.
4. Elderly people experience senile warts. The reasons for their appearance differ from the previous ones - these are not viral growths. They look like keratinized, dark-colored, greasy plaques.

Warts must be distinguished from moles (birthmarks, nevi). The latter can be congenital or acquired. They appear as a result of filling the epidermal cells with pigment and transforming them into melanocytes. Their danger lies in the fact that nevi can become the progenitors of melanoma - one of the most dangerous types of cancer. This can happen due to the simplest things: frequent rubbing, injury or abuse of ultraviolet radiation.

Why do warts appear?

Naturally, the toads and frogs mentioned above have nothing to do with the appearance of warts. The causes of these skin defects are infection with the human papillomatosis virus (HPV). This does not apply to senile warts. The virus that causes warts has more than 110 varieties. It lives only in the skin and mucous membranes, without infecting the blood and other organs.

How do warts occur? The causes of HPV are concentrated in the lowest layer of skin. As you know, epidermal cells, as they mature, move upward from the bottom of the skin, where dead cells are exfoliated. The papillomavirus also moves with them. Reaching the surface, it provokes the formation of contagious warts.

Factors contributing to infection

You can become infected with HPV through direct contact with the affected areas of the skin and mucous membranes of the virus carrier. And also using his nail file and other hygiene items.

The virus has two stages: active and inactive. He can stay in the latter for years, and the person does not even realize that such a dangerous “roommate” lives inside his skin. When the immune system fails, the virus begins to actively multiply and comes out. If a person develops warts, the reasons for this may lie in decreased immunity.

Skin lesions are also dangerous in relation to HPV infection. That is, contact with a person who has warts does not always lead to illness. Infection occurs due to a combination of three factors - the active phase of the development of the virus, a decrease in the immunity of the person in contact and a violation of his skin.

Variants of virus behavior

Papillomavirus is quite unpredictable. Sometimes warts go away on their own without treatment over a period of months or years. This occurs more often in children. Warts are a rather interesting phenomenon; they may not develop according to the classical pattern. If other illnesses “gain momentum” without treatment, and when proper treatment If the patient recovers, then with warts it is impossible to say with certainty how they will behave in one case or another.

It happens that it does not bring relief, and the number of growths not only does not decrease, but also increases. But even if the drugs helped and you got rid of the warts, no one guarantees that after a while you will not encounter the same problem again. Statistics say that relapses occur in a third of those infected with papillomavirus.

Warts: what to do?

This is the application medicinal herbs, and burning out growths with acids, and evaporating them, and semi-shamanic remedies, when you need to anoint a wart with something, and then bury this piece so that it rots.

As a result of all these actions, the warts may disappear. But no one can say with certainty whether the folk remedy helped, or whether the person’s immune system worked.

In any case, you need to consult a doctor. It is the dermatologist who can determine with a 100% guarantee whether a wart has developed into a malignant formation, prescribe effective ones, or determine what method is best to get rid of it.

Local treatment

Acid solutions are used for it. The most common medium is a viscous substance called paint. It contains salicylic and lactic acids. Sometimes more aggressive substances are used: trichloroacetic, nitric, carbolic, cantharidic acids.

This treatment method is characterized by duration. Warts should be treated continuously with prescribed products for several days in a row. But one of the advantages of local treatment is that it rarely leaves scars on the skin.

But when surgical removal warts and the formation of a scar, albeit minor, cannot be avoided. Excision is used when large areas of skin are affected. The wart is scraped out with a special scalpel and the wound is sutured. But there is a possible risk of recurrent infection through blood.

Local treatment usually includes immunomodulatory drugs. After all, an excellent state of immunity is the key to a quick recovery and a factor in preventing relapses of the disease.

Burn out with cold or electric shock

There are methods for removing warts using electric current or cold. The first is called electrocoagulation. This procedure is carried out quickly and effectively, under local anesthesia. The patient feels virtually nothing while the doctor uses high-frequency electric current to cauterize the tissue affected by the virus. As a result of the procedure, the pathogen dies and the wart is destroyed. But small scars can remind you that it was there.

