Genital warts, also known as venereal warts or condylomata acuminata, are caused by the human papilloma virus (HPV). More than 80 types of HPV are known to exist and quite a few of these types cause genital warts, e.g. HPV types 6 and 11. Other HPV types cause common warts on the hands, feet, or elsewhere on the body. Other types (HPV types 16 and 18) can cause cancer of the cervix, the external genital skin, or the anus. Therefore, female partners of affected persons are recommended to see their gynecologist for occult infection. The HPV types that cause genital warts, however, very rarely cause cancer. Although genital warts are usually sexually transmitted, they can infrequently be seen in infants who have been delivered vaginally to mothers with HPV in their genital tracts.
Genital warts are particularly a problem in pregnant women and in persons whose immunity has been lowered by cancer, AIDS, organ transplantation, immune suppressive medications, or certain other medications. Only a small percentage of people infected with HPV will develop genital W31ts. Many persons are “carriers” of H PV and may never develop warts but may still be able to pass HPV to their sexual partners. A Ithough the incubation period from contacting HPV unti I development of warts may be several months, some people may not develop warts for years after contact with HPV.
What do genital warts look like?
Warts can be rough or smooth surfaced and are typically flesh colored. Genital warts may be large or small, and can be found as a single growth or in a group. They can appear on the external genital skin, inside the vagina, or in the anus.
Why should I have my warts treated?
Most people have their warts treated because they and/or their partner do not like the way they look or they want to reduce the risk of passing the virus to their partners. Other people want their warts treated because they can itch or bleed and are difficult to keep clean. Still other people find that genital warts interfere with bowel movements, urination, or with sexual intimacy.
Will treatment of my warts mean that I am no longer infectious?
Successful therapy of warts does not guarantee that all the HPV is gone, but a person is probably less contagious after successful wart treatment.
How are warts diagnosed?
Most genital warts are diagnosed by simple visual inspection by the doctor. Not all warts, however, are readily apparent and the doctor may add a dilute Vinegar solution to the area to make the warts more easily seen. In some cases, the doctor may choose to surgically remove a growth and send it to the laboratory for microscope evaluation to confirm whether it is truly a wart.
How are warts treated?
Treatment of warts in any location may be difficult, and recurrences are always possible following any treatment. The treatment selected will depend on the number of warts, their specific location, and other factors. Genital warts can be treated in the doctor’s office with surgery or with chemicals. Surgery includes simple excision, removal with an electric needle, freezing (usually with liquid nitrogen), or laser excision. These therapies may be painful, may involve some loss of blood, and may make a person more susceptible to a bacterial infection during the healing phase. Chemical medications include acids (e.g. bichloroacetic acid or trichloroacetic acid), 5-fluorouracil cream (a drug used to treat cancer), and podophyllin. These chemicals can be irritating and may cause serious burns if accidentally placed on normal skin. Podophyllin is a crude plant extract that is applied in a doctor’s office usually every one to two weeks. Since these surgical and chemically destructive treatments do not affect the underlying HPV, the warts may recur. The only antiviral drug that doctors have had to treat genital w311s until recently was interferon alpha. Use of this drug was never widely accepted due to the fact that it had to be given by injection and that it often produced fever, chills, and headaches.
Recently, two treatments have become available that patients can use in the privacy of their homes: podofilox gel and imiquimod cream. Podofilox stops the growth of the wart cells, while imiquimod induces the body to produce proteins that act against the HPV and boost the immune system locally. Both treatments can eradicate most warts and both can cause mild local irritation, but neither causes systemic side effects (i.e. outside the local treatment area). Because podofilox has no antiviral activity or ability to boost the local immune system, about one in three patients will have a recurrence of warts during the following three months. Imiquimod uses the body’s immune system to attack the wart virus, In one large study only one in eight patients successfully treated with imiquimod will have a recurrence of warts in the following three months.
Are there new treatments for warts under study? New therapies for genital warts are being investigated. One of the most promising areas is that of HPY vaccines which are being studied both for the treatment and for the prevention of HPV related Walts and cancers.
How do you prevent transmission? Doctors believe that transmission can be reduced by successful treatment of warts and by the use of condoms. Neither method, however, can prevent transmission in every case, especially for warts not covered by a condom. Knowing one’s sexual partner and other forms of safe sex help reduce transmission, but only abstinence is 100% effective.