Overview

Genital warts, also known as condyloma acuminatum, are small growths or bumps that appear on or around the genital or anal areas. They are caused by certain strains of the Human Papillomavirus (HPV), which is a very common virus.

Genital warts are most commonly spread through skin-to-skin contact, usually during sexual activity. Anyone who is sexually active can get them, though they are most common in young adults. Yes, genital warts are contagious and can be passed to others even when warts are not visible. Living with genital warts can be distressing, and it's understandable to feel worried or embarrassed, but please know you're not alone and there's support available.

Symptoms

You might notice one or more of the following:

• Small, flesh-colored, pink, or grey bumps - in the genital or anal area.
• Growths that can be flat, raised, single, or in clusters - that may look like a cauliflower.
• Itching or discomfort - in the affected area.
• Bleeding with intercourse - (if warts are present in the vagina or anus).
• Warts can appear - on the vulva, vagina, cervix, penis, scrotum, or around the anus. Less commonly, they can appear in the mouth or throat after oral sex with an infected person.
• Sometimes, there are no noticeable symptoms - or the warts are too small to be seen.
• The size and number of warts can vary greatly.

Diagnosis

A doctor can usually diagnose genital warts by looking at them during a physical examination. They will ask about your medical history and sexual health.

In some cases, if the diagnosis isn't clear or if the warts don't respond to initial management, a small skin sample (biopsy) might be taken and examined under a microscope. For women, a Pap smear may be done to check for HPV-related changes on the cervix, as some HPV types that cause genital warts are different from those that cause cervical cancer, but co-infection is possible.

Management & Treatment

Finding out you have genital warts can be unsettling, but please know there are many effective ways to manage them. The main goal of treatment is to remove the visible warts, which can help with any discomfort and address cosmetic concerns. It's also important to understand that while treatments can remove the warts, they don't eliminate the underlying HPV virus from your body.

For some people, genital warts may actually clear up on their own within two years without any treatment, thanks to the body's immune system. If the warts aren't bothering you, "watchful waiting" might be an option to discuss with your doctor.

Professional Medical Treatments If you choose to treat the warts, it's essential to see a healthcare provider. They can offer treatments that are safe for the delicate genital area.

• Topical Medications: Your doctor may prescribe a cream or solution you can apply at home. These work by either boosting your immune system's ability to fight the virus or by directly destroying the wart tissue. Common prescriptions include Imiquimod, Podofilox, and Sinecatechins (a green tea extract).
• In-Office Procedures: A dermatologist can perform several procedures to remove warts:
  • Cryotherapy: This involves freezing the warts off with liquid nitrogen.
  • Excision: The warts are carefully cut away.
  • Electrocautery: An electric current is used to burn off the warts.
  • Laser Treatment: A focused beam of light destroys the wart tissue, often used for widespread or tough-to-treat warts.

Important Safety WarningDo not use over-the-counter (OTC) wart removers that are meant for hands or feet. These products are too harsh for the sensitive skin of the genital area and can cause significant pain and irritation.

Home Care and Lifestyle Living with this condition can be frustrating, but some lifestyle adjustments can help.

• Keep the area clean and dry to minimize irritation.
• Avoid shaving or waxing the affected area, as this can cause the warts to spread.
• Using condoms during sexual activity can help reduce the risk of transmission to a partner, though they don't offer complete protection as HPV can be present on skin not covered by a condom.

It may take several weeks or months for treatments to be effective, and sometimes warts can return, requiring another round of treatment. If you feel the treatments aren't working, it's important to follow up with your doctor. They are your best partner in managing this condition.

Duration & Outlook

The timeline for genital warts can vary. Sometimes, the body's immune system can clear the warts on its own within months to a couple of years, but this doesn't always happen. Even if warts disappear, the HPV virus that causes them can remain in the skin, meaning warts can come back (recur).

Genital warts are generally considered a chronic condition because the HPV virus can persist. While the warts themselves can be managed, recurrences are common. It's important to monitor for any warning signs for complications, such as warts that grow rapidly, bleed, or develop into open sores, as these should be evaluated by a doctor.

Prevention

The best way to prevent genital warts is to prevent HPV infection.

• Vaccination against HPV - is available and highly effective, especially when given before sexual activity begins.
• Using condoms consistently and correctly - during sexual activity can reduce the risk of getting or spreading genital warts, but they don't offer complete protection as HPV can infect skin not covered by a condom.
• Limiting the number of sexual partners - can also lower your risk.
• Avoid sexual contact - if you or your partner has visible warts or is undergoing treatment for them.

Causes & Triggers

Genital warts are caused by infection with certain types of the Human Papillomavirus (HPV). There are many types of HPV, but types 6 and 11 cause most cases of genital warts.

The main trigger for developing genital warts is direct skin-to-skin contact with an area infected with HPV, most commonly during vaginal, anal, or oral sex. Anyone who is sexually active can get genital warts. Risk factors include:

• Having unprotected sex.
• Having multiple sexual partners.
• Starting sexual activity at a young age.
• Having a weakened immune system (due to conditions like HIV or immunosuppressive medications).
• Smoking.

When to see a doctor

It's important to see a doctor if you notice:

• Any new bumps, growths, or unusual skin changes in your genital, pubic, or anal area, or on your thighs.
• Itching, pain, or bleeding in the genital area.
• If your sexual partner has been diagnosed with genital warts or HPV.

You should see a dermatologist or your primary healthcare provider if you suspect you have genital warts. An accurate diagnosis is important, and a healthcare professional can discuss your situation with you, even if you're just seeking understanding at this stage. They can also check for other sexually transmitted infections.

Frequently Asked Questions (FAQs)

• Can genital warts turn into cancer? The types of HPV that most commonly cause genital warts (types 6 and 11) are considered low-risk for cancer. However, it's possible to be infected with multiple HPV types, including high-risk types that can cause cancers (like cervical, anal, or penile cancer). Regular check-ups are important.
• If I have genital warts, does my partner have them too? Not necessarily. Your partner may have been exposed to HPV and may or may not develop visible warts. Sometimes the immune system controls the virus without warts appearing. It's important for your partner to be aware and consider getting checked.
• Can genital warts spread to other parts of my body? Genital warts prefer the moist skin of the genital and anal areas. It's uncommon for them to spread to other body parts like hands or feet, as different HPV types cause warts in those areas. However, they can spread within the genital region.
• Do condoms completely prevent genital warts? Condoms can reduce the risk of getting or spreading genital warts if used correctly and consistently, but they don't eliminate the risk entirely. HPV can infect skin areas not covered by a condom.
• Will genital warts go away on their own? Sometimes genital warts can go away without any intervention, as the body's immune system fights off the virus. However, this can take months or even years, and in many cases, they may persist or recur. It's best to see a doctor for an accurate diagnosis.

Remember, if you have concerns about genital warts or any skin condition, please consult with a healthcare professional. They are there to help you understand what's happening and guide you.

References

• American Academy of Dermatology. (n.d.). Genital warts: Diagnosis and treatment. Retrieved from https://www.aad.org/public/diseases/a-z/genital-warts-treatment
• Mayo Clinic. (2022, August 2). Genital warts. Retrieved from https://www.mayoclinic.org/diseases-conditions/genital-warts/diagnosis-treatment/drc-20355240
• NHS. (2023, March 17). Genital warts. Retrieved from https://www.nhs.uk/conditions/genital-warts/
• Healthline. (2023, February 27). Genital Warts. Retrieved from https://www.healthline.com/health/std/genital-warts