Genital Warts - Treatment and Prevention

Overview
Genital warts are one of the most common sexually transmitted diseases (STDs) in the world. The human papillomavirus (HPV) is the virus that causes genital warts.

HPV actually refers to a group of more than 60 viruses that have been identified by scientists and are responsible for warts anywhere on the body, but only certain types are sexually transmitted.

Experts estimate that as many as 26 million Americans are infected with HPV, and the rate of infection appears to be increasing. About one-third of HPV-type viruses are spread through sexual contact and live only in genital areas of the body. Only one type of HPV causes genital warts. Other types of HPV cause cervical cancer and other genital cancers.

Like many sexually transmitted diseases, HPV usually causes a silent infection, or one that does not have visible symptoms.

Symptoms
In women, the warts occur on the outside and inside of the vagina, labia, cervix (the opening to the uterus), around the anus or even on the thighs. In men, genital warts are less common. If present, they are seen on the tip of the penis. Sometimes they are also found on the shaft of the penis, the scrotum or around the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person, although the instances of this are rare.

The warts can appear raised or flat, small or large, and single or clumped in a group that sometimes looks like cauliflower. Normally, the warts are flesh-colored or a bit lighter, and painless. Less often they appear as slightly pink or gray. Rarely, they cause itching, pain, or bleeding.

Genital warts often occur in clusters and can be very tiny. They can also be spread into large masses on genital tissues. Left untreated, genital warts often disappear. In other cases, they eventually may develop a fleshy, raised growth with a cauliflower-like appearance.

The incubation period of genital warts is about two to four months, and it can take from four to six weeks to infect a partner with HPV. In two-thirds of infected people, it can be up to nine months before any warts appear.

Low-risk papilla viruses cause warts but not cervical cancer. However, high-risk viruses cause cervical cancer and are also associated with vulvar cancer, anal cancer and cancer of the penis (a rare cancer). Although most HPV infections do not progress to cancer, it is particularly important for women who have cervical dysplasia to have regular pap smears. Potentially precancerous cervical disease is readily treatable.

A health care provider can usually diagnose genital warts by direct visual examination. Women with genital warts should also be examined for possible HPV infection of the cervix with a pap smear test.

Common Treatments
Depending on factors such as size and location, genital warts are treated in several ways. Keep in mind that while treatments can eliminate the warts, none totally kill the virus and warts often reappear after treatment.

Treatments commonly include podophyllin solution, which is applied to the affected area and later washes off. Podophyllin is applied by a doctor or a nurse, and is best used on small, external warts. It is safe and relatively inexpensive, but causes some pain and discomfort. Podophyllin needs to be washed off after one to four hours and you will need to be treated weekly for up to six weeks in most cases. Very large amounts can cause harmful side effects, including nerve damage. Do NOT use this treatment if you are pregnant.

Small warts can be removed by cryosurgery (freezing), electrocautery (burning) or laser treatment. Occasionally, surgery is needed to remove large warts that have not responded to other treatment. Some health care providers use antiviral drugs to treat warts that have recurred after removal by traditional means. These drugs are injected directly into the warts. The drug is expensive and does not reduce the rate of recurrence.

Finally, you can let the warts go away by themselves. Within three months, 20 to 30 percent of patients' non-cervical warts clear up by themselves.

For more information on treatments, click here.

Prevention
The only way to prevent HPV infection is to avoid direct contact with the virus, which is transmitted by skin-to-skin contact. If warts are visible in the genital area, sexual contact should be avoided until the warts are treated. Using a latex condom during sexual intercourse may provide some protection and will usually prevent warts from being transmitted to the cervix, but that's no guarantee.

Ask Your Physician
You should consult your health care provider if you find genital warts on yourself or on your sexual partner(s). Because there is no way to predict whether the warts will grow or disappear, people who suspect that they have genital warts should also be examined and treated.

Click for more information about HPV, coping with HPV and how to detect early signs.