What Is Genital Warts?
Genital warts, also known as condylomata acuminata, are small growths in the genital area, commonly appearing around the vaginal opening or inside the vagina on the cervix, around the anus, on the penis, and on the perineum (the area between the genitals and anus). They are highly contagious, and are most commonly spread through sexual or other intimate body contact.
It may take from three to 12 months after infection for a wart to appear. In addition, the virus may remain in skin tissues even after warts are removed, making recurrence common. Conditions producing excess vaginal moisture and discharge, such as yeast infections or pregnancy, may encourage wart growth in women.
Genital warts are linked to an increased risk of cervical and penile cancer. (Cervical cancer is detected in the early curable stages by Pap smear. All sexually active women should have a Pap smear at least every one to three years, so that if cancer develops, it may be detected early.) Other sexually transmitted diseases, such as syphilis or gonorrhea, may be transmitted at the same time as the genital wart virus.
Who Gets Genital Warts?
According to the Centers for Disease Control and Prevention (CDC), an estimated 20 million people in the United States are infected with HPV and about 5.5 million are exposed to the virus each year. Approximately 1 percent of sexually active adults in the United States have genital warts. Although the CDC reports that new cases of genital warts appeared to decrease in 2012, between 500,000 and 1,000,000 develop genital warts each year.
Infection is most common in people aged 15 to 40 and affects men and women equally. As many as 50-75% of sexually active people are infected with HPV during their lifetime, and in most cases, the infection causes no symptoms and resolves without treatment.
Approximately 90% of men infected with HIV also have HPV. Persistent HPV infection in women is the primary risk factor for cervical cancer.
Small, red, rounded or flat, itchy bumps on or around the vagina, anus, penis, or perineum.
Warts can also develop in the mouth or throat as a result of oral sex.
Several warts may grow together into a cauliflower-like configuration.
The human papillomavirus (HPV) causes genital warts. Most of the more than 80 strains of the virus produce only harmless warts, but some have been associated with greater risk of cervical or penile cancer. Most persons with HPV infection are completely without symptoms.
Genital warts may be spread by sexual activity, and they spread more easily than other types of warts.
As with other sexually transmitted diseases, genital warts in children may be evidence of sexual abuse. However, newborns may acquire HPV when they pass through an infected birth canal.
What If You Do Nothing?
The warts themselves are benign, and if left untreated, they may disappear on their own. They are more likely to grow larger and more numerous, however, and treatment is necessary to prevent further growth and reinfection.
Patient history and physical examination are needed. Women’s pelvic examinations should include a Pap smear (a test in which a small sample of cells is scraped from the cervix); in addition, the doctor may examine the vagina with a colposcope (a magnifying instrument for viewing the inside of the vagina and the cervix).
Blood samples may be taken to rule out other sexually transmitted diseases.
A culture of vaginal or penile discharge may be taken to rule out gonorrhea or chlamydia.
A biopsy (removal and analysis of tissue samples) may be performed to rule out cancer.
A doctor may apply podophyllin or trichloroacetic acid, chemical solutions that gradually destroy warts.
The patient may be given a prescription for home treatment with imiquimod (Aldara) or podofilox (Condylox).
Genital warts may be removed by applying liquid nitrogen, which freezes and thus destroys warts (cryosurgery). Warts may also be burned away with an electric probe (electrocauterization) or destroyed with laser surgery.
The sexual partner(s) of the infected person should be examined as well. However, in many cases, they will have no symptoms.
Do not attempt to remove genital warts using over-the-counter wart preparations. Such chemical solutions are too harsh for sensitive genital skin and may cause disfigurement.
The Food and Drug Administration (FDA) has approved a cervical cancer vaccine for girls and women between the ages of 9 and 26. This vaccine (Gardasil) has been shown to protect against the human papillomavirus (HPV). Gardasil has also been approved for use in boys and men between the ages of 9 and 26 to prevent genital warts caused by HPV types 6 and 11.
Three injections of the vaccine are administered over a 6-month period. Side effects include headache, fever, and injection site reactions (e.g., pain, itching, redness, swelling, bruising).
Practice safe sex. Use a latex condom during sexual intercourse to help prevent spreading or contracting genital wars.
Check your partner. If you notice any signs of genital warts, ask that he or she seek medical attention. It’s also important that both partners in a sexual relationship receive care of one if them has genital warts. If both partners are infected but only one is treated, then reinfection may occur.
When To Call Your Doctor
Make an appointment with a doctor if you or your sexual partner display symptoms of genital warts.
Robert Hurd, M.D., American Board of Internal Medicine and Professor of Endocrinology and Health Care Ethics, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.