Genital Warts: When it’s more than meets the eye

Jul 08, 2018 Dr Zulfikar Bux, Features / Columnists

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By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Having warts around the genital area is always a reason for concern. While some warts may be self-limiting, others can persist and can indicate more serious underlying conditions. Patients sometimes ignore these warts and present when they become more complicated. Today we will shed some light on this uncomfortable condition. Hopefully it will help to bring about some amount of urgency for patients that have genital warts.

WHAT ARE GENITAL WARTS?

Genital warts may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps and are caused by the human papillomavirus (HPV). There are many kinds of HPV. Not all of them cause genital warts. HPV is associated with cancer of the vagina, anus and penis. Not all HPV infections cause cancer.

WHERE DO GENITAL WARTS GROW?

In men, genital warts can grow on the penis, near the anus, or between the penis and the scrotum. In women, genital warts may grow on the outside lining of the vagina called the vulva, around the anal region, the vagina and on the cervix (the mouth of the womb). Genital warts vary in size and may even be so small that you can’t see them.

HOW DO YOU GET HPV?

HPV is a sexually transmitted infection (STI). The most common way to get HPV is by having oral, vaginal or anal sex with someone who is infected with HPV. The only sure way to prevent genital warts is to not have sex. If you are sexually active, having sex only with a partner who isn’t infected with HPV and who only has sex with you will lower your risk of getting genital warts.
Just because you can’t see warts on your partner doesn’t mean he or she doesn’t have HPV. The infection can have a long incubation period. This means that months can pass between the time a person is infected with the virus and the time a person notices genital warts. Sometimes, the warts can take years to develop. In women, the warts may be where you can’t see them–inside the body, on the surface of the cervix. Using condoms may prevent you from catching HPV from someone who has it. However, condoms can’t always cover all of the affected skin.

HOW ARE GENITAL WARTS DIAGNOSED?

If you notice warts in your genital area, see your doctor. Your doctor may be able to diagnose the warts just by examining you. For women, a Pap or a VIA test can help detect changes on the cervix that are caused by genital warts.

CAN GENITAL WARTS BE TREATED?

Yes. Genital warts must be treated by your doctor. Do not try to treat the warts yourself. The warts can be removed, but the viral infection itself can’t be cured. The virus goes on living inside your skin. This is why the warts often return after they have been removed. You may need to have them removed more than once.

HOW ARE GENITAL WARTS REMOVED?

One way to remove the warts is to freeze them. This is called cryotherapy. The warts can also be taken off with a laser. A treatment called the loop electrosurgical excision procedure (LEEP) can be used to remove the warts. With this method of removal, a sharp instrument shaped like a loop is passed underneath the wart and the wart is cut out of the skin.
Special chemicals can be used to remove the warts. These chemicals dissolve warts in the genital area. They may have to be applied to the area a number of times over a period of several weeks before the treatment is complete. Chemicals you can buy at the store to remove warts from your hands should not be used for genital warts. They can make your genital skin very sore.

HOW DO I PREVENT GENITAL WARTS?

Genital warts are a sexually transmitted infection (STI) caused by the human papilloma virus (HPV). The only sure way to prevent genital warts is to abstain from sex or to avoid being promiscuous or avoid a promiscuous partner. Using a condom may help prevent you from getting HPV, but condoms are not 100% effective. They do not cover all the affected skin, and you may still get HPV, even if you use a condom.

WHAT ABOUT THE HPV VACCINE?

There are two types of HPV vaccine. Both types help protect against the HPV strains that are most likely to cause cervical cancer. One type also helps protect against the HPV strains that are most likely to cause genital warts.
Routine HPV vaccination is recommended for the following groups of people:
• Boys and girls ages 11 to 21
• Women ages 22 to 26
• Men ages 22 to 26 years of age who have a compromised immune system (HIV, Diabetes etc)
• Gay and bisexual men
The vaccines are given as shots (injections in the upper arm) and require 3 doses. The vaccine is most effective if children receive it before they start having sex.

WHAT IF I DON’T GET GENITAL WARTS TREATED?

Genital warts can grow if you do not get them treated. If you are sexually active, you also risk infecting your partner. Certain kinds of HPV can cause abnormal cells to grow on the cervix. Sometimes, these cells can become cancerous if left untreated. Other kinds of HPV can cause cancer of the vulva, vagina, anus, or penis.
Sexual intercourse is part of human nature. The less risky and promiscuous we are with it, the lesser our chances of getting genital warts and the complications that comes with it.

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