Genital Warts

Genital warts are one of the most common types of sexually transmitted infections. The virus that causes warts is called the human papillomavirus (HPV). There are many different types of HPV, and almost everyone who is sexually active gets at least one type at some point.

They can affect the moist tissues of the genital area. They can look like small skin-colored bumps. The bumps may look like cauliflower. Often, warts are too small to be seen with the naked eye.

Some strains of genital HPV can cause genital warts. Others can cause cancer. Vaccines can help protect against certain types of genital HPV. Genital warts can be caused by low-risk HPV infection. Treatment can include topical prescription treatments and medical procedures to remove the wart.

HPV infection is especially dangerous for people with vulvar infections because high-risk strains can also cause cervical and vulvar cancer.

Symptoms

Genital warts, caused by certain strains of the human papillomavirus (HPV), often don’t cause any symptoms. However, when symptoms do occur, they may include:

• Small, Flesh-Colored Bumps: These can appear on the genital area, such as the penis, scrotum, groin, thighs, vagina, or cervix. They might be flat or raised, singular or in clusters.
• Itching or Discomfort: Some individuals might experience itching or discomfort in the genital area due to the presence of warts.
• Pain or Bleeding During Sex: Warts can cause irritation or minor bleeding during sexual intercourse.
• Changes in Skin Texture: In some cases, the appearance of the skin may change, becoming rough or bumpy.

It’s crucial to note that some cases of HPV infection, including genital warts, can be asymptomatic, meaning the infected person might not display any visible signs or symptoms. Regular screening and medical check-ups, especially if sexually active, are important to detect and manage any potential infections.

Causes

They are caused by specific strains of the human papillomavirus (HPV), primarily HPV types 6 and 11. HPV is a sexually transmitted infection (STI) that spreads through skin-to-skin contact, most commonly during sexual activity, including vaginal, anal, or oral sex.

Factors that increase the risk  include:

• Sexual Activity: Having unprotected sex or multiple sexual partners increases the likelihood of HPV transmission.
• Skin-to-Skin Contact: Direct contact with an infected person’s genital area, even if no penetrative sex occurs, can lead to transmission.
• Weakened Immune System: Individuals with weakened immune systems due to conditions like HIV/AIDS, organ transplantation, or certain medications are more susceptible to HPV infections, including genital warts.
• Genetics: Some individuals might be genetically predisposed to being more susceptible to HPV infections.

Remember, not everyone who is exposed to HPV will develop genital warts. However, HPV infections can still be transmitted even if warts are not visible, making regular screenings and safe sexual practices crucial in preventing and managing the spread of HPV and associated conditions like genital warts.

Risk factors

Several factors can increase the risk :

• Sexual Activity: Engaging in sexual activity, especially unprotected sex or having multiple sexual partners, increases the risk of contracting HPV, the virus that causes genital warts.
• Age: Younger individuals, particularly those in their late teens and early 20s, are at a higher risk of HPV infection, including genital warts, as they may have more sexual partners and are less likely to have developed immunity to the virus.
• Weakened Immune System: Conditions or medications that weaken the immune system, such as HIV/AIDS, organ transplantation, or certain medications like corticosteroids, increase susceptibility to HPV infections, including genital warts.
• Personal Hygiene and Habits: Poor genital hygiene practices and habits might contribute to the risk of developing genital warts. However, hygiene alone is not the sole factor; the primary mode of transmission is through skin-to-skin contact during sexual activity.
• Previous HPV Infection: Having a history of other types of HPV infections or genital warts can increase the risk of future outbreaks.
• Smoking: Smoking has been linked to a higher risk of developing genital warts, possibly due to its impact on the immune system’s ability to fight HPV infections.

It’s important to note that while these factors can increase the risk, they don’t guarantee the development of genital warts. Practicing safe sex, getting vaccinated against HPV, and maintaining a healthy lifestyle are essential in reducing the risk of contracting genital warts and other HPV-related infections. Regular screenings and consultations with healthcare providers are crucial for early detection and appropriate management.

Complications

HPV infection can lead to health problems.

Cancer

Cervical cancer is closely related to genital HPV infection. Certain types of HPV are also associated with cancers of the vulva, anus, penis, and mouth and throat.

HPV infection does not always lead to cancer, but women need to have regular Pap tests to check for cervical cancer. Pap tests are key for those infected with high-risk types of HPV.

Problems during pregnancy

Rarely, warts can get bigger during pregnancy. This makes urine hard. Warts on the vaginal wall can prevent vaginal tissues from stretching during childbirth. Large warts on the vulva or vagina may bleed during childbirth.

Rarely a baby born to a pregnant woman with genital warts will develop warts in the throat area. The baby may need surgery to prevent airway obstruction.

Prevention

Preventing involves a combination of vaccination, safe sexual practices, and regular screenings.

HPV vaccination

Getting vaccinated against HPV is one of the most effective ways to prevent genital warts and other HPV-related diseases. The HPV vaccine is recommended for adolescents and young adults but can also be administered up to age 45 in certain cases.

Safe sex practices

Consistently using condoms or other barrier methods during sexual activity can reduce the risk of HPV transmission. While condoms may not fully protect against HPV since the virus can be present in areas not covered by a condom, they still provide some level of protection.

Limiting sexual partners

Having fewer sexual partners and being in a mutually monogamous relationship with someone who has been tested and is free of STIs can lower the risk of HPV transmission.

Regular screenings

Routine check-ups with healthcare providers, including pelvic exams for women and genital exams for men, can help detect any signs of genital warts or other HPV-related issues early on.

