Genital Warts

What are genital warts?

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

What are the symptoms?

Genital warts are small, flesh-colored, grayish white or pinkish white growths. 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.

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.

Sometimes the warts may go away without treatment. They may, however, to grow and form larger cauliflower-like 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 changes in the cells that suggest a viral infection, or your healthcare provider may see them during the exam.

How are they diagnosed?

Your healthcare 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 tissue 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.

Because HPV is often passed from one person to another during sexual activity, you may have tests for other sexually transmitted diseases (STDs).

How are they treated?

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)
• waiting to see if the warts go away on their own

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, other warts can grow.

If you have genital warts and plan to get pregnant, get treatment for the warts before you get pregnant. If you get genital warts while you are pregnant, it is rare for the HPV to affect the baby. However, warts tend to grow and you may get more of them during the pregnancy. Usually the warts are not treated until after you deliver your baby. A cesarean delivery (C-section) will not have to be done to prevent spread to the baby. You may need to have a C-section, however, if your healthcare provider thinks the warts are so big and many that a vaginal delivery may cause too much bleeding. Rarely does the baby develop warts after the delivery.

How long will the effects last?

Certain types of HPV infection of the cervix can lead, in time, to cervical cancer in women. 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.

How can I help take care of myself?

• If you have genital warts and plan to get pregnant, have your warts checked by your healthcare provider.
• Keep the genital area clean and dry. You can use a hair dryer to help dry the area.
• Wash your hands thoroughly after touching the area with warts.
• Don't scratch the warts.
• Get follow-up exams according to your healthcare provider's recommendations.
• Have a Pap test as often as your healthcare provider recommends.

How can I help prevent the spread of genital warts?

Not having any sexual contact is the best way to prevent the spread of HPV.

Researchers have developed a vaccine called Gardasil to prevent types of HPV infections that are high risk for cancer of the cervix and warts. The vaccine has recently been approved for use by the FDA. If you already have HPV, it will not cure your infection, but it will prevent infections with several other types of HPV.

The Gardasil shot is approved for girls and women 9 to 26 years old. It is given in 3 doses within a period of 6 months. Gardasil may protect you from HPV for 5 years. Researchers are doing studies to see if a booster shot after 5 years is needed.

Gardasil is usually not given to pregnant women.

Here are some other things you can do to help prevent HPV or its complications:

• Get an exam and Pap test every year.
• Do not have sexual intercourse until you are married or over the age of 18.
• Use latex or polyurethane condoms during sex. Even after your warts are gone, you can infect your partner because the virus is still in your body. Condoms can reduce the risk of getting genital warts from another person, but HPV can spread from areas not covered by a condom.
• Have just one sexual partner who is not sexually active with anyone else.
• Avoid sexual contact until the genital warts or HPV is completely treated and healed.
• Avoid smoking. Studies show that smoking increases the risks and problems related to HPV infection.