Genital wart
| Genital wart | |
|---|---|
| Specialty | Infectious diseases, dermatology  |
Genital warts (or Condyloma, Condylomata acuminata, or venereal warts) is a highly contagious sexually transmitted infection caused by some sub-types of human papillomavirus (HPV). It is spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner. Genital warts are the most easily recognized sign of genital HPV infection. They can be caused by strains 6, 11, 30, 42, 43, 44, 45, 51, 52 and 54 of genital HPV; types 6 and 11 are responsible for 90% of genital warts cases.[1] Most people who acquire those strains never develop warts or any other symptoms. HPV also causes many cases of cervical cancer; types 16 and 18 account for 70% of cases.
Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or penis area. In women they occur on the outside and inside of the vagina, on the opening (cervix) to the womb (uterus), or around the anus. They are approximately as prevalent in men, but the symptoms may be less obvious. When present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus. Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.
Treatment
Genital warts often disappear without treatment, but sometimes eventually develop a fleshy, small raised growth. There is no way to predict whether they will grow or disappear.
Depending on the size and location of the warts, and other factors, a doctor will offer one of several ways to treat them.
- Imiquimod (Aldara®) a topical immune response cream, applied to the affected area
- A 20% podophyllin anti-mitotic solution, applied to the affected area and later washed off
- A 0.5% podofilox solution, applied to the affected area but not to be washed off
- A 5% 5-fluorouracil (5-FU) cream
- Trichloroacetic acid (TCA)
- Pulsed dye laser
- Liquid nitrogen cryosurgery
- Electric or laser cauterization
Podophyllin and podofilox should not be used during pregnancy, as they are absorbed by the skin and may cause birth defects in the fetus. 5-fluorouracil cream should not be used while trying to become pregnant or if there is a possibility of pregnancy.
Small warts can be removed by freezing (cryosurgery), burning (electrocautery), or laser treatment. Surgery is occasionally used to remove large warts that have not responded to other treatment.
Some doctors inject the antiviral drug interferon-alpha directly into the warts, to treat warts that have returned after removal by traditional means. The drug is expensive, and does not reduce the rate that the warts return.
Although treatments can remove the warts, they do not remove the HPV virus, so warts can recur after treatment. The virus remains in the body for a lifetime.[2] According to the Center for Disease Control's report on HPV to Congress in 2004, studies have shown that 70% of new HPV infections clear within one year, as many as 91% clear within two years. The median duration of new infections is typically eight months. The gradual development of an effective immune response is thought to be the likely mechanism for HPV DNA clearance. The state of the immune system determines the chances of removing the virus entirely and can be affected by factors such as HIV infection, certain medications, stress, or illness.[3] There is even some suggestion that effective treatment of the wart may aid the body's immune response[citation needed].
Misdiagnosis cautions
It is a common misconception among men that hirsuties papillaris genitalis are genital warts. Hirsuties papillaris genitalis is not contagious and no treatment for it is necessary. Some may deem it unsightly and there are various methods of ridding the penis of the condition such as carbon dioxide laser treatment.
Genital warts (condylomata) should not be confused with Molluscum contagiosum (MC), which is often transmitted sexually, but does not occur internally as do condylomata. MC looks like small warts, which are much smaller than condylomata genital warts. It does not increase the risk of cervical cancer for women.
Genital warts should also not be confused with Fordyce's spots, which are considered benign.
References
External links
- University of California, Santa Barbara's SexInfo has articles on both Anal Warts and Genital Warts
- Genital warts at the Open Directory Project
- HPV information from the US CDC
- Index page of genital wart images (Note - hosted on advertising site)
- CDC Report to Congress