Quit smoking

Smoking has been linked to an increased risk of HPV-related complications, including genital warts. Quitting smoking may help reduce this risk.

Maintaining a healthy immune system

A strong immune system is better equipped to fight off HPV infections. Maintaining good overall health through a balanced diet, regular exercise, and managing stress can support a healthy immune system.

Remember, while these measures can significantly lower the risk of contracting genital warts, no method is foolproof. Practicing a combination of these preventive measures provides the best chance of reducing the risk of HPV infection and genital warts. If you suspect you have been exposed to HPV or experience any symptoms, seeking medical advice promptly is crucial for proper evaluation and treatment.

How are diagnosed?

A healthcare provider can detect external genital warts by looking at them and may order a biopsy for confirmation. Internal warts are more challenging to diagnose.

Providers use the following tests to diagnose :

• Pelvic exam: You may have a Pap test as part of a pelvic exam to check for cervical changes caused by genital warts. The provider may also perform a colposcopy to examine and biopsy the vagina and cervix.
• Rectal exam: The provider uses a device called an anoscope to look inside the anus for warts.

Call a healthcare provider if you think you have genital warts. Other sexually transmitted infections (and even things like moles or skin tags) look like genital warts. An accurate diagnosis is essential to get the right treatment.

Treatment

If the wart does not cause discomfort, you may not need treatment. But in case of itching, burning, and pain, medicine or surgery can help you eliminate the disease’s spread. If you are concerned about the spread of the infection, treatment can also help. Although warts often return after treatment. And there is no cure for the virus itself.

Medications

Treatments  that can be performed on the skin include:

• Imiquimod (Zyclara): This cream boosts the immune system’s ability to fight. Do not have sexual contact while the cream is on the skin. It may weaken condoms and diaphragms and irritate your partner’s skin. One of the possible side effects is a change in the color of the skin at the place of drug administration. Other side effects may include blisters, body aches, cough, rash, and fatigue.
• Podophyllin (Podocon-25) and podofilox (Condylox): Podophyllin is a plant substance that destroys genital wart tissue. Podofilox contains the same active ingredient but can be used at home. Never put podofilox inside your body. It is also not recommended to use this medicine during pregnancy. Side effects can include mild skin irritation, soreness, and pain.
• Trichloroacetic acid: This chemical treatment burns the genital warts. It can also treat internal warts. Side effects can include mild skin irritation, soreness, and pain.
• Sinecatechins (Veregen): This ointment can treat the body and warts inside or around the anus. Side effects can include skin discoloration, itching or burning, and pain.

Do not try to treat with over-the-counter wart removers. These drugs are not intended for use in the genital area.

Surgery

Surgery may be needed to remove larger warts or those that do not heal with medication. If you are pregnant, you may need surgery to remove warts that the baby may come into contact with during delivery. Genital wart surgeries include:

• Freezing with liquid nitrogen: This method is also called cryotherapy. Freezing works by creating a blister around the wart. As the skin heals, the warts disappear, and new skin appears. It may be necessary to repeat the treatment; the main side effects include pain and swelling.
• Electrocautery: This method uses electric current to burn the wart. You may have some pain and swelling afterward.
• Surgical excision: Warts can be removed during surgery. You will need a medicine called anesthesia to prevent you from feeling pain during this treatment. You may be sore afterward. Laser treatments This approach uses an intense beam of light.

The bottom line

Genital warts, caused by certain strains of HPV, are sexually transmitted and appear as small, flesh-colored bumps on the genital area. Prevention through vaccination, safe sex practices, and regular screenings is crucial. Treatment involves various options like topical medications, surgical removal, or laser therapy, but there’s no cure for HPV itself. Persistence or recurrence of warts is possible even after successful treatment, necessitating ongoing medical care. Seeking professional guidance and emotional support is important when dealing with genital warts for effective management and care.

Additional questions

1. How common are genital warts?

They are fairly common, especially among sexually active individuals. According to the Centers for Disease Control and Prevention (CDC), they are one of the most common sexually transmitted infections. It’s estimated that millions of new cases of genital warts occur each year in the United States alone. The prevalence of genital warts can vary based on factors such as age, sexual behavior, and geographic location.

2. How do genital warts affect pregnancy?

Genital warts during pregnancy can pose risks of transmission to the baby during childbirth or potential complications due to hormonal changes. Treatment options may be limited during pregnancy to ensure the safety of the developing fetus. While transmission to the baby is rare, pregnant individuals with genital warts must receive proper medical evaluation and guidance from healthcare providers to manage any potential risks and ensure a safe delivery

3. What is the difference between genital warts and herpes?

Genital herpes is similar to genital warts because they are both sexually transmitted infections. However, herpes causes sores and fluid-filled blisters on the genitals. These warts are small bumps that usually do not cause open sores. Both diseases are spread during vaginal and anal sex.

4. Where do genital warts appear?

They can appear in various areas of the genital region, including:

• Penis
• Scrotum
• Vagina
• Cervix
• Groin
• Anal Region

5. Are genital warts itchy?

They don’t usually cause itching in most cases. However, some individuals might experience mild itching or discomfort in the genital area where the warts are present.

 

References

https://www.mayoclinic.org/diseases-conditions/genital-warts/diagnosis-treatment/drc-20355240

https://my.clevelandclinic.org/health/diseases/4209-genital-warts

https://www.healthline.com/health/std/genital-warts#outlook

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/genital-warts

https://www.medicalnewstoday.com/articles/155236

https://patient.info/sexual-health/sexually-transmitted-infections-leaflet/anogenital-warts#nav-3