HPV, or human papillomavirus, is a group of over 100 infections that frequently are symptom free. Approximately 30% of this group are sexually transmitted diseases (STDs) that result in contact from an infected person. One cannot be sexually active and prevent receiving HPV from an infected person, since the virus may be present on the genitals and on the skin surrounding the genitals. Any type of contact with another person's genitals or surrounding areas can transmit HPV, and most STDs can be spread without sexual intercourse.
HPV has recently received a great deal of attention because it is now known that some forms of HPV cause all forms of cervical cancer. HPV is often not noted by those infected. In some instances forms of HPV will result in genital warts that may be present on the genitals or around the anus, but frequently HPV presents no symptoms, or such insignificant symptoms that they are ignored by those infected.
HPV has no current cure. Oral medications may temporarily cause the warts to resolve. Yet like Herpes, the warts may also recur and need to be retreated at a later date. The real goal in treatment is to make the patient aware of the potential risks associated with HPV, since most diagnoses occur in the presence of an abnormal PAP smear test.
The PAP is part of what should be a yearly gynecological exam for women. It takes a tiny amount of tissue from the cervix, which is then examined by a lab to determine if any abnormal cells exist. Sometimes abnormal cells occur once only and never recur. In other cases, future pap smears will show continuing spread of abnormal cells indicating cervical cancer.
When genital warts are not present, the PAP is the only way to test for HPV. No test exists for men, which is unfortunate, since HPV may also cause penile cancer. In the absence of available testing, caution is urged by the Centers for Disease Control (CDC) of the US.
Since HPV is now indicated in a serious type of cancer, scientists are actively working to better methods for HPV diagnosis. There is also research into a possible vaccine at a future date. For now, the medical community is exerting its efforts toward education of the public about HPV, so that women will be certain not to skip their recommended yearly gynecological exams. The CDC also recommends that all who have genital warts or who have had contact with someone with HPV should discuss this with their physicians.
HPV infection is caused by a virus. More than 100 types of HPV have been found. Some types cause genital warts and some can lead to cervical cancer. Types 6 and 11 cause most genital warts. Other types such as 16 and 18 are high-risk and can cause abnormal cell changes on the cervix.
How the disease is spread (transmission):
HPV infection occurs when the virus enters your body through a cut, abrasion or small tear in the outer layer of your skin. The virus is transferred primarily by skin-to-skin contact.
The virus can be spread to or from the genitals, anus, mouth, or throat during moral or immoral/mortally sinful sexual activities.
After the infection occurs, it may spread to other areas of the genitals or to the anal area.
You can spread the virus even if you do not have any symptoms of infection or any visible warts.
There is a small chance that a pregnant woman can pass the virus to her baby. It is unknown if it is spread during vaginal delivery or if it is spread during the pregnancy. Most women with genital warts do not need to have a cesarean delivery. But your doctor might recommend a cesarean delivery if the genital warts would be in the way or bleed a lot during vaginal delivery.
Infection with the human papillomavirus (HPV) usually does not cause any symptoms and does not always produce visible genital warts. Some types of HPV cause cell changes to the cervix that can cause an abnormal Pap test.
When symptoms do develop, they usually occur 2 to 3 months after infection. But symptoms have been known to occur from 3 weeks to many years after infection.
Symptoms that may occur with genital warts include:
Irritation.
Itching.
Bleeding.
Genital warts can be different sizes and shapes.
They may be large, or they may be too small to be seen with the naked eye. They may appear individually or in groups.
Warts may look like tiny bunches of cauliflower or like flat, white areas that are very difficult to see.
In women and men, warts may appear in the groin, on and around the genitals, in the urethra, or in the rectum or anus.
In women:
Genital warts may appear on the vulva, vagina, cervix or near the anus.
Women are often unaware of warts inside the vagina or on the cervix until a doctor finds them.
In men:
Genital warts may occur on the outside of the penis, scrotum or around the anus.
