Genital Warts

Genital warts, also known as venereal warts, or condylomata acuminata, are caused by the human papilloma virus (HPV). More than 100 types of HPV are known to exist. Low risk types (HPV 1, 2, and 3) cause warts on the hands, feet, and other parts of the body. Types (6 and 11) can cause warts on the genitals or anus (genital warts), and other types (H PV 16 and 18) call cause cancer of the cervix, external genitalia, and anus. The HPV types that cause genital warts only rarely cause cancer. Genital warts are usually sexually transmitted and all partners should be checked thoroughly. They can also be seen in infants who have been delivered vaginally to mothers with HPV in their genital tracts; therefore, alternate methods of delivery should be considered.

Only a small percentage of people infected with HPV will develop genital warts. Many people are “carriers” of HPV who may never develop warts, but may still be able to pass HPV to their sexual partners. The incubation period from contracting HPV until the development of warts may be several months; although, some people may not develop warts for years after contact with HPV. People who have lower immunity due to cancer, AIDS, organ transplantation, immune suppressive medications, or certain other medications are more susceptible.

What do genital warts look like?
Genital warts may be rough or smooth surfaced, and are typically flesh-colored, but some may be darker. They can be large or small, and can be found as a single growth or in groups. They can appear on the external genital skin, inside the vagina, or the anus.

How are warts diagnosed?
Most genital warts are diagnosed during an examination by a dermatologist. The growth may be surgically removed and sent to the laboratory for microscopic evaluation to confirm the diagnosis.

Why should warts be treated?
Removing warts reduces the risk of passing the virus to partners. Genital warts can itch or bleed and interfere with bowel movements, urination, and sexual intimacy. They are also unsightly and are difficult to keep clean.

How are warts treated?
The treatment depends on the number of warts, their specific location, and other factors. Recurrences are always possible. The dermatologist can use both surgical and nonsurgical (chemical) treatments. Surgery includes:

  • Simple excision
  • Removal with an electric needle
  • Cryosurgery (freezing with liquid nitrogen)
  • Laser

These methods may require local anesthesia, and time is required for healing.

Non-surgical methods include chemicals that destroy the warts. These methods require multiple office visits at two-week to three-week intervals and include:

  • Acid applications (bichloroacetic acid or trichloroacetic acid) which produces irritation.
  • Interferon injections (an antiviral drug) which often produces fever, chills, and headaches.

Prescriptive medicines for use at home that may also be used include:

  • Podofilox gel or solution which stops the growth of the wart cells.
  • Imiquimod cream helps the body to produce proteins that act against HPV and boosts the local immune system. It is associated with the lowest recurrence rate after complete clearance.

Both methods may cause mild irritation.

New therapies are being investigated including vaccines for both the treatment and prevention of HPV-related warts and cancers.

Will the warts recur and am I still infectious?
Successful therapy of warts does not guarantee that all HPV is gone since the virus may be deep in the layers of the skin. After successful treatment, the possibility of transmission may still exist; however, a person is probably less contagious.

How do you prevent transmission?
Knowing one’s sexual partner and other forms of safe sex help reduce transmission, but only abstinence is 100% effective. Transmission can be reduced by the proper use of condoms if the appropriate conditions are met, and by the successful treatment of warts. Neither method, however, can prevent transmission in every case, especially for warts found in an area that the condom does not cover.