Genital warts are soft growths that appear on the genitals. They can cause pain, discomfort, and itching. Genital warts a sexually transmitted infection (STI) caused by certain low-risk strains of the human papillomavirus (HPV). These are different from the high-risk strains that can lead to cervical dysplasia and cancer.
HPV is the most common of all STIs. Men and women who are sexually active are vulnerable to complications of HPV, including genital warts. HPV infection is especially dangerous for women because some types of HPV can also cause cancer of the cervix and vulva.
Treatment is key in managing this infection.
What Are the Symptoms of Genital Warts?
Genital warts are transmitted through sexual activity, including oral, vaginal, and anal sex. You may not start to develop warts for several weeks or months after infection. Genital warts aren’t always visible to the human eye. They may be very small and the color of the skin or slightly darker. The top of the growths may resemble a cauliflower and may feel smooth or slightly bumpy to the touch. They may occur as a cluster of warts, or just one wart.
Genital warts on males may appear on the following areas:
. inside or around the anus
For females, these warts may appear:
. inside of the vagina or anus
. outside of the vagina or anus
. on the cervix
Genital warts may also appear on the lips, mouth, tongue, or throat of a person who has had oral sexual contact with a person who has HPV. Even if you can’t see genital warts, they may still cause symptoms, such as:
. vaginal discharge
If genital warts spread or become enlarged, the condition can be uncomfortable or even painful.
What Causes Genital Warts?
Most cases of genital warts are caused by HPV. There are 30 to 40 strains of HPV that specifically affect the genitals, but just a few of these strains cause genital warts. The HPV virus is highly transmittable through skin-to-skin contact, which is why it’s considered an STI.
In fact, HPV is so common that the Centers for Disease Control and Prevention (CDC)Trusted Source says that most sexually active people get it at some point. However, the virus doesn’t always lead to complications such as genital warts. In fact, in most cases, the virus goes away on its own without causing any health problems.
Genital warts are usually caused by strains of HPV that differ from the strains that cause warts on your hands or other parts of the body. A wart can’t spread from someone’s hand to the genitals, and vice versa.
Risk Factors for Genital Warts
Any sexually active person is at risk of getting HPV. However, genital warts are more common for people who:
. are under the age of 30
. have a weakened immune system
. have a history of child abuse
. are children of a mother who had the virus during childbirth
What Are Other Possible Complications Of HPV?
HPV infection is the main cause of cancer in the cervix. It can also lead to precancerous changes to the cells of the cervix, which is called dysplasia.
Other types of HPV may also cause cancer of the vulva, which are the external genital organs of women. They can also cause penile and anal cancer.
How Are Genital Warts Diagnosed?
To diagnose this condition, your doctor will ask questions about your health and sexual history. This includes symptoms you’ve experienced and whether you’ve engaged in sex, including oral sex, without condoms or oral dams. Your doctor will also perform a physical examination of any areas where you suspect warts may be occurring.
For women only
Because warts can occur deep inside a woman’s body, your doctor may need to do a pelvic examination. They may apply a mild acidic solution, which helps to make the warts more visible.
Your doctor may also do a Pap test (also known as a Pap smear), which involves taking a swab of the area to obtain cells from your cervix. These cells can then be tested for the presence of HPV.
Certain types of HPV may cause abnormal results on a Pap test, which may indicate precancerous changes. If your doctor detects these abnormalities, you may need either more frequent screenings to monitor any changes or a specialized procedure called a colposcopy.
If you’re a woman and concerned that you may have contracted a form of HPV known to cause cervical cancer, your doctor can perform a DNA test. This determines what strain of HPV you have in your system. An HPV test for men isn’t yet available.
How Are Genital Warts Treated?
While visible genital warts often go away with time, HPV itself can linger in your skin cells. This means you may have several outbreaks over the course of your life. So, managing symptoms is important because you want to avoid transmitting the virus to others. That said, genital warts can be passed on to others even when there are no visible warts or other symptoms.
If your warts aren't causing discomfort, you might not need treatment. But if you have itching, burning and pain, or if you're concerned about spreading the infection, your doctor can help you clear an outbreak with medications or surgery.
However, warts often return after treatment. There is no treatment for the virus itself.
Genital wart treatments that can be applied directly to your skin include:
. Imiquimod (Aldara, Zyclara). This cream appears to boost your immune system's ability to fight genital warts. Avoid sexual contact while the cream is on your skin. It might weaken condoms and diaphragms and irritate your partner's skin. One possible side effect is skin redness. Other side effects might include blisters, body aches or pain, a cough, rashes, and fatigue.
. Podophyllin and podofilox (Condylox). Podophyllin is a plant-based resin that destroys genital wart tissue. Your doctor applies this solution. Podofilox contains the same active compound, but you can apply it at home.
Never apply podofilox internally. Additionally, this medication isn't recommended for use during pregnancy. Side effects can include mild skin irritation, sores or pain.
. Trichloroacetic acid. This chemical treatment burns off genital warts, and can be used for internal warts. Side effects can include mild skin irritation, sores or pain.
. Sinecatechins (Veregen). This cream is used for treatment of external genital warts and warts in or around the anal canal. Side effects, such as reddening of the skin, itching or burning, and pain, are often mild. Don't try to treat genital warts with over-the-counter wart removers. These medications aren't intended for use in the genital area.
You might need surgery to remove larger warts, warts that don't respond to medications or, if you're pregnant, warts that your baby can be exposed to during delivery. Surgical options include:
. Freezing with liquid nitrogen (cryotherapy). Freezing works by causing a blister to form around your wart. As your skin heals, the lesions slough off, allowing new skin to appear. You might need to repeat the treatment. The main side effects include pain and swelling.
. Electrocautery. This procedure uses an electrical current to burn off warts. You might have some pain and swelling after the procedure.
. Surgical excision. Your doctor might use special tools to cut off warts. You'll need local or general anesthesia for this treatment, and you might have pain afterward.
. Laser treatments. This approach, which uses an intense beam of light, can be expensive and is usually reserved for extensive and tough-to-treat warts. Side effects can include scarring and pain.
Home Remedies for Genital Warts
Don’t use OTC treatments meant for hand warts on genital warts. Hand and genital warts are caused by different strains of HPV, and treatments designed for other areas of the body are often much stronger than treatments used on the genitals. Using the wrong treatments may do more harm than good.
Some home remedies are touted as helpful in treating genital warts, but there is little evidence to support them. Always check with your doctor before trying a home remedy.
How To Prevent Genital Warts?
HPV vaccines called Gardasil and Gardasil 9 can protect men and women from the most common HPV strains that cause genital warts, and can also protect against strains of HPV that are linked to cervical cancer.
A vaccine called Cervarix is also available. This vaccine protects against cervical cancer, but not against genital warts.
Individuals up to age 45 years can receive the HPV vaccine, as well as those as young as age 9. The vaccine is administered in a series of two or three shots, depending on age. Both types of vaccine should be given before the person becomes sexually active, as they’re most effective before a person is exposed to HPV.
Using a condom or a dental dam every time you have sex can also reduce your risk of contracting genital warts. The important thing is to use a physical barrier to prevent transmission.
Coping and outlook
Genital warts are a complication of HPV infection that’s common and treatable. They can disappear over time, but treatment is essential in preventing their return and possible complications.
If you think you have genital warts, talk to your doctor. They can determine if you have warts and what your best treatment options are.
In addition, it’s important to talk to your sexual partner. This may sound difficult, but being open about your condition can help you protect your partner from also getting an HPV infection and genital warts.
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