Exposure to extreme cold is also detrimental to the virus. The cryodestruction method is based on this. The growths are treated with liquid nitrogen. The patient will have to accept that the procedure is painful. And the bubble that appears as a result of a cold burn will take seven to ten days to disappear. But instead of a scar, where the wart once “sat”, there will be only a pinkish spot.

Laser wart removal

A new trend in the difficult fight against warts is the use of laser. This method has positive reviews. Warts are removed almost completely and painlessly in 1-2 minutes, under local anesthesia.

Due to the use of the most modern technologies, precise exposure of the laser beam to the required area and depth, depending on the damage, is achieved.

The laser “evaporates” the wart in layers, while the skin around the growth is not affected. A small depression remains in its place. Two weeks after the wart has been removed with a laser, the skin takes on a healthy appearance.

When exposed to a laser beam, the lower layers of the epidermis do not overheat. This means that the risk of getting changes in skin pigmentation, burns or scars at the intervention site is minimized. The epidermis heals quickly due to the fact that the laser stimulates regenerative processes in the skin and kills bacteria, which prevents inflammation.

Radio wave knife

The latest development in the field of removing tumors, not only warts of all types, but also papillomas, moles, and others, is a radio wave knife.

As with the influence of a laser beam, only damaged tissue falls under the knife blade, and the destructive effect on the underlying cells is minimal.

Therefore, exposure to a radio wave knife causes virtually no pain to the patient. Radio waves affect the root of the wart, which significantly reduces the risk of its reappearance.

If you have warts, it's up to you to decide what to do with them. But even if you are not inclined to get rid of them using radical methods, you still need to make sure that they do not carry the danger of degenerating into cancer. It is not without reason that with almost all methods of removing growths, their tissue is sent for histological examination. As always, the principle works: it is better to prevent a disease than to treat it later.

The appearance of warts on the skin is caused by the human papillomavirus. The answer to the question of whether warts can disappear on their own is confidently given by medicine, explaining this phenomenon by good immunity. Warts are transmitted through direct contact with an infected person or through objects. Therefore, you need to monitor your immunity so that your body can fight the virus. The appearance of papillomas is a signal to strengthen your immunity.

The appearance of warts is a more dangerous phenomenon than their disappearance.

The reason for the self-disappearance of a wart

More than half of the world's population are carriers of the papilloma virus, but why doesn't everyone infected have papillomas? The reason for this is the impaired immunity of the virus carrier. There are cases when papilloma simply disappears, without any treatment or surgical intervention. The immune system produces interferons that actively destroy viruses. Warts most often appear in children with a developing body's defense system. Not all types of papillomas disappear on their own; for example, over time, ordinary, flat or youthful, plantar papillomas disappear. With other types of formations, it is better to consult a doctor.

If the wart disappears, this does not mean that the immune system has overcome the infection. Only the external manifestations of the virus have disappeared, because today effective therapy HPV does not exist. Relapses are also possible when, under favorable conditions, papillomas appear in 30% of cases after successful treatment. From 40 to 50% of all formations caused by papilloma disappear on their own within a few years.

Normalizing your diet and strengthening your immune system will have a positive effect on the natural healing of warts.

How to increase the body's chances of coping with warts?

To make warts disappear, you need to strengthen your immune system. In addition to using immunomodulatory drugs, you should adhere to the following tips:

1. Avoid stress, because hormones that are released during stressful situations in the human body suppress and destroy the immune system.
2. Lead a healthy lifestyle, do exercises. When all muscle groups work, the blood does not stagnate, the cells receive the right amount of oxygen.
3. Maintain a sleep schedule. It has been proven that disruption of biological rhythms makes the body susceptible to infections.
4. Get examined by a dentist, gynecologist, urologist, or ENT specialist in a timely manner. Do not launch sharp and chronic diseases.

A rational lifestyle, positive emotions, and walks in the fresh air will significantly increase immunity and help cope with infections in the body.

When the body is infected with papillomavirus, growths appear on the surface of the skin and mucous membranes. After treatment they disappear, but due to the chronic course of the disease they may reappear. In some cases, signs appear that make it clear that the wart is going away, and over time it disappears without treatment.

