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Health Information Genital Warts -
(Condyloma Acuminata, Venereal Warts, Human
Papillomavirus)
En Español (Spanish Version)
Definition
Genital warts (condylomata
acuminatum) are growths or bumps that appear
on the vulva, in or around the vagina or
anus, on the cervix, and on the penis,
scrotum, groin, or thigh. The warts may be
raised or flat, single or multiple, small or
large. Some may cluster together forming a
cauliflower-like shape.
Rarely, genital
warts also can develop in the mouth or
throat of a person who has had oral sex with
an infected person. Genital warts
are one of the most common forms of sexually
transmitted diseases.
Causes
Genital warts
are caused by the
human papillomavirus (HPV).
HPV is a
family of more than 80 extremely common
viruses. Many types of HPV cause harmless
skin warts, such as those on the fingers or
feet. Only a few specific types of HPV are
thought to cause genital warts.
HPV is easily
spread during oral, genital, or anal sex
with an infected partner. About two-thirds
of people who have sexual contact with a
partner who has genital warts will develop
them also, usually within three months of
contact.
Most people will
be exposed to a form of HPV at some point in
their lives, although not all will become
infected or develop symptoms. Warts can
appear within several weeks after sexual
contact with an infected person, or they can
take months to appear.
Complications of HPV
Cancer
Most
strains of HPV that produce genital
warts do not cause cancer. But
certain strains of HPV may cause
cervical cancer, or less
commonly, cancers of the vulva,
anus, or penis. For this reason, it
is important for women to have
annual
pap tests to detect any
HPV-related abnormalities.
Pregnancy/Childbirth Complications
Genital
warts may become larger during
pregnancy, which may make it
difficult to urinate. If the warts
are in or near the vaginal opening,
they may block the birth canal
during delivery.
Risk Factors
A risk factor is
something that increases your chance of
getting a disease or condition. Risk factors
for contracting HPV and/or genital warts:
- Age: 15-30
years old
- Multiple
sexual partners
- Having sex
without condoms
-
Skin-to-skin contact with an infected
partner
- Previous
history of genital warts
- Pregnancy
- Smoking
- Oral
contraceptives
- Having sex
at an early age
Symptoms
Genital warts
often look like fleshy, raised growths with
a cauliflower shape. They often appear in
clusters.
In women, warts
may be found in the following areas:
- Vulva or
vagina
- Inside or
around the vagina or anus
- Cervix
In men, genital
warts are less common. If present, they are
usually found in the following areas:
- Tip or
shaft of the penis
- The scrotum
- Around the
anus
The following
symptoms may also be present:
- Bleeding
- Itching
- Irritation
- Burning
- Secondary
bacterial infection with redness,
tenderness, or pus
Diagnosis
Evidence of
genital warts may be diagnosed by the
following:
Visual Exam
A doctor can
diagnose genital warts by visual
examination. If external warts are
found, the cervix is usually checked for
warts as well. Application of acetic
acid may assist in identifying lesions
that do not have classic features.
Pap Smear
Abnormal Pap
smear results may indicate the presence
of HPV. However, the Pap test is not the
most accurate test for HPV. Further
tests, such as a
colposcopy, should be performed if
Pap results are abnormal.
Colposcopy and Biopsy
Colposcopy
is a test that enables the doctor to
identify warts that might not be easily
visible. A
biopsy involves taking a sample of
tissue to be tested.
HPV Testing
A swab of
some cells from the affected area can be
checked for specific types of HPV.
Treatment
Treatment for
genital warts depends on the size and
location of the warts. Treatment only
alleviates the symptoms. It does not cure
the virus. Since the virus remains, warts or
other complications may recur later.
Treatments may
include:
Topical Treatments
Your doctor
may recommend one of the following
treatments or solutions to be applied to
the affected areas:
-
Imiquimod cream
-
Podophyllum resin
-
Podofilox solution
-
5-Fluorouracil cream
-
Trichloroacetic acid
Cryosurgery, Electrocautery, or Laser
Treatment
Cryosurgery
(freezing), electrocautery (burning),
and laser are all methods that instantly
destroy warts. These methods are used if
the warts are small, or if the warts are
large and have not responded to other
treatment. Surgical removal is sometimes
recommended for large warts. An
antiviral drug, called alpha-interferon,
can be injected directly into warts that
keep recurring.
Prevention
The only way to
completely prevent the spread of an HPV
infection is to avoid physical contact with
an infected sexual partner.
Latex condoms
may help reduce the spread of HPV infection
and genital warts. However, they are not
100% effective because they cannot cover the
entire genital area.
Other preventive
measures include:
- Sexual
abstinence
- Monogamous
sexual relationships
- Regular
check-ups for sexually transmitted
diseases
- Regular Pap
smears for women starting at age 18 or
at the onset of sexual activity,
whichever comes earlier
Vaccine
A
vaccine called Gardasil has been
approved to prevent infection by
some—but not all—of HPV strains that
cause cervical cancer. Approved for use
in females aged 9-26, the vaccine is
given as a series of three injections
over a 6-month period. There is a
catch-up vaccination recommended for
women between the ages of 13-26,
regardless of their sexual history, who
were never vaccinated or did not
complete the recommended series.
Gardasil is
the first vaccine ever developed to
primarily prevent a cancer. The vaccine
reduces the risk of infection from four
strains of HPV, including the two
strains—16 and 18—that account for over
70% of HPV infections leading to cancer.
In a recent large trial involving women
aged 15-26, the vaccine effectively
reduced the incidence of precancerous
cervical lesions over a three year
period.
Special Considerations
Anogenital warts
are rare in children. Such a diagnosis
should prompt consideration of sexual abuse
and should be reported.
RESOURCES:
American Social Health Association
www.ashastd.org
Planned Parenthood
www.plannedparenthood.org
United States Centers for Disease Control
and Prevention
www.cdc.gov/std
CANADIAN RESOURCES:
Health Canada
www.hc-sc.gc.ca/index_e.html
Sex Information and Education Council of
Canada
www.sieccan.org
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