Genital Warts (HPV)

What Are Genital Warts?

Genital warts are soft growths that occur on the genitals. Genital warts are a sexually transmitted infection (STI) caused by certain strains of the human papillomavirus (HPV). These skin growths can cause pain, discomfort, and itching. They are especially dangerous for women because some types of HPV can also cause cancer of the cervix and vulva.

What Are the Symptoms of Genital Warts?

Genital warts are not always visible to the human eye. They may be very small and flesh-colored or slightly darker. The top of the growths may resemble a cauliflower and may feel smooth or slightly bumpy to the touch.

Genital warts on males may appear:

  • on the penis
  • on the scrotum
  • on the groin
  • on the thighs
  • inside or around the anus

Genital warts in females may appear on:

  • the inside of the vagina or anus
  • the outside of the vagina or anus
  • the cervix

Genital warts may also appear on the lips, mouth, tongue, or throat of a person who has had oral sexual contact with an infected person.

Even if you cannot see genital warts, they may still cause symptoms, such as vaginal discharge, itching, bleeding, or burning. If genital warts spread or become enlarged, the condition can be very painful and uncomfortable.

What Causes Genital Warts?

There are more than 40 types of HPV that specifically affect the genital area. However, according to the Centers for Disease Control (CDC), 90 percent of genital warts are caused by HPV 6 or HPV 11. (CDC, 2011)

The HPV virus is highly transmittable through skin-to-skin contact, which is why it is considered a sexually transmitted infection. Any sexually active person is at risk for HPV. According to the American Academy of Dermatology (AAD), nearly half of people who have sex have had some type of HPV infection, though it is more common in people under the age of 30. (AAD)

What Are the Complications of HPV?

HPV is the main cause of cervical cancer (cancer of the cervix, which is the lower end of the uterus) and can also cause precancerous changes to the cells of the cervix (dysplasia).

Other types of HPV may also cause cancer of the vulva (the external genital organs of women), as well as penile and anal cancer.

How Are Genital Warts Diagnosed?

Your physician will perform a physical examination of any areas where you suspect warts may be occurring. Because warts can be deep inside the body for women, your physician may need to perform a pelvic examination as well. Your doctor may apply a mild acidic solution, which helps to make the warts more visible.

A physician can also take a swab of the area to obtain cells from your cervix (Pap smear). These can then be tested for the presence of HPV. Certain types of HPV may cause abnormal results on a Pap smear, which may indicate precancerous changes. If your doctor detects these abnormalities, your doctor may suggest more frequent screenings to monitor these changes.

Your doctor will also ask questions about your health and sexual history. This includes symptoms you have experienced and any times you have engaged in unprotected sex, including oral sex.

If you are concerned you may have contracted a form of HPV known to cause cervical cancer, your physician can perform a DNA test. This determines what strain of HPV you have in your system.

How Are Genital Warts Treated?

While visible genital warts often go away with time, the virus cannot be cured once it is in your bloodstream. This means you may have several outbreaks over the course of your life. This makes managing symptoms important because you want to prevent transmitting the virus to others. Genital warts can be passed on to others even when there are no visible warts or other symptoms.

You may wish to treat genital warts to relieve painful symptoms or to minimize their appearance. You cannot treat genital warts with over-the-counter wart removers or treatments.

Your physician may prescribe topical wart treatments, including:

  • imiquimod (Aldara)
  • podophyllin and podofilox (Condylox)
  • trichloroacetic acid (TCA)

If visible warts do not go away with time, you may require surgery to remove them. Your physician can burn, freeze, laser, or cut off genital warts.

Because certain types of HPV that cause genital warts are also associated with cervical cancer and precancerous changes in the cervix, women who have been diagnosed with genital warts may need to have Pap smears every three to six months after their initial treatment to monitor any changes in the cervix.

How to Prevent Genital Warts

An HPV vaccine called Gardasil can protect men and women from the most common HPV strains that cause genital warts, and can also protect against strains of HPV that are linked to cervical cancer. A vaccine called Cervarix is also available. This vaccine protects against cervical cancer, but not against genital warts.

According to the Mayo Clinic, the Advisory Committee on Immunization Practices recommends HPV vaccinations for girls and boys between the ages of 11 and 12. (Mayo Clinic, 2012)

However, men and women up to age 26 can receive the HPV vaccine. These vaccines should be received before becoming sexually active, as they are most effective before a person is exposed to HPV.

In addition to the vaccine, wearing a condom every time you have sex can reduce your risk of contracting genital warts.