Warts are benign growths that can go away on their own thanks to the body's immune system. This is typical for vulgar and plantar warts. Symptoms of self-resolution of the process include:

• education stopped spreading to new areas;
• the growths protruding above the surface gradually merge with the surrounding skin;
• the growths dry out and gradually fall off;
• the wart has stopped growing or its size has decreased;
• color has changed;
• the phenomena of hyperkeratosis gradually decrease.

Vulgar and juvenile warts disappear within 2 years. Plantar – up to several months. There are no visible skin defects left. It is more difficult with growths in the genital area. They are characterized by a course lasting many years with periodic relapses. Sometimes the virus that causes genital HPV infection persists in the body throughout a person’s life.

Reasons for the disappearance of growths

The skin and mucous membrane perform a barrier function, protecting the internal environment of the body from external factors. Human papillomavirus infects cells in the basal layer of squamous epithelium, which makes up the physiological barrier. This happens especially easily as a result of injury.

Having penetrated the cells, the virus has a pathological effect and disrupts vital processes. As a result, condylomas, papillomas, and warts are formed.

Local protection is due to cellular and humoral factors. The dominant role belongs to cells, represented by mononuclear cells and Langerhans cells. They transmit the virus antigen (usually its proteins) to other immunocompetent cells (lymphocytes). T lymphocytes make it possible to identify and destroy infected body cells along with the virus. A certain role is played by immunoglobulins (antibodies) to the virus, which are produced by plasma cells, and interferons. The mechanism works when vaccinated against papillomavirus.

Interferons provide nonspecific protection of the body against infections of viral etiology. They are produced in response to the penetration of a foreign antigen into the cell. As a result of the influence of interferons, anabolic processes in the infected cell are disrupted, that is, protein synthesis is disrupted. In addition, programmed cell death, apoptosis, is triggered. Interferons can increase the activity of immune cells. They belong to humoral factors, like antibodies and interleukins. Interleukins allow cells of the immune system to interact with each other.

Violations of any of these systems lead to the active progression of HPV and warts:

• decreased immunity due to hypo/vitaminosis, taking medications that affect the immune system, serious illnesses (mainly oncology), HIV infections;
• hormonal changes: pregnancy, menopause, puberty;
• chronic diseases in the acute stage.

With the normal function of local and general immunity factors, an effective fight against the viral agent and the warts that caused it occurs.

Strengthening the immune system will help cope with the disease:

• seasonal prevention of hypovitaminosis;
• hardening;
• maintaining personal hygiene;
• balanced diet;
• active lifestyle;
• rejection of bad habits.

In some situations, when hormonal changes occur in the body, preconditions are created for the activation of the virus, which causes the appearance of growths. But after normalization hormonal levels, the body manages to effectively fight the manifestations of infection. This applies to juvenile warts.

How long does it take for a wart to go away?

Formations caused by human papillomavirus go away on their own within two years. How long a wart goes away depends on resistance, that is, the body’s ability to resist the influence of external factors, and the reactivity of the immune system.

Factors contributing to infection cannot be ruled out and must be eliminated. Juvenile warts go away after puberty, when endocrine system will come back to normal.

You should not hope for self-resolution of the disease.
If you notice changes in the growth and understand that it will soon fall off, you should not try to speed up the process. It can cause harm and contribute to relapse.
There is no treatment that specifically targets the virus yet. Doctors try to reduce its concentration and help the patient’s body cope on its own. Sometimes this cannot be achieved. Then the disease turns into chronic form.

Can a wart go away without external influence?

If you leave the growths alone, you will not spread the virus to other parts of the body and prevent self-infection. Warts can disappear on their own, without external influence, but only over time. This is true for youth and plantar.

Despite the possibility of self-healing, warts with HPV must be removed, especially in places of frequent injury. If formations appear, you should immediately seek help from a dermatologist. The appearance of warts in the form of condylomas is dangerous. Highly oncogenic types of HPV that cause genital warts are, under certain conditions, the cause of cervical cancer. They don't go away on their own. They pose a health hazard, are highly contagious - transmission of the virus occurs in 9 out of 10 cases - specific localization, which causes discomfort, in some cases pain, inflammation.

