HPV: External Genital Warts
What are the symptoms of genital warts?
Where can genital warts appear?
How can a person find out if they have genital warts?
How can a person reduce the risk of getting genital warts?
How are genital warts treated?
What are the symptoms of genital warts?
Only certain types of HPV cause genital warts. Other types, not related to genital warts, can cause abnormal cell changes on the genital skin, usually on a female's cervix.
What do warts look like?
Genital warts appear as growths or bumps. Warts may be raised or flat, single or multiple, small or large. They tend to be flesh-colored or white in appearance. Warts usually do not cause itching or burning. Sometimes genital warts are so small that they can not be seen with the naked eye. This is sometimes called "sub-clinical HPV." Therefore, a person may not even know he or she has the type or types of HPV that cause genital warts. The types of HPV that cause raised external genital warts are not linked with cancer. These types are usually harmless.
Where
can genital warts appear?
Females
Males
Vulva
(entire outer female genital area)
Penis
In or around the vagina
Scrotum
(balls)
In
or around the anus
In
or around the anus
Groin
(where the genital area meets the inner thigh)
Groin
(where the genital area meets the inner thigh)
Cervix
(somewhat uncommon, and they would cause cell changes, not raised
"warts")
How often can genital warts appear?
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Some people only have one episode, while others have recurrences
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When warts are present, the virus is considered active
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When warts are gone, the virus is latent (sleeping) in the skin cells - it may or may not be contagious at this time
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Genital warts may or may not return after the first episode
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A healthy immune system helps fight the virus
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Warts may appear within several weeks after sex with someone who has the wart-types of HPV, or it may take several months or years to appear. Or, warts may never appear. This makes it hard to know exactly when or from whom someone got the virus.
How can a person get genital warts?
- Any person who is sexually active can get genital warts.
- The types of HPV that cause genital warts are usually spread by direct skin-to-skin contact during vaginal, anal or (rarely) oral sex with someone who has this infection.
- Genital warts are most likely to be transmitted when symptoms (warts) are actually present, but sometimes warts are too small to see with the naked eye (sub-clinical HPV).
- Very little is known about passing sub-clinical HPV to sex partners. Some experts think it may be less contagious than genital warts you can see.
- The types of HPV that cause genital warts do not usually seem to cause warts on other body parts such as the hands.
- Warts on other parts of the body, such as the hands, are caused by different types of HPV. People do not get genital warts by touching warts on their hands or feet.
- Warts are not commonly found in the mouth, so some experts believe that transmission through oral sex is not likely.
How can a person find out if they have genital warts?
Sometimes, warts can be very hard to see. Also, it can be hard to tell the difference between a wart and normal bumps on the genital area. If someone thinks he or she has warts or have been exposed to HPV, they should go to a doctor or clinic. A doctor or nurse will check more closely and may use a magnifying lens to find smaller warts.
A biopsy is not necessary for diagnosing genital warts. This is only done if the bump is unusual looking or discolored.
To look for warts or other abnormal tissue, doctors or nurses may put acetic acid (vinegar) on the genitals. This causes warts to turn white and makes them easier to see, especially if they are viewed through a magnifying lens such as a colposcope. However, the vinegar can sometimes cause other normal bumps to be highlighted, so this method of diagnosis can be misleading.
There are no blood tests available to diagnose a person for HPV.
How can a person reduce the risk of getting genital warts?
Any person who is sexually active can come across this common virus.
Ways to reduce the risk are:
- Not having sex with anyone.
- Having sex only with one partner who has sex only with you. People who have many sex partners are at higher risk of getting other STDs.
- If someone has visible symptoms of genital warts, he or she should not have sexual activity until the warts are removed. This may help to lower the risk of giving the virus.
- Condoms, used the right way from start to finish each time of having sex may, help provide minimal protection - but only for the skin that is covered by the condom. Condoms do not cover all genital skin, so they don't protect 100%.
- Spermicidal foams, creams and jellies are not proven to act against HPV and genital warts, but they work against some other STDs. These are best used along with condoms, not in place of condoms.
- If someone was exposed to a type of HPV that causes genital warts, it would be unlikely that he or she will become re-infected with that same type, since immunity will be set-up at some point.
- It is important for partners to understand the "entire picture" about HPV so that both people can make informed decisions based on facts, not fear or misconceptions.
How are genital warts treated?
- Currently, there is no treatment to cure HPV; there is no cure for any virus at this point. However, there are several treatment options available for genital warts.
