Periungual is medically defined as associated with the part surrounding the fingernails or toenails.  Periungual warts are a lot similar to the appearance of common warts, tan, or brownish in colour, with a rough surface. They appear under, or around toenails and fingernails.   In the beginning they are about the size of a pinhead, smooth and virtually impossible to spot.  But as the weeks progress, they grow to pea size.  They then turn into rough, irregular bumps that can affect nail growth, causing them to detach, as the sheer size of a wart cluster elevates the nail.   In the most severe cases, nails can be permanently deformed.  Further complications may arise if the wart enters the nail plate, since this can lead to a fungal infection.It can become painful too, as it grows in size.

What Causes Periungual Warts?

The culprit is the human papilloma virus (HPV). This wart-causing virus can be easily transferred from person to person by direct contact.  It’s a highly contagious infectious agent which can enter the body through cuts and abrasions.  The warts can be contracted by touching objects that have been used by infected individuals, or when they go barefooted in public areas.  People who pass their time biting their nails, or tearing at their cuticles, could be candidates for periungual wart infection, because these activities can wound the skin surrounding the nails.The broken skin surfaces make it easier for the virus to take hold.

A spa could be a medium for spreading the HPV virus.  Regular manicures and pedicures can put the individuals at high risk for periungual warts.  You should make sure that the establishment practises good sanitation rules, and that the crew observe hygiene by frequently washing their hands after servicing each client.  One sure fire way of avoiding the exposure to HPV virus (if you do not have it yet), or spreading it (if you have it already), is by bringing your own manicure/pedicure kit to the salon, or visiting one that uses disposable liners.

Symptoms

It’s very easy to spot the presence of periungual warts as ugly growths around or under toe and finger nails. These nail warts not only look like rough bumps with uneven borders, but can sometimes have a cauliflower like appearance around the nail.  If left untreated, they can be particularly painful, especially for young children, as the large lesions may cause the nail plate to lift.  Without the nail to protect the nail bed, they become open to the elements and infection.

 Treatment

The golden rule is to keep the nails clean and dry all the time. If not, there is a danger of spreading the virus to other parts of the body if nails are bitten, and hands are not washed. The proper way of cutting the toenails and the fingernails is straight, with a slight curve in the middle, to avoid development of ingrown nails.  Wear shoes of the right size; and if you are wearing socks, the material should be made of cotton for better air circulation, so that the feet will not soak in perspiration for a long time.

 Just like all other warts that plague humans, it is possible to treat those that have made a home on the skin around finger and toe nails with salicylic acid, laser therapy, the freezing process (cryotherapy), and various other topical treatments.

Periungual warts can be dealt with effectively, even at home, using medicines bought over the counter.  Some of the medicines are made of natural ingredients, which are a lot safer and milder on the skin, compared to medicines which contain salicylic acid.  Nonetheless, the objective of these medicines is to progressively disperse the wart.  Like in all medications, you should watch out for signs of allergic reaction, like burning, itching, and redness.

At times these kinds of warts might not be responsive to over-the-counter medicines, or home remedies.  If the wart has become a source of pain or discomfort, it should then be brought to the doctor for treatment. Adult individuals that suddenly develop a lot of warts should go to see a doctor or dermatologist.  In general, it is unusual for adults to have sudden wart outbreaks.  If this happens, it can be a symptom of some illness that is causing the deterioration of the immune system.  A thorough physical check up, with blood tests, could help determine if the individual has some illness that is causing the wart outbreak.

No matter how difficult, treatment should start as soon as possible to prevent the nail from lifting. However, warts lying under the nail present a more difficult challenge to physicians or podiatrists, and traditional treatments are ineffective.  That’s because the viral induced growths are much harder to get to.  While liquid nitrogen and salicylic acid treatments can’t reach them, and in fact may actually damage the nail in the process,  laser therapy has proven to be a very effective treatment.

                                 Your feet mirror your general health . . . cherish them!