Men are often unaware they have genital warts, even when they can be seen, until the warts are identified by a doctor.
In most cases, your body's immune system defeats an HPV infection before it has a chance to create any warts. When warts do appear, they may vary in appearance depending on which variety of HPV is involved:
Genital warts. Genital warts may appear as flat lesions, small cauliflower-like bumps or tiny stem-like protrusions.
Common warts. Common warts appear as rough, raised bumps that usually occur on the hands, fingers or around fingernails. In most cases, common warts are simply a nuisance because of their appearance, but they may also be painful or susceptible to injury or bleeding.
Plantar warts. Plantar warts are hard, grainy growths that usually appear on the heel or ball of your feet, areas that feel the most pressure. These warts may cause discomfort or pain.
Flat warts. Flat warts are flat-topped, slightly raised lesions darker than your regular skin color. They usually appear on your face, neck, hands, wrists, elbows or knees. HPV infections that cause flat warts usually affect children, adolescents and young adults.
Symptoms of genital warts may be similar to those of other conditions.
Most cases of cervical cancer are caused by two specific varieties of genital HPV. These two HPV strains usually don't cause warts, so women often don't realize they've been infected. Early stages of cervical cancer typically cause no signs or symptoms. That's why it's important for women to have regular Pap tests, which can detect precancerous changes in the cervix that may lead to cancer.
Some HPV infections may cause lesions to form on your tongue, tonsils, soft palate, or within your larynx and nose.
Other conditions that may cause symptoms similar to genital warts caused by infection with the human papillomavirus (HPV) include:
Skin conditions that cause wartlike growths, such as seborrheic keratosis.
Rare skin cancers, such as melanoma or squamous cell cancer of the vulva.
A skin disease caused by a virus (molluscum contagiosum) that produces soft, rounded masses.
A noncancerous tumor of fibrous tissue (fibroma).
A noncancerous tumor of fat tissue (lipoma).
A flattened, moist, raised growth that occurs in advanced syphilis (condyloma latum).
A tumor (adenoma) occurring in a gland, such as a mucus-producing gland.
Call your doctor if you have any of the following symptoms:
Sores, bumps, rashes, blisters, or warts on or around your genitals or anus
Burning, pain, or severe itching while urinating
For women, an abnormal vaginal discharge that smells bad
For men, an abnormal discharge from your penis
Call your doctor if you suspect you have been exposed to a sexually transmitted disease (STD). Avoid marital relations until you have been examined by a doctor.
Home treatments may not cure HPV and genital warts. But a doctor may prescribe medicine that you can use at home, such as podofilox lotion or gel or imiquimod cream.
Caution: Do not use nonprescription wart removal products to treat genital warts. These products are not intended for the genital area and may cause serious burning.
You can use at-home care to feel more comfortable.
Take sitz baths. Fill a tub with a few inches of warm water and sit in it for 10 or 15 minutes every day.
Squeeze warm water from a bottle over your genital area to provide comfort and cleansing.
Use a heat lamp or a hair dryer several times a day to dry your genital area. Make sure to hold the lamp or dryer at least 18 inches from your skin.
It is important to remember that most infections are minor, without serious complications. Some cases of HPV and genital warts disappear without treatment, although human papillomavirus (HPV) may still be present in your body's cells.
Medicine may be used to destroy bothersome genital warts, relieve your symptoms, and reduce the amount of area affected by warts, particularly when the warts are visible, bothersome, and growing in a small area.
Topical medicine often is the first treatment. For safety, a doctor will apply the topical medicines that could damage the skin around the warts. You can apply other medicines at home. If warts return after one course of treatment with topical medicine, they are treated again only if there are clear reasons for retreatment.
Medicines are not used to treat abnormal cell changes found on a Pap test.
