Genital Warts (HPV)


There are more than 100 different types of wart virus, some infecting hands, knees and feet, others the face, and others the genital area. More than 30 wart virus types can infect the genital area – some of these cause warts, but are very unlikely to lead to cancer. Genital warts  result from infection caused by  the Human Papillomavirus (HPV). Genital warts can be found on the skin around the genital area, vagina, cervix, penis, scrotum, urethra (urine opening) or anus. As tests become increasingly sophisticated, more and more adults are found to have some form of genital wart virus. It can be present as either genital warts or as an infection of the skin which is not visible to the naked eye – this is called ‘subclinical infection’.

There may be no symptoms at all. If symptoms are present they will generally appear 2-3 months after being infected, but can take much longer. Outbreaks of warts can then reappear periodically.

Transmission

The most common way of spreading the wart virus is through direct contact between infected skin on the penis, urethra, scrotum, vagina, vulva, cervix or anus and uninfected skin in the same areas of the partner’s body.

Signs and Symptoms

Genital warts most commonly appear as pinkish/white small lumps or larger cauliflower-shaped lumps on the genital area. Genital warts can appear on or around the penis, scrotum, thigh or anus. In women genital warts can develop around the vulva, inside the vagina or on the cervix.

Testing

A physical examination of the infected area is needed to detect warts. Consult your doctor if signs or symptoms are present.

Treatment

There is no treatment that can completely eliminate genital warts once a person has been infected. Often outbreaks of genital warts will become less frequent over time, until the body naturally clears the virus and the warts disappear of their own accord. However, in some people the infection may linger.

A doctor can give various treatments to clear genital warts, but they may reappear even after treatment. Genital warts are caused by a virus, not a bacterium, so antibiotics will not get rid of them. Common treatments include:

  • Podophyllin resin – a brown liquid that removes genital warts by stopping cell growth.
  • Podopfilox lotion/gel – can be applied to the wart(s) by the patient at home.
  • Cryocautery (also called cryotherapy) – uses liquid nitrogen to freeze more persistent warts every 1 to 3 weeks for a short period.
  • Laser treatments – this approach, which uses an intense beam of light, can be expensive and is usually reserved for very extensive and tough-to-treat warts.
  • Electrocautery – an electrical current is used to super-heat a needle which burns the wart cells and cauterises the blood vessels. A local anaesthetic is used to prevent any pain and the procedure is usually carried out at a doctor’s surgery. Electrocautery is used only after other treatments have failed.
  • Surgical excision – the doctor will perform minor surgery to remove the wart under local anaesthetic.

Genital Warts and HIV

Outbreaks of warts can be more severe and harder to treat in HIV positive people. Some types of genital wart virus have been linked to a greater risk of anal cancer. This risk appears even greater for HIV positive people.

Prevention

Condoms are important in protecting against most forms of sexually transmitted infections (STIs), including genital warts. In the case of the HPV  virus, the question of protection is more complicated. Rather than being spread by semen, vaginal secretions, or blood,  genital warts are most often spread when infected skin rubs against uninfected skin.  The HPV virus can affect a much larger area of tissue than is covered by the condom; thus condoms do not provide complete protection. However, condoms provide a physical barrier that protects the most common sites of infection, and by doing so,  condoms do lower the overall risk of getting genital warts, as well as the risk of acquiring other STIs.