Bruce P.Robinson, MD

Genital Warts

Genital warts affect the moist tissues of the genital area. They can look like small, flesh-colored and be flat or bumpy or have a cauliflower-like appearance. Some genital warts are so small they cannot be seen. They can cause pain, discomfort or itching. Genital warts, also known as venereal warts, or condylomata acuminata, are caused by the human papilloma virus (HPV). More than 100 types of HPV are known to exist. Low risk types (HPV 1, 2, and 3) cause warts on the hands, feet, and other parts of the body. The low risk strains - Types (6 and 11) can cause warts on the genitals or anus (genital warts), and other high risk strains - Types (HPV 16 and 18) can cause cancer of the cervix, external genitalia, vulva, and anus.

Genital warts are sexually transmitted disease (STD) and all partners should be checked thoroughly. They can also be seen in infants who have been delivered vaginally to mothers with HPV in their genital tracts; therefore, alternate methods of delivery should be considered.

Only a small percentage of people infected with HPV will develop genital warts. Many people are carriers of HPV who may never develop warts, but may still be able to pass HPV to their sexual partners. The incubation period from contracting HPV until the development of warts may be several months although some people may not develop warts for years after contact with HPV. People who have lower immunity due to cancer, AIDS, organ transplantation, immune suppressive medications, or certain other medications are more susceptible.

How are genital warts diagnosed?

To diagnose this condition, your doctor will do the following:

  • Ask questions about your health and sexual history. This includes symptoms you’ve experienced and whether you’ve had sex, including oral sex, without condoms or oral dams.
  • Perform a physical examination of any areas where you suspect warts may be occurring. Your doctor may be able to diagnose genital warts just by viewing them.

Are genital warts for life?

Although HPV isn't curable in all cases, genital warts are treatable. You can also go extended periods of time without an outbreak, but it may not be possible to get rid of the warts forever. That's because genital warts are only a symptom of HPV, which may become a chronic, lifelong infection for some.

What is the fastest way to get rid of genital warts?

If you've developed genital warts, your doctor has a few options for treatment. The fastest way to remove them is through surgery or to freeze them off with liquid nitrogen. Some doctors might use an electric current or laser treatment to burn off the warts.

What happens if genital warts is left untreated?

Genital warts can go away with treatment from your healthcare provider or with prescription medicine. If left untreated, genital warts may go away, stay the same, or grow in size or number. Cervical precancer treatment is available.

Testing

Your doctor may apply a mild acidic solution, called an acetowhite test, to your skin to help make genital warts more visible. It may cause a slight burning sensation.

If you have a vulva, your doctor may also need to perform a pelvic examination, because genital warts can occur deep inside your body.

How are genital warts treated?

While visible genital warts often go away with time, HPV itself can linger in your skin cells. This means you may have several outbreaks over the course of your life.

So managing symptoms is important because you want to avoid transmitting the virus to others. That said, 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. However, you can’t treat genital warts with over-the-counter (OTC) wart removers or treatments.

Medications

Your doctor may prescribe topical wart treatments that might include:

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

Surgery

If visible warts don’t go away with time, you may need minor surgery to remove them. Your doctor can also remove warts through these procedures:

  • electrocautery, or burning warts with electric currents
  • cryosurgery, or freezing warts
  • laser treatments
  • excision, or cutting off warts
  • injections of the drug interferon

How to prevent genital warts

To help prevent genital warts, HPV vaccines, condoms, and other barrier methods are available:

  • Gardasil and Gardasil 9 can protect people of all genders from the most common HPV strains that cause genital warts, and can also protect against strains of HPV that are linked to cervical cancer.
  • People from ages 9 to 45 can receive these vaccines. They’re administered in a series of two or three shots, depending on age. Both types of vaccine should be given before the person becomes sexually active, as they’re most effective before a person is exposed to HPV.
  • Using a condom or a dental dam every time you have sex can also lower your risk of contracting genital warts. The important thing is to use a physical barrier to prevent transmission.

When to contact a doctor

If you think you have genital warts, talk with your doctor. They can determine if you have warts and what your best treatment options are.

In addition, it’s important to talk with your sexual partner. This may sound difficult, but being open about your condition can help you protect your partner from also getting an HPV infection and genital warts.

Coping and outlook

Genital warts are a complication of a low risk HPV infection that’s common and treatable. They can disappear over time, but treatment is essential in preventing their return and possible complications.

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