Treatment applied at home
The following medicines can be applied to the affected area (topical treatment) at home:
Imiquimod (such as Aldara)
Podofilox lotion or gel (such as Condylox)
Sinecatechins (such as Veregen)
Do not use these medicines during pregnancy.
Imiquimod and podofilox appear to be the most effective medicine options that can be applied at home. Read the instructions carefully before using these medicines.
Treatment applied by a doctor
Treatment by a doctor can:
Treat areas that you cannot reach easily.
Treat a large area.
Remove the warts quickly.
Be expensive.
Be painful.
Have side effects
Medicines applied by a doctor include:
Trichloroacetic acid (TCA) or bichloroacetic acid (BCA).
Podophyllin resin.
Intralesional (injected into wart lesion) interferon.
Fluorouracil (such as Efudex).
Treatment during pregnancy
Treatment for pregnant women includes trichloroacetic acid (TCA) and bichloroacetic acid (BCA), which have been found to be both effective and safe. Podophyllin resin, interferon, and fluorouracil should not be used during pregnancy because they can harm the fetus.
What to Think About
Avoid sexual contact until the condition is completely healed.
Some medicine may be more expensive than others.
Warts on the vulva or penis that do not go away on their own or after treatment often are biopsied to rule out precancerous or cancerous conditions.
Removing genital warts does not cure an HPV infection. Although warts may go away with topical treatment, they may return because the HPV virus may still be in the body's cells.
Even if genital warts have been removed or destroyed you may still be able to infect your partner with with HPV.
You may have surgery to remove genital warts if they are widespread and medicine or freezing (cryotherapy) fails to remove them.
If you have a high-risk type of HPV that causes an abnormal Pap test, your doctor may recommend certain types of surgery. For more information about surgical methods to treat abnormal cell changes, see the topic Abnormal Pap Test.
Surgery Choices
Surgical methods that may be used include:
Cryosurgery: Abnormal tissue is frozen off.
Loop electrosurgical excision procedure (LEEP): Tissue is removed using a hot wire loop.
Laser treatment: A beam of light destroys the abnormal tissue.
Cone biopsy: A cone-shaped sample of tissue is removed from the cervix.
Surgical treatment for pregnant women
Surgical choices for pregnant women with genital warts include electrocautery, surgical excision, loop electrosurgical excision (LEEP), and laser surgery.
What to Think About
The success of surgery is related to the number of warts present. The success rate is higher and additional treatments are less likely to be required when surgery is performed on fewer and smaller warts. But surgery is less likely to be needed for a few small areas of warts.
Surgery may be more expensive than some other treatment choices.
You can reduce your risk of becoming infected with the human papillomavirus (HPV) or another sexually transmitted disease (STD). You also can reduce the risk of spreading HPV to your partner.
Preventing a sexually transmitted disease (STD) is easier than treating an infection after it occurs.
Talk with your marital partner about STDs before having sexual relations. Find out whether he or she is at risk for an STD. Remember that it is possible to be infected with an STD without knowing it. Some STDs, such as HIV, may be in your blood for 3 to 6 months before they can be detected.
Be responsible.
Avoid sexual contact if you have symptoms of an STD or are being treated for an STD.
Avoid sexual contact with your marital partner if he or she has symptoms of an STD or who may have been exposed to an STD until he or she has been treated.
Don't commit non-procreative immoral/mortally sinful forms of sex.
Don't fornicate. Having several sex partners increases your risk of getting an STD.
Live chaste. If you are sexually active within a marriage, try to abstain on a consistent basis to reduce the risk of developing STDs.
If you are age 26 or younger, you can get the HPV shot. The vaccines Cervarix and Gardasil protect against two types of HPV that cause cervical cancer. Gardasil also protects against two types of HPV that cause genital warts. Three shots are given over 6 months. The series of shots is recommended for girls age 11 or 12 and can be given to females ages 9 to 26. Females can get either vaccine. And males ages 9 to 26 can get three Gardasil shots to reduce the chance of getting genital warts.