In this case, cryodestruction (freezing with liquid nitrogen), hardware methods - laser cauterization, radioknife, diathermoelectrocoagulation, chemical substances with a destructive effect. Methods of hardware surgery and freezing are used for formations on the arms, face, legs, and intimate area. Chemicals have been widely used for the appearance of plantar warts. The removal procedure is absolutely painless. It assumes quick results, but does not guarantee the absence of relapse.

Sometimes traditional methods are used. Celandine has gained particular popularity.

At home, a lapis pencil, Verrukatsid, comes to the rescue. They allow you to eliminate formations by cauterization.

Home methods eliminate the source of infection, preventing further spread of the disease.

How to avoid recurrence of warts

If the wart has disappeared, it is important to understand: there is no guarantee of a complete cure. The disease may enter a latent form. It is necessary to consult a doctor to conduct tests for the presence of HPV in the body. This will allow you to adjust further actions. During recovery, you should follow the following recommendations:

• avoid promiscuous sexual intercourse;
• adhere to personal hygiene rules: wash your hands after visiting public places, use personal hygiene products;
• avoid direct contact with an infected person;
• strengthen immunity;
• to refuse from bad habits.

If it turns out that the virus continues to be in the body, relapses are difficult to avoid. You should be periodically examined by a dermatologist. This is especially true for women. In case of relapse, immediately carry out treatment measures.

The appearance of papillomas on the body is provoked by various strains of the virus.

But they are not always able to cause the appearance of neoplasms.

As a rule, this occurs against the background of a decrease in the body's defenses.

Reasons for the disappearance of warts

Papillomas appear as a result of exposure to different strains of the human papillomavirus (HPV). At least half of the world's population is carriers of this disease, but not everyone develops warts. This is due to the fact that the development of these formations occurs under the influence of another factor - low immunity.

Warts can appear due to low immunity.

An immunodeficiency state can be triggered by several factors:

• childhood;
• colds;
• changes in hormonal levels during adolescence, as well as in women during pregnancy or menopause;
• chronic diseases of internal organs;
• acute depressive states, etc.

Warts are a type of infection spread by the human papillomavirus family, which has more than 100 varieties. Warts can appear on any part of the body.

They can grow on the surface of the skin, on the mucous membrane oral cavity, on the genitals and even in the rectal area. The most common types of human papillomavirus are responsible for the appearance of warts on the skin (hands and fingers), while less common types cause the formation of warts in the genital and rectal areas.

It should be noted that some people have increased natural resistance to papillomaviruses, so they rarely develop warts.

Are warts contagious?

Yes, skin warts can be passed from one person to another through contact with a wart. You can also become infected by using a towel or other personal hygiene item that has been used by a person with warts.

Genital warts are extremely contagious and can be transmitted through oral, vaginal or anal sex. If your partner has warts on their genitals, it is very important to use condoms during sex. In women, warts can grow on the cervix, so often they are not even aware of this problem and unknowingly infect their partners.

Experts note that a wart can disappear for several reasons. This is normal practice and extremely rarely such changes are associated with any serious disorders in the body, often quite the opposite - this is a direct indication that it has begun to recover.

This may be caused by:

• Medical practice shows that common and flat warts are prone to self-destruction, and this happens within a two-year period after their appearance;
• The growths may pass due to the age characteristics of the body. During the period of maturation, an unstable immune system malfunctions and benign neoplasms appear on the skin. But when everything returns to normal, they tend to disappear;
• If the education took place in an older person, then this may indicate the restoration of the body’s defenses;
• It is also noted that the immune system develops resistance to some types of growths, and it contributes to their disappearance.

This is the main list of reasons why a wart on the skin may disappear. It is noted that about 40% of such growths can self-destruct over time, but this is not a reason to relax, since the human papillomavirus itself, which causes their appearance, still remains in the body and as soon as the opportunity arises, it will certainly manifest itself in the form of growths again.

