Genital warts: causes, symptoms, and treatments

Genital warts: causes, symptoms, and treatments

Genital warts, also known as venereal warts or condylomata acuminate, are one of the most common types of sexually transmitted infections (STIs).

A genital wart is an infection of the skin in the genital or anal area, as well as the mucous membranes of the rectum, cervix, and vagina.

In this article, we will look at the causes, diagnosis, and treatment of genital warts. We will also discuss any potential complications and how to avoid catching them.

Here are some key points about genital warts. More detail and supporting information is in the main article.

  • Genital warts are contagious
  • They are caused by papillomavirus infecting the skin
  • The biggest risk factor for genital warts is unprotected sex
  • Some genital warts respond well to topical medication

What are genital warts?

A genital wart is a contagious, projecting fleshy growth on the external genitals or anus, consisting of fibrous overgrowths covered by a thickened epithelium (outer layer).

Genital warts are due to sexual contact with a person infected with human papillomavirus (HPV); they are usually benign (non-cancerous), but many subtypes have the potential for malignant (cancerous) change.

Causes of genital warts

Genital warts on the base of a man's penis.

Photo credit: Wikimedia Commons

Genital warts, like other non-STD warts, are caused by various types of the human papillomavirus (HPV) that infect the top layers of the skin.

There are over 100 different types of HPV that may cause warts, but only a small number of strains can cause genital warts.

Those that do cause genital warts, unlike other wart-causing HPVs, are highly contagious and are passed on through sexual contact with a person who is infected.

It is estimated that up to 65 percent of people who have sexual relations with a person who has genital warts will become infected and develop them too.

Genital warts often appear about 3 months after infection - however, in some cases, there may be no symptoms for many years.

Around 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year.

Risk factors for genital warts

  • Having unprotected sex
  • Having unprotected sex with many different people
  • Having sex with a person whose sexual history is unknown
  • Oral sex raises the risk of genital warts developing in the mouth or throat
  • Starting sexual relations at a young age
  • Having stress and other viral infections (such as HIV or herpes) at the same time

Complications of genital warts

  • Cancer - HPV infection is associated with cervical cancer, as well as cancer of the vulva, anus, and penis. Of course, not all HPV infections lead to cervical cancer, but it is crucial for a woman's long-term health that she has regular Pap tests.
  • Pregnancy problems - there is a very small risk that, as a mother with genital warts gives birth, she may cause the baby to have warts in their throat (laryngeal papillomatosis). Also, hormonal changes that occur during pregnancy may cause genital warts to grow, bleed, or increase in number.

Diagnosing genital warts

Normally, a visual inspection is enough to diagnose genital warts.

  • Women - genital warts may exist on the vulva (lips around the vagina), cervix (entrance to the uterus), upper thighs, inside the vagina, on the anus, and inside the anus.
  • Men - genital warts may exist on the penis, scrotum (sack which holds the testes), urethra (tube that carries urine), upper thighs, on the anus, and inside the anus.

A patient should be examined by a doctor to confirm a diagnosis of genital warts. People should go for a checkup if:

  • The patient or partner has genital wart symptoms
  • The patient recently had unprotected sex with a new partner
  • The patient or partner have had unprotected sex with somebody else
  • The patient's partner tells him/her that he/she has an STD
  • The patient has an STD
  • The patient is pregnant
  • The patient is trying to get pregnant

A doctor can usually diagnose genital warts if any are visible. The examination may involve looking inside the vagina or anus. On rare occasions, a biopsy of the wart may be taken.

Sometimes, even if no warts are detected, the doctor or nurse may ask the patient to come back at a later date. Visible warts might not appear straight after infection.

What do genital warts look like?

  • They may appear as flesh-colored or gray swellings (bumps) in the patient's genital area
  • If several are clustered together, they may have a cauliflower-like shape
  • Some genital warts are so small that they can only be detected with a colposcopic exam of the cervix and vagina or a Pap smear

Treatment for genital warts

Sometimes a topical cream can remove the majority of genital warts.

Doctors will only treat patients who have visible warts. The type of treatment depends on:

  • The location of the warts
  • How many warts there are
  • What the warts look like

Treatment is aimed at getting rid of the visible warts and lowering the number of viruses present. If the amount of viruses can be lowered, the patient's immune system has a better chance of fighting them off.

The following treatments are effective in getting rid of genital warts:

  • Topical medication - a cream or liquid is applied directly onto the warts for a few days each week. This may be administered at home or at a clinic - depending on the kind of treatment. Treatment may continue for several weeks.
  • Cryotherapy - the warts are frozen, often with liquid nitrogen. The freezing causes a blister to form around the wart. As the skin heals, the lesions slide off, allowing new skin to appear. Sometimes repeated treatments are needed.
  • Electrocautery - electric current is used to destroy the wart. The patient will generally be given a local anesthetic.
  • Surgery - the wart will be cut out (excised). A local anesthetic will be used.
  • Laser treatment - an intensive beam of light is used to destroy the wart.

It is not uncommon for doctors to use more than one treatment at the same time. Treatments are not painful, but may sometimes be uncomfortable, with some soreness and irritation for 1 or 2 days. OTC painkillers can be taken by patients after treatment.

Some patients who feel sore may find that a warm bath helps. After a bath, the affected area must be dried completely. Patients should not use bath oils, soap, or creams until well after the treatment is completed.

OTC treatments for ordinary warts (non-genital warts) are not suitable for the treatment of genital warts.

Genital warts will usually eventually go away, even if left untreated. They do sometimes get bigger in size and populate in larger numbers, without treatment.

Experts say that untreated genital warts are not harmful to the health of the infected person, but they may be uncomfortable and not look appealing. However, treating warts greatly reduces the risk of passing them on to another person.

Pap tests and genital warts

A pap test, also known as a Pap smear, is a procedure to test for cervical cancer in women. The test involves collecting cells from the woman's cervix. Cervical cancer is a possible complication of HPV infection.

Women should have regular pelvic exams and Pap tests. These also help detect cervical and vaginal changes which may be triggered by genital warts.

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