Genital Warts

What are genital warts?

Genital warts are similar to common warts but are found around or in the penis, anus, vagina, or cervix. They are single or multiple soft, fleshy, small growths on the skin.

How do they occur?

Like other warts, genital warts are caused by a virus. The name of the virus that causes genital warts is human papillomavirus, or HPV. There are many types of HPV. The types of virus that most often cause genital warts are called HPV-6 and HPV-11.

Genital warts may spread to other nearby parts of the body and they may be passed from person to person by sexual activity. They are spread by skin-to-skin contact. They are more contagious, or more easily spread, than other warts. Genital warts are usually first seen 1 to 6 months after you have been infected. However, you can be infected with HPV without having any visible warts.

What are the symptoms?

In women, warts can grow in the area of the vulva (the folds of skin around the opening of the vagina), on the cervix, inside the vagina or urethra, or around the anus. In men, warts can grow on the tip or shaft of the penis and sometimes on the scrotum, in the urethra (the tube that carries urine out of the body), or around the anus.

Genital warts are flesh-colored, grayish white, or pinkish white. They usually appear as thin, flexible, solid bumps on the skin that look like small pieces of cauliflower. Some warts, however, are small and flat and may not be easily noticed.

Sometimes the warts may disappear on their own without treatment. They are more likely, however, to grow and form larger cauliflowerlike clusters of warts. You may have no symptoms, or you may have occasional mild irritation, burning, itching, tenderness, foul smell, pain with intercourse, increased vaginal discharge, or bleeding.

When genital warts are on the cervix or in the vagina, they may not cause any noticeable symptoms. However, a Pap test may show cell changes that suggest a viral infection.

How are they diagnosed?

Your health care provider will examine your skin and the wart. Your provider may put a liquid on the skin to make it easier to see the wart. An instrument called a colposcope will magnify the area so your provider can look more closely at the skin or the cervix. A sample of skin may be taken for lab tests to help confirm the diagnosis. A scope may be used to check for warts in the bladder and the urethra.

Often warts that cannot be seen are diagnosed when women have a Pap test.

How are they treated?

Both sexual partners need treatment if they have genital warts. Treating just one partner is not very effective because the other partner will reinfect the treated partner.

The main methods of treatment are:

• putting medicine on the warts
• surgically removing the warts
• freezing the warts with liquid nitrogen (cryotherapy)
• destroying the warts with a laser
• burning off the warts using a wire loop and electric current (electrocautery).

You may need a local anesthetic to numb the area before some of these treatments.

Removal of the warts does not get rid of the virus. Because you will still have the virus after treatment, the warts could come back. Genital warts that persist or come back after standard treatment may be treated with interferon shots. Interferon is a medicine that boosts the body's immune response and helps keep viruses from multiplying.

How long will the effects last?

Genital warts can be successfully treated and removed. However, in some people the warts may reappear weeks or months later. If the warts reappear, they need to be retreated or removed again.

Certain types of HPV infection of the cervix can lead, in time, to cervical cancer in some women. However, the HPV-6 and HPV-11 types of virus, which are the usual cause of genital warts, rarely lead to cancer and are called low-risk HPVs. High-risk types of HPVs cause growths that are usually flat and nearly invisible, as compared with the warts caused by types HPV-6 and HPV-11.

What can I do to help prevent the spread of genital warts?

To prevent the spread of warts to other areas of the body or to other people:

• Keep the genital area clean and dry. You can use a hair dryer to help dry the area.
• Don't scratch the warts.
• Avoid sexual contact until the warts are completely healed.
• Use latex or polyurethane condoms during sexual intercourse. Condoms can reduce your risk of getting genital warts, but warts can spread from areas not covered by a condom.
• Wash your hands thoroughly after touching the area with warts.
• Have a Pap test as often as your health care provider recommends.