The appearance of papillomas on human skin is not such a rare phenomenon. Papillomavirus is present in most people, but good immunity prevents it from becoming active. Warts begin to grow only when the body is weakened by diseases, age-related hormonal changes, bad habits and poor lifestyle. Is the opposite effect possible? Quite.

But, besides this factor, there are a couple more reasons why the papilloma can fall off on its own.

• The person actively began strengthening the immune system and succeeded in this. I gave up bad habits, put things in order in my diet, adding to it necessary vitamins and microelements, began to play sports. In this case, the body can independently deal with papillomas.
• During adolescence and in pregnant women, hormonal fluctuations are almost inevitable, which can lead to the activation of the papillomavirus. But a return to normal is also possible, and then you can observe a phenomenon when the papilloma dries up and falls off.
• The most unpleasant reason why papillomas fall off on their own also needs to be mentioned. This can happen due to the development of hemangioma. It simply displaces another formation, which falls off over time. The hemangioma itself is considered benign, but it would be a good idea to check with an oncologist.

These are the three main reasons why a wart falls off on its own. Should we pay attention to this? Necessarily.

Types of papilloma virus

Today, about a hundred strains of human papillomavirus are known. Scientists did not invent clever names for each type, but simply designated them by numbers. For example, HPV 1, 2, 3, and so on up to a hundred.

— non-oncogenic – 1, 2, 3, 5;

- papilloma viruses of low oncogenic risk - these are mainly numbers 6, 11, 42, 43, 44;

- papilloma viruses of high oncogenic risk - 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68.

What causes the development of warts?

• Those who started their sexual life early.
• Women who have had abortions many times.
• Exposure to constant stress.
• Women who have been taking oral contraceptives for a long time.

Pay attention to plantar warts, flat warts on the skin and genital warts. They can be located anywhere. Cracks and burning may be bothersome. The area around the eyes may be affected, in overweight people - skin folds, the area under the breasts, armpits, neck.

As for problems “on the female side”, with active reproduction of HPV you can observe the following symptoms:

• Bleeding after sexual intercourse.
• Fatigue.
• Loss of appetite.

These symptoms may accompany cervical cancer early stages. Every year, about 500,000-600,000 new cases of this dangerous disease are discovered in the world.

This is especially true in underdeveloped countries where there are no annual cancer screening programs for women. The mortality rate from cervical cancer reaches 41%.

In some countries, the practice of vaccinating not only girls, but also boys against the human papillomavirus has become common. In men, this virus can also cause cancer of the penis, testicles, prostate, and urethra.

It is believed that men's risk of getting the disease is reduced if they are circumcised and stop smoking.

Condylomas in women - how to deal with them

The virus is incurable if it has firmly established itself in the body. They are actively looking for a cure, but so far there has been little success. The DNA of the papilloma virus is embedded in the cell and is poorly recognized by the immune system, especially in people with immunodeficiency. Poor living conditions, ecology, bad habits and concomitant diseases do not help get rid of the virus.

At a young age, independent elimination (elimination) is possible within 2-3 years. Then the immune system weakens and can no longer completely cope with the virus.

When the body weakens papilloma condylomas, warts appear again. It is by these signs that you can find out that you are a carrier of the infection.

Warts and papillomas are the only manifestation, but they appear only in people with immunodeficiency.

If you become infected with one type of virus and are cured, you can then catch papillomavirus with a different genotype. It happens that there are 2 or 3 genotypes present in the body at the same time.

It is necessary for a doctor to know the genotype to assess the risk of developing cancer. HPV in women is widespread, warts are very common, but not everyone gets cancer.

There are also varieties of the virus that contribute to the development of larynx and throat cancer. It is believed that the genotypes that cause flat warts are somewhat “more harmful” than those that cause genital warts, similar to cauliflower inflorescences.

Thus, warts are not purely a cosmetic problem. It is imperative to remove them and, if detected, undergo not only a dermatological examination for skin cancer, but also a gynecological one, and it is advisable to send your partner to a urologist if you find suspicious skin growths in the genital or anal area.

It has been proven that in men, HPV causes cancer in rare cases; women should be more concerned. Do not forget that any trauma, obesity or excess weight creates a favorable background for the activation of the virus in the body.