- The goal of any treatment should be to remove visible genital warts to get rid of annoying symptoms. No one treatment is best for all cases.
- Treating the warts may possibly help reduce the risk of transmission to a partner who may have never been exposed to the wart-types of HPV.
- When choosing what treatment to use, the health care provider will consider the size, location and number of warts, changes in the warts, patient preference, cost of treatment, convenience, adverse effects, and their own experience with the treatments.
- Some treatments are done in a clinic or doctor's office; others are prescription creams that can be used at home for many weeks
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Cryotherapy (freezing off the wart with liquid nitrogen). This can be relatively inexpensive, but must be done by a trained doctor or nurse.
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Podophyllin (a chemical compound that must be applied by a doctor or nurse). This is an older treatment and is not as widely used today.
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TCA (trichloracetic acid) is another chemical applied to the surface of the wart by a doctor or a nurse.
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Cutting off warts. This has the advantage of getting rid of warts in a single office visit
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Electrocautery (burning off warts with an electrical current)
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Laser therapy (using an intense light to destroy warts).This is used for larger or extensive warts, especially those that have not responded well to other treatments. Laser can also cost a lot of money. Most doctors do not have lasers in their office and the doctor must be well-trained with this method.
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Interferon (a substance injected in to the wart). This is rarely used anymore due to extensive side effects and high cost. Less expensive therapies work just as well with fewer side effects.
At-home prescription
creams:
These are only available by a prescription from a doctor:
- Podofilox cream or gel (Condylox®). This is a self-applied treatment for external genital warts. It doesn't cost much, is easy to use and is safe, but it must be used for about 4 weeks.
- Imiquimod cream (Aldara®). This is also a self-applied treatment for external genital warts. It is safe, effective and easy to use. This cream is different than any other treatments. Other treatments work by destroying the wart tissue, but Aldara actually boosts the immune system to fight HPV.
What about pregnancy and genital warts?
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Most pregnant women who have had genital warts previously but no longer do would be unlikely to have any complications or problems during pregnancy or birth.
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Most children are born healthy to women with a history of genital warts.
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Because of hormone changes in the body during pregnancy, warts can grow in size and number, bleed, or, in extremely rare cases, make delivery harder.
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Very rarely, babies exposed to the wart-types of HPV during birth may develop growths in the throat.
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Despite this risk, a woman with genital warts does not need to have a cesarean-section delivery unless warts are blocking the birth canal. This is because the risk of a cesarean section is greater than the very rare risk to the baby of getting warts.
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It is important that a pregnant woman notify her doctor or clinic if she or her partner(s) has had genital warts. This way they can determine if they need to treat the warts or not during the pregnancy.
Is it normal to feel upset about genital warts?
Yes, it is normal. Some people feel very upset. They feel ashamed, fearful, confused, less attractive or less interested in sex. They feel angry at their sex partner(s), even though it is usually not possible to know exactly when or from whom the virus was spread. Some people are afraid that the genital warts could lead to cancer (they cannot) or that they will never be able to find a sexual partner again. It is normal to have all, some or none of these feelings. It may take some time, but it is important to know that it is still possible to have a normal, healthy life, even with warts.
More
Information on HPV and other STD's
For additional questions about this or any other STD's and other diseases,
CDC (Centers for Disease Control) provides several toll-free hotlines
for public use. The hotlines provide referrals and more answers to your
questions. Be sure to request free printed information when you call the
hotlines.
- CDC
National STD and AIDS Hotlines:
1-800-342-2437 or 1-800-227-8922. The hotlines are open 24 hours a day, seven days a week. For Spanish call 1-800-344-7432, 8:00 a.m. to 2:00 a.m. eastern standard time, seven days a week. For the deaf and hard-of-hearing call 1-800-243-7889, 10:00 a.m. to 10:00 p.m. eastern standard time, Monday through Friday. - CDC
National Immunization Information Hotline:
English 1-800-232-2522 Spanish 1-800-232-0233 8 a.m. to 11 p.m. eastern standard time. For the deaf and hard-of-hearing call 1-800-243-7889. Monday through Friday 10 a.m. to 10 p.m. eastern standard time. - CDC
Public Response Hotline (CPR):
English 1-888-246-2675 span 1-888-246-2857 Monday through Friday 8 a.m. to 11 p.m. eastern standard time 10 a.m. to 8 p.m. Saturday and Sunday. For the deaf and hard-of-hearing 1-866-874-2646 10 a.m. to 1 p.m. eastern standard time Monday through Friday.