Related topics: •  Chlamydia •  Crab Lice •  Gonorrhea •  Herpes •  Scabies •  Syphilis

Warts are never welcome, but finding them on your genitals is particularly disagreeable. Genital warts (also called venereal warts) are flesh-colored, pink, or grayish-white growths that appear on the genital and anal areas of the body.

Like all warts, they're caused by a type of human papilloma virus (HPV). Skin-to-skin contact during sexual activity is what allows them to spread, and spread they have. An estimated 20 million Americans have the HPV virus that causes the warts today, with some 6.2 million of us contracting it each year. To put it another way, at least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives, according to the Centers for Disease Control and Prevention.

Human papilloma virus is a virus with more than 100 different types, which are responsible for conditions that range from the relatively harmless and common plantar warts found on the soles of the feet to the more worrisome genital warts. (One type of HPV causes warts on the hands and feet; another kind produces them in the genital region.) Some types of genital HPV don't cause warts at all, while others have been linked to cervical cancer.

Most people who who are infected with HPV do not know it. Sometimes women will notice painless flesh-colored or grayish growths on the vulva (the outer, visible part of the female genitals), inside the vagina, or around the anus. A man might notice them on the tip or shaft of the penis. These growths, which might be itchy or mildly sore, can increase in size and develop a cauliflower-like appearance.

Other possible symptoms include mild irritation, burning, itching, or pain around the genitals or anus; increased or foul-smelling vaginal discharge or vaginal bleeding; or pain accompanying intercourse.

Often the virus will remain in the skin or mucous membrane and never produce warts. And if it does, there's a very good chance you won't notice them, especially if they're hidden inside the vagina, on the cervix, or inside the urethra (the tube that carries urine from the bladder out of your body). The warts may also be small and flat, so that they're not easily noticed even if they're on the outside of the body.

If genital warts are left untreated, they may disappear on their own within six months. The HPV virus will still be in your system, however, so the warts could reappear later.

Most women are diagnosed with HPV after they receive an abnormal Pap test, the cancer-screening test women receive during their annual gynecological exams. Many pre-cancerous changes to the cervix are related to HPV, although it is still very rare that HPV will cause cancer. Another test, called the HPV DNA, is available to test for HPV in women and can help health care providers decide if further tests or treatment is necessary. No HPV tests are currently available for men.

The warts themselves are benign and don't cause cancer. But some types of the HPV virus (whether they give rise to warts or not) are major risk factors for cervical cancer. This is one reason it's so important for women to get Pap tests as part of their regular gynecological exams.

According to the Centers for Disease Control, cancers of the penis, vulva, vagina, and anal area are linked to certain types of the HPV virus as well.

Currently, there is no treatment to cure HPV. There are very good treatments, however, for the problems HPV can cause, like genital warts and cervical cell changes.

Genital warts can be removed, which may help reduce discomfort, although experts disagree about the value of removing warts. In 20 to 30 percent of cases, external genital warts will disappear by themselves if left alone, a fact that leads some doctors to recommend a "wait and see" approach. Other physicians, however, advise that the warts be removed immediately. Although this isn't certain, some researchers believe that the HPV virus may spread to sexual partners more readily if genital warts are visible. Warts may be removed in a clinic or doctor's office through cryotherapy (freezing off the warts with liquid nitrogen), electrocautery (burning them off with an electrical current), chemicals, lasers or knives. Some procedures may require a local anesthetic. Patients have reported that the acid is excruciatingly painful when applied to anal warts, so review all the options with your doctor. Most chemical methods of wart removal aren't approved for pregnant women.

Your doctor might also want to remove the less common internal warts (in the vagina, on the cervix, inside the anus, or in the man's urethra).

Depending on the size and location of your warts, your doctor may recommend imiquimod, a cream you apply at home. Imiquimod enhances your immune system, helping your body rid itself of the warts and delaying or even preventing their recurrence.

It is very important that you not try to get rid of genital warts by using over-the-counter medicines that are meant to be used on the types of warts found on the hands and feet. They're too harsh for the genital area.

If the warts are going to reappear, they'll usually do so within the first three months after treatment. In 70 to 80 percent of cases, there's no recurrence within the first six months. Remember, though, that the HPV virus will remain in your body. As with other sexually transmitted diseases, your partner must be treated as well, since an infected partner can easily spread genital warts to you.

In June 2006, the US Food and Drug Administration approved the first vaccine developed to prevent cervical cancer and other diseases related to genital human papillomavirus (HPV). The vaccine protects against certain types of HPV that are responsible for 70 percent of cervical cancers and 90 percent of genital warts. The Advisory Committee on Immunization Practices recommends the vaccine for all girls between the ages of 11 to 12-years-old, and for females between the ages of 13 to 26-years-old who have not been vaccinated. The Centers for Disease Control advises using other prevention methods in addition to the vaccine since it does not work for all HPV types.

If you're not in a monogamous relationship, be sure you don't have unprotected sex; condoms can help prevent the spread of genital warts. But since warts can occur on parts of the genital and anal areas that condoms don't cover, the virus can be still be spread through sexual contact. If you're considering a new sexual partner, both of you should be tested for sexually transmitted diseases before having sex, according to federal health agencies.

-- Paige Bierma has written for Hippocrates, Safety + Health, and other publications.

Further Resources

American Social Health Association

P.O. Box 13827

Research Triangle Park, NC 27709

1-877-HPV-5868

http://www.ashastd.org/hpvccrc/hpvfaqs.html

References

Last updated April 27, 2009
Copyright © 1999 Consumer Health Interactive

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