Every year, 60 million new cases of HPV are registered worldwide. Virus genotypes 16 and 18 are the most common. If the doctor finds condylomas, he will refer you for PCR diagnostics. The results will necessarily indicate the type of virus. Types 16, 35 and 18 of the virus are the most common reason cancer of the vulva, cervix and anus.

This terrible phenomenon can be prevented with the help of the HPV vaccine, which appeared in 2008. Vaccination against human papillomavirus is now mandatory in 40 countries.

The global medical community is no less concerned about the problem of cervical cancer than, for example, hepatitis B, vaccinations against which also appeared not so long ago. The duration of protection is 10-15 years.

In the first case, it increases the likelihood of self-elimination of the HPV virus in women under 32 years of age. The vaccine also prevents infection with new types of the virus.

The vaccine is administered according to the scheme 0-1-6 months or 0-2-6 months. It depends on the manufacturer. The vaccine is safe and does not increase the risk of cancer, which has been proven by numerous studies.

Most common side effects is pain at the injection site and headache. Also very rarely, there may be a short-term loss of consciousness immediately after administration.

Therefore, the patient is asked to sit for 10 minutes. The vaccine is not given during pregnancy.

If one or two doses have already been administered, the last one remains, it is administered only after birth. Breastfeeding will not be an obstacle.

In the future, you need to boost your immunity, take vitamins, strengthen your body, and take protective measures during sex. Using condoms reduces the risk of re-infection with a new genotype of the virus. If you manage to drive the papillomavirus into an inactive state, then it will not pose much of a danger. Any disease is easier to prevent.

We remind you that self-administration of antiviral and immunomodulators is unacceptable. In case of human papillomavirus, such measures are rarely needed and are carried out only together with an immunologist. If you do not have HIV, you do not have cancer, the immune system itself can “put to sleep” the papillomavirus.

Also don't miss: age-related changes in a woman's body

If we consider the medical classification of female gynecological diseases, then condyloma is an inflammatory process of viral origin, which is a risk factor for a disease such as cervical cancer. Based on this, if condylomas are identified through a full examination, treatment should be started immediately. How to treat condylomas in women, what are the causes and symptoms?

What are genital warts

Is it true that warts are a sign of cancer?

There is some truth in this statement. Some types of warts are indeed a symptom of precancerous disease. This includes senile keratomas or senile papillomas that appear in older people.

Experts believe that the papilloma virus, which most often causes warts, provokes cells to malignant degeneration. This is why warts on the hands are considered potentially dangerous to humans. But most often, the appearance of warts depends on the immune system. This is a kind of manifestation viral infection and nothing more.

Do I need to be tested for atypical cells after HPV vaccination?

It is worth remembering that cervical cancer screening is still needed after receiving the HPV vaccine. Therefore, do not refuse examinations and tests.

The fact is that cervical cancer can have other causes, for example, other urogenital infections. Traumatization from abortion and childbirth also has a bad effect on the cervix.

But if you have HPV in your body, your risk of getting cervical cancer increases by 50%. You need to be attentive to yourself even after menopause.

HPV has a chronic course with periodic exacerbations. It is impossible to completely get rid of the virus after 30-32 years. There are more than 100 genotypes of the virus.

Treatment

In most cases, HPV persists in a person for life. However, there are cases when it was expelled (eliminated) from the body and the person recovered, or the condylomas disappeared - they went away by themselves. To accelerate the elimination of the virus and clear the skin of growths, it is necessary to undergo a course of immunostimulating and antiviral therapy.

For the treatment of HPV the following are used:

1. Interferons.
2. Antiviral drugs.
3. Immunostimulants.

In the treatment of papillomavirus, interferons are used - Reaferon, Viferon. Reaferon is available in the form of ampoules for injection, as well as for oral administration.

Viferon in the form rectal suppositories, gel. Immunostimulants are also used - Polyoxidonium, Echinacea extract, Cycloferon as prescribed by a doctor.

Vitamin complexes strengthen the immune system, helping it fight infections. The drug Cidofovir suppresses the development of viruses.

