Genital warts

What are genital warts?

Genital warts are warts that form on the skin of the genital area. They are caused by certain subtypes of the human papillomavirus (HPV), the same virus that causes warts on other areas of the body. Genital warts are spread through sexual intercourse, so they are classified as a sexually transmitted infection, and can affect both men and women. Genital warts also are known as condyloma acuminata or venereal warts. They can develop anywhere near the vagina, cervix, genitals, or rectum.

Because genital warts can take six months to develop, you can have the infection without having any symptoms. Human papillomavirus also causes virtually all cases of cervical cancer worldwide. The subtypes that are most likely to cause cancer are different from those that usually cause warts. However, many people are infected with more than one subtype. Therefore, people with genital warts are more likely to be infected with a cancer-causing virus as well.

Symptoms of genital warts

Genital warts appear on moist surfaces, especially at the entrance of the vagina and rectum in women. In men and women, they can appear anywhere in the genital or anal area. They may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. Individual warts usually measure 1 to 2 millimeters in diameter — much smaller than the diameter of a pencil eraser — but clusters can be quite large. In some cases, warts can be so small that you can't see them. Genital warts may not cause any symptoms, or they may cause itching, burning, tenderness or pain.

Diagnosing genital warts

Your doctor will ask about your medical history and about your sexual habits and any prior episodes of sexual transmitted infections. Your doctor will then examine you to look for evidence of genital warts. Their appearance is very characteristic, and most often the diagnosis does not require further testing. If necessary, a vinegar-like solution placed on the skin turns the warts white and makes diagnosis easier.

Other diagnostic tests may include:

• Anoscopy – An instrument called an anoscope may be inserted into the anus to visualize warts beyond visible skin
• Tissue biopsy – A small piece of tissue is removed and examined in a laboratory
• Colposcopy – An instrument called a colposcope is used to magnify and inspect possible warts in the vagina and on the cervix
• Papanicolaou (Pap) smear.

All sex partners also should be examined for the infection.

Expected duration of genital warts

Genital warts may go away on their own or with treatment, or they may last for years. It is common for genital warts to return after they are removed.

Preventing genital warts

The best way to prevent genital warts is to avoid sex or have sex with only one uninfected partner. Using condoms also may help to prevent infection. However, condoms can't always cover all affected skin. Factors that increase your risk of becoming infected include:

• having other STDs (because the risk factors are the same)
• multiple sex partners
• smoking
• certain vitamin deficiencies
• medications or medical conditions that suppress the immune system.

If you have had genital warts, you should be tested for cervical cancer at least once every year. Cervical cancer can be prevented with regular screening (Pap smears), and can be cured in most cases when it is detected in early stages.

HPV vaccines help prevent genital warts in addition to decreasing the risk of cervical and anal cancer. The vaccines are given as a set of three shots over six months. The vaccine will not cure existing infections.

The Centers for Disease Control and Prevention (CDC) recommends that all 11- and 12-year-old girls get the shots, although girls as young as 9 could receive it. For catch-up, the CDC also recommends that teens and young women be vaccinated against HPV.

The vaccine works best before an individual has been exposed to HPV. Early vaccination provides the greatest chance of preventing cervical cancer and genital warts. Older girls and young women were included in the CDC recommendations because even if they've had some exposure to HPV, it may not be to the strains contained in the vaccine, so they will likely still get some protection.

The CDC recommends the HPV vaccine for boys ages 11 or 12 years, older boys, and young men if they have not previously had the shots.

Treating genital warts

Treatment depends on the size and location of the warts. Even though the warts may be removed, there may still be some virus remaining in the skin, which is why the warts often return. Some of the medications used to treat genital warts cannot be used during pregnancy, so it's important to tell your doctor if you could be pregnant.

Small warts may be treated with medications applied to the skin. In some cases, applying liquid nitrogen (cryotherapy) to warts will freeze the tissue and make warts disappear. Some larger warts require laser treatment, or surgical removal.

Do not treat genital warts yourself with nonprescription drugs used for wart removal on hands, because these chemicals can make the genital area very sore.

Your doctor may prescribe a medication that you can apply to the warts at home. Apply this medication carefully to avoid damaging surrounding healthy tissue, keep it out of your eyes, and wash it off after the number of hours your doctor instructs you to leave it on. Your doctor also may suggest that you apply a protective coating of petroleum jelly on delicate surrounding tissue before you apply your prescribed medication.

You will be told to avoid sexual relations until treatment is completed.

When to call a professional

Contact your physician if you notice warts or bumps on your genital area, or if you have itching, burning, tenderness, or pain in that area. Call your doctor immediately if you develop signs of infection, such as fever, chills, or muscle aches.

Prognosis

Genital warts may go away on their own or with treatment. It is common for them to return. Certain strains of the virus (HPV), which causes genital warts, cause virtually all cases of cervical cancer worldwide, though only a small percentage of the women who become infected will develop cancer. Cervical cancer develops slowly over decades. If you have genital warts, it is possible that you have also been infected with a cancer-causing strain of the virus. You should be sure to get Pap smears regularly.

Additional info

Centers for Disease Control and Prevention (CDC)
https://www.cdc.gov