With fewer than 600 cases worldwide, this skin disorder still sparks fear and stigma -- but a dermatologist helps separate fact from fiction.
Imagine a person with tree bark for hands, small branches like growths sprouting from their face, and a body transforming, almost botanically. Sounds fictional, right?
This, unfortunately, is a haunting living reality for some individuals, predisposed to a rare genetic condition called Epidermodysplasia Verruciformis (EV), more commonly known as the Tree Man Syndrome.
"EV is an extremely rare inherited disorder," explains Dr. Ajay Rana, dermatologist, aesthetic physician, and founder of ILAMED. "It is caused by mutations in genes like TMC6 or TMC8, which make the body unable to fight off certain strains of the human papillomavirus (HPV) -- especially beta-HPVs."
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Patients develop flat scaly lesions and wart-like growths that can cover the hands, feet, face, and even torso. These growths harden over time, closely resembling tree bark.
A difficult diagnosis and complex treatment
The diagnosis of tree man syndrome is not easily confirmed. "We rely on a combination of clinical observation, skin biopsy, HPV testing, and genetic testing to confirm the condition," says Dr Rana. The lesions typically appear in early childhood and tend to worsen with age.
Even after diagnosis, treatment remains challenging. "There is no permanent cure at present, " Dr Rana notes. "We manage symptoms with surgical removal, topical treatments like retinoids, and experimental antiviral therapies."
The surgeries, unfortunately, aren't a permanent solution - the lesions can easily reappear. Additionally, the risks for skin cancer in these patients are significantly higher, making regular checkups critical.
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The baseless fear of contagion
Any skin disorder usually comes attached with the stigma, with this extreme appearance, it is common to assume contagion. In reality, you cannot catch tree man syndrome by touching someone who has it. It's not caused by poor hygiene either; even those living in the cleanest environments can have it if they have faulty genes. Dr. Rana stresses. "The condition is purely genetic. The HPV strains involved don't behave like typical infections -- they only become a problem in people who are genetically predisposed."
Prevention in picture?
Since EV is a genetic disorder, there is no known way to prevent it in those who inherit the faulty genes. However, genetic counseling can help families with a history of the syndrome understand the risks for future generations.
"Early detection and consistent monitoring can help reduce complications, especially the risk of skin cancer," Dr. Rana adds.
What's it like living like a tree man?
Patients with EV face severe challenges on all fronts -- medical, emotional, psychological, social, and financial. The wart-like lesions can become extremely painful over time, and as they grow in size and weight, basic movements become difficult.
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The chronic nature of the condition often leads to anxiety, depression, and frustration. The rarity of the disease -- with fewer than 600 cases documented worldwide -- also contributes to misdiagnosis, neglect, and social isolation. In India, where cases are even rarer, patients often lack access to specialized care, particularly in rural areas.
In places where illiteracy, misinformation, or superstition prevail, patients may never come forward -- or worse, may face community-driven violence, even witch hunts. "People living with EV should not be stigmatised or isolated," Dr Rana sternly concludes.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.