First of all, we note that in order for the wart to disappear on its own, without directly removing it, specialists use immunomodulatory and antiviral drugs. But often such treatment can be delayed, since the weakened body takes a long time to recover.

Because of this, patients themselves agree to more radical measures - drug treatment by using drugs that destroy the structure of the wart.

Of these, the most commonly used are:

• Salipod. This drug is available in the form of a patch, the base of which consists of salicylic acid - it is this that destroys the growth;
• Feresol. Thanks to this product, which burns out tumors, a wart, depending on its size, can disappear after just a few cauterizations;
• Dufilm. Another option for cauterization, which uses two acids: lactic and salicylic;
• Collomak. The drug contains acids and bactericidal substances. If applied to the growth several times a day, the treatment process will take a very short period of time.

There are also products that cauterize warts:

• Solcoderm. This is a special solution that contains as many as four acids;
• Vartek. This option is available in cream format;
• Condyline. Another solution that also prevents inflammatory processes.

To these same pharmaceutical products These include the well-known “Superchistotel”, freezing preparations “Wartner Cryo” and “Cryopharma”.

Never try to solve the problem yourself.

There are many cases where, after using folk remedies, deep scars and burns remained on the skin.

If it didn’t work out to improve immunity, and papillomas continue to annoy a person, then you can’t do without integrated approach. Nowadays, fortunately, there are a huge number of techniques that can eliminate these growths from human skin.

This is the creodestruction method, when the growth is burned with liquid nitrogen, and the laser coagulation method, when the neoplasm is removed layer by layer using laser beams, and the electrocoagulation method, when the papilloma is removed using high-frequency currents, and surgical excision of the wart.

Folk methods of combating benign skin formations also occupy a special place. The most important thing is to start taking action and not let everything take its course!

Contact for medical care or not, everyone decides for themselves.

However, it is worth thinking about removing the condyloma if it is located in places where it is constantly injured. This can provoke a sharp growth, infection and even the development of an oncological process.

Be sure to visit a doctor if you notice that the papilloma has changed its size, color or acquired a different shape.

The manifestations of the papilloma virus can be eliminated using different methods. It is necessary to consult a dermatologist. He will assess the condition of the tumor and indicate which method of elimination is necessary in this case.

Immunomodulators are prescribed as part of drug therapy.

These include Cidofovir, Interferon, Inosine Pranobex.

If the examination reveals a pathology that could provoke the development of papillomas, therapeutic methods are directed specifically at it.

Sometimes this is enough for condylomas to go away on their own without treatment.

In only 10% of people, after the virus enters the body, it remains there in large quantities and causes the appearance of pathological growths in various locations.

Can papillomas go away on their own and is it necessary to treat the disease? This is one of the frequently asked questions on forums dedicated to this topic. If the warts are located in places that are subject to regular mechanical stress (friction, pinching by clothing, etc.), you need to visit a specialist and find out how dangerous inaction will be.

Can papillomas disappear on their own?

Papillomavirus is an incurable disease. A person can be a carrier of a viral organism, or he can experience all the manifestations himself. Drugs that would destroy the structure of the virus have not yet been created, but in exceptional cases, HPV goes away on its own.

If growths on the body appeared before the age of 17, a healthy and young body with a strong immune system will cope with them very quickly. In such cases, HPV self-healing occurs over a period of several weeks to six months, with almost all of the virus leaving the body.

There are about 70 strains of the virus, including oncogenic and non-oncogenic. If HPV is type 1, then waiting for the papilloma to go away on its own is very dangerous. If such formations are not removed in a timely manner, benign ones can become malignant.

Do papillomas go away on their own - world treatment practice

In Russia, a combination of several therapies is used to treat this infection:

• Destructive;
• Immunomodulatory;
• Antiviral.

Can HPV go away in adulthood without these therapies? Since only one’s own immunity can cope with the infection, experts prescribe immunocorrective drugs based on interferon (Viferon, Cycloferon), as well as others (Amiksin, Likopid).

Our experts believe that in order for HPV to go away, it is necessary to take a course of immunomodulation, and also take antiviral drugs, such as Groprinosin, Isoprinosin, Aldara, Panavir.

