GENITAL WARTS : symptoms, causes and treatment

As the name suggests, genital warts affect the moist tissues of the genital area. Genital warts may look like small, flesh-colored bumps or have a cauliflower-like appearance. In many cases, the warts are too small to be visible. Genital warts are one of the most common types of sexually transmitted infections.

Nearly all sexually active people will become infected with at least one type of human papillomavirus (HPV), the virus that causes genital warts, at some point during their lives. Women are somewhat more likely than men to develop genital warts.

Like warts that appear elsewhere on your body, genital warts are caused by the human papillomavirus (HPV). Some strains of genital HPV can cause genital warts, while others can cause cancer. Vaccines can help protect against certain strains of genital HPV.

In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person.

The signs and symptoms of genital warts include;
  • Small, flesh-colored or gray swellings in your genital area.
  • Several warts close together that take on a cauliflower-like shape.
  • Itching or discomfort in your genital area.
  • Bleeding with intercourse.

Genital warts may be so small and flat that they can’t be seen with the naked eye. Sometimes, however, genital warts may multiply into large clusters.

Causes and Risk factors

The human papillomavirus (HPV) causes warts. There are more than 40 different strains of HPV that specifically affect the genital area. Genital HPV is spread through sexual contact. In most cases, your immune system kills genital HPV and you never develop signs or symptoms of the infection.

The Centers for Disease Control and Prevention estimates that nearly all sexually active people will become infected with at least one type of HPV at some point during their lives. Factors that can increase the risk of becoming infected include:

  • Having unprotected sex with multiple partners.
  • Having had another sexually transmitted infection.
  • Having sex with a partner whose sexual history you don’t know.
  • Becoming sexually active at a young age.

Treatment

There is no cure for the virus itself. If your warts aren’t causing discomfort, you may not need treatment. But if your symptoms include itching, burning and pain, or if visible warts are causing emotional distress, your doctor can help you clear an outbreak with medications or surgery. However, the lesions are likely to come back after treatment.

Genital wart treatments that can be applied directly to your skin include:

  • Imiquimod (Aldara, Zyclara) : This cream appears to boost your immune system’s ability to fight genital warts. Avoid sexual contact while the cream is on your skin. It may weaken condoms and diaphragms and may irritate your partner’s skin. One possible side effect is redness of the skin. Other side effects may include blisters, body aches or pain, cough, rashes, and fatigue.
  • Podophyllin and podofilox (Condylox) : Podophyllin is a plant-based resin that destroys genital wart tissue. Your doctor must apply this solution. Podofilox contains the same active compound, but can be safely applied by you at home. Your doctor may want to administer the first application of podofilox, and will recommend precautionary steps to prevent the medication from irritating surrounding skin. Never apply podofilox internally. Additionally, this medication isn’t recommended for use during pregnancy. Side effects can include mild skin irritation, sores or pain.
  • Trichloroacetic acid (TCA) : This chemical treatment burns off genital warts, and can be used for internal warts. Side effects can include mild skin irritation, sores or pain.
  • Sinecatechins (Veregen) : This cream is used for treatment of external genital warts and warts in or around the anal canal. Side effects are often mild and may include reddening of the skin, itching or burning, and pain.

Don’t try to treat genital warts with over-the-counter wart removers. These medications aren’t intended for use in the moist tissues of the genital area. Using over-the-counter medications for this purpose can cause even more pain and irritation.

You may need surgery to remove larger warts, warts that don’t respond to medications or — if you’re pregnant — warts that your baby may be exposed to during delivery. Surgical options include:

  • Freezing with liquid nitrogen (cryotherapy) : Freezing works by causing a blister to form around your wart. As your skin heals, the lesions slough off, allowing new skin to appear. You may need repeated cryotherapy treatments. The main side effects include pain and swelling.
  • Electrocautery : This procedure uses an electrical current to burn off warts. You may have some pain and swelling after the procedure.
  • Surgical excision : Doctors may use special tools to cut off warts. You’ll need local or general anesthesia for this treatment, and you may have some pain afterward.
  • Laser treatments : This approach, which uses an intense beam of light, can be expensive and is usually reserved for very extensive and tough-to-treat warts. Side effects can include scarring and pain.

Prevention

Using a condom every time you have sex can significantly reduce your risk of contracting genital warts. Although condom use can reduce your risk, it is not 100 percent effective. You can still get genital warts.

A vaccine known as Gardasil protects against four strains of HPV that cause cancer, and is used to prevent genital warts. In 2014, the U.S. Food and Drug Administration approved a vaccine called Gardasil 9, which protects against nine strains of HPV.

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