The drug Papillux will help you quickly get rid of papillomas and warts

Today it is possible to get rid of papillomas even without resorting to the expensive services of cosmetologists and dermatologists. Now you can use Papillux to eliminate warts, spines, papillomas and other skin defects at home.

Papillux is a remedy for papillomas and warts, which has become a real breakthrough in medicine, as it has completely natural composition and at the same time it is very efficient. The price of the drug remains affordable to everyone. Balm Papilux is the first medicinal product, which is ideal for removing absolutely any type of papillomas.

Removing warts using surgery

In this case, several different paths can be considered, depending on which method will best suit the patient:

• Laser removal;
• Excision with a radio wave knife;
• Freezing a wart with liquid nitrogen;
• Electrocoagulation;
• Removing the growth with a scalpel (used very rarely).

As mentioned earlier, in addition to all this, drugs are prescribed that increase immunity and actively suppress the virus. Which method to choose to combat warts is initially determined by the patient himself, but you definitely shouldn’t wait for such skin formations to go away on their own; for this you need to at least try to improve your immunity.

Folk remedies

Folk remedies in combination with other treatment methods also speed up the process of disappearance of papillomas.

Make a strong decoction of this plant and steam the warts for an hour every day. A minimum of 10 procedures are required.

Propolis lotions

Steam the new growth and make a lotion from softened propolis. Leave for 2-3 days.

Applications

Mix clay, onion minced through a meat grinder and sea salt in equal proportions. Apply the resulting mass to the papillomas.

Melissa decoction

Pour 2 tablespoons of dry lemon balm leaves into 400 ml of boiling water and leave for a quarter of an hour. You need to take this remedy 100 ml three times a day for 14 days.

Who is at risk for developing complications from HPV?

Patients who have been diagnosed with human papillomavirus infection and have its external manifestations in the form of growths should know the basic rules of first aid for skin injuries. They should have antiseptic agents in their home medicine cabinet, as well as a bandage, cotton wool and a sterile plaster.

Even after careful sanitization, this category of patients must be examined by the attending physician.

In the vast majority of cases, the consequences of the papilloma drying out and falling off on its own will be minimal. Just like a normal cut. But some unpleasant things can happen.

• If the papilloma was torn off due to injury, or, more simply put, torn off by accident, its roots could remain inside, and this could lead to the fact that not one, but several formations could grow around the damaged area.
• By leaving the place where the wart fell off untreated, you can wait for inflammation due to infection getting inside the open wound.
• If the papilloma is damaged and left unattended, there is a possibility that it will degenerate into a dangerous malignant tumor, which can lead to very unpleasant consequences. This happens quite rarely and in most cases is easily diagnosed by specialists, but it’s not worth the risk.
• If, before falling off, the papilloma darkens, or an inflammatory process begins around it, this is a very alarming bell. Inflammation can be localized quickly enough by using the right medications in a timely manner. But if darkening is observed or even the papilloma has turned black and fallen off, you should consult an oncologist. Moreover, you shouldn’t wait until it disappears on its own. This phenomenon is a sign of the degeneration of papilloma into a malignant tumor and surgical intervention simply necessary.

There is no point in waiting until papillomas begin to disappear on their own. Why this can happen was described above, but it’s worth repeating because it doesn’t only apply to warts.

Modern look most people's lives do not involve active physical exercise. The food also leaves much to be desired.

And we are in the fresh air only on the way to work and home, and this statement is absolutely unfair for those who live in big cities, where the atmosphere is not fresh. As a result, the immune system, the only defense against viruses and infections given to us by nature, simply cannot cope.

Risk factors

Activation of the virus, during which tumors begin to appear, occurs under the following conditions:

• childhood;
• active sex life with frequent changes of sexual partners;
• pregnancy;
• elderly people;
• early onset of sexual activity;
• chronic pathologies of internal organs;
• severe colds;
• constant physical strain, stress;
• contact with a person suffering from a similar problem;
• radioactive exposure.

Any of the above factors is accompanied by a decrease in immunity.

It is in such conditions that an encounter with a virus is a potential threat for the development of papillomas on the body.