Genital Warts – Causes, Symptoms, Treatment & Prevention

What are Genital Warts?

Genital warts also called condylomata acuminata, Condyloma or venereal warts are one of the most common sexually transmitted infections (often occurring after unprotected sexual contact).

Human papillomavirus (HPV) is the cause of the infection, which is usually benign but can potentially become malignant over time.

There are over 120 types of HPV found, most of which do not cause human diseases. Some types cause warts on the skin of the hands, the feet, or other areas.

About 40 types are transmitted through sexual contact and can lead to the development of warts in the genital organs in men and women. 90% of genital warts are mainly caused by HPV type 6 or 11. [1]

Genital Warts
f01: Clinical presentation of genital warts from Patient 1 (A) and 2(B)
Source: www.openi.nlm.nih.gov

Usually, the virus remains in the skin in an inactive state, but it can be transmitted to sexual partners.

The time from infection with the virus to the development of warts is typically from one to several months, but sometimes warts can develop years after a contact with an infected person.

What do genital warts look like?

The most common genital warts are one or more small formations, having the color of the surrounding skin with a grainy, cauliflower-like surface. They appear in the genitals – outside and in the vagina and cervix in women; on the penis in men, and also around the anus in both men and women.

Genital Warts
Figure 1: Clinical findings in patient #10. (A) A crusted, verrucous plaque (average dimensions, 22×40 mm) located on the penile shaft. (B) After the second intralesional bleomycin injection, the genital warts had nearly resolved, although mild erosion had developed. (C) Clearance of genital warts with hypopigmentation at 2 weeks after 4 treatment sessions of intralesional bleomycin injection.
Credits: www.openi.nlm.nih.gov

Genital warts can also appear in the mouth when people have had oral sex with an infected partner. Normally warts are not accompanied by subjective symptoms, but in some of the cases, a person may feel itching in the affected area.

Tongue
Figure 1: Papillomatosis lesion on the tip of the tongue
Source: www.openi.nlm.nih.gov

How can genital warts be spread?

Sexually transmitted warts are a disease which can infect a person and deliver to their partners during oral, genital and anal intercourse.

Low-risk types of HPV are transmitted in the same way as the high-risk types – through intimate contact, most often during sex (vaginal or anal). “Low-risk” means that although it causes genital warts, there is no risk that this type can cause cervical cancer.

Therefore, it is quite possible for a woman with genital warts to have a normal Pap test as well as a negative HPV test. Pap test examines the presence of cellular changes caused by the “high-risk” or potentially cancerous virus and HPV test conducted in parallel with the Pap test, examines the presence of the virus particles.

It should be noted that the warts are specific for the particular areas. This means that they do not spread to other parts of the body (the same as warts on the hands do not affect the genital area). The hands, however, can transmit HPV from the genitals of one person to those of his partner.

Recent statistics show that 5.6% of sexually active, 18- to 59-year-old men and women in the United States reported a history of ever having genital warts diagnosed by a health care provider. [7]

Symptoms

Genital warts are formations that appear in the genital area – externally: within the vulva or the anus; internally on the penis – in the vagina or on the cervix.

Entities which are usually humid and flesh-colored, can be formed separately or in groups (often resembling the shape of cauliflower) and may be raised or flat, small or large. In rare cases, HPV-associated lesions can be red or brown.

Genital Warts
Source: www.commons.wikimedia.org

It should be noted that some warts are so small that they are difficult to be seen with a naked eye, even when they are on the surface of the body. Genital warts are usually painless but depending on their sizes and locations can become painful or pruritic.

However, the symptoms of genital warts are not permanent and may clear on their own within a few days or weeks, especially if you have a strong immune system.

How to diagnose genital warts?

In case you have any doubt about sexually transmitted warts it is better to consult a doctor. Usually, the diagnosis of genital warts is clinical, made by visual inspection. Such condition can be confirmed by the biopsy [2] (a small sample of tissue taken from the body in order to be examined).

Women with genital warts should be examined for possible damage to the vagina and cervix. Not all warts are visible, however, and in some cases to facilitate their visualization physician should conduct an additional test.

How to prevent genital warts infection?

The only way to prevent such infection with the virus is to avoid sexual contact with a partner affected by warts until their complete elimination.

It is assumed that successful treatment and the lack of visible warts on the genitals reduces the possibility of transmission of the virus from person to person. The use of condoms also reduces the possibility of transmission of infection, but only if after the insertion of the condom all visible warts are covered.

Despite the existence of these methods, there is no way to feel completely protected, especially if the warts are still quite small and in areas not covered by the condom.

Why do genital warts have to be treated?

Genital warts should be treated, as treatment procedures reduce the risk of transmitting the disease to other partners. With the presence of warts, it becomes very difficult to maintain good hygiene in the genitals area.

The most important reason why genital warts should be treated is because of the amelioration of symptoms (including the cosmetic concerns).

How to treat genital warts?

Treatment of warts is often difficult, and you should have in mind that it is possible that after their removal, warts may reoccur. This happens not because of a new infection, but because the treatment only destroys the existing wart, it cannot eliminate the virus that lives on the skin. Especially when the immune system is weakened, genital warts can grow again.

There is no known method to completely eliminate the virus from the body.

Home remedies

There are various natural and homemade remedies to cure HPV genital warts, which can be applied directly on the affected skin.

Apple cider vinegar

The well known anti-inflammatory qualities of the apple cider vinegar can work miracles for genital warts removal. For those who prefer natural remedies, this could be the most effective method.

The ACV should be applied on the affected skin (e.g. use a cotton pad soaked in ACV). Do the procedure before going to bed, just make sure that the cotton pad is fixed on the affected area for at least  4 hours per night or until next morning.

Follow this procedure regularly for about a week and genital warts will be completely removed. The ACV will also help to properly heal the inflamed tissues. Unfortunately, this treatment will only destroy warts, not the HPV.

Garlic

Garlic has very strong antimicrobial properties, which is beneficial for any type of infection

Smash 3-4 garlic cloves, crush them and apply on the affected area. Cover it with a bandage but make sure that the garlic is fixed well. Leave the garlic on the skin for a couple of hours. Repeat daily, until the area is completely healed. It will take about a week to remove warts.

Castor oil/ Tea tree oil

Soak a cotton pad in castor oil/ tea tree and make sure it stays fixed on the affected are. Change the cotton pad 2 or 3 times daily for no longer than a week. By this time, genital warts should have disappeared.

 Keep your genital area dry

Moist tissues in the body, such as the genital area, provide an excellent source of moisture for bacteria and are particularly prone to bacterial growth. You should always keep your genital area dry as this way you will not allow harmful bacteria to grow. Always dry thoroughly after taking a shower, swimming etc.

Over the counter treatment

The choice of therapeutic agent depends on the number, size, and locations of warts. They can be treated by topical drugs – creams or solutions that are applied onto warts on a specific schedule. It is also important to notice that the complete wart removal cannot be expected immediately (after 1-2 applications). It will take longer to notice visible results, therefore, you will need to be patient and to strictly follow the instructions provided.

Terrasil®

Wart Removal MAX

This is the most popular product for genital warts removal on the Web. Still the reviews available in a form that is not effective enough. Half of the customers are extremely satisfied with the results, the other half claims that there are no visible results after treating warts and also warn that the ointment is not worth the money spent.

Warticide

Plantar and Genital Wart Remover Liquid

This liquid formulation is developed for both plantar and genital warts treatment. Reviews for this product are also conflicting as that most of the people who purchased the product are very satisfied with the results but others express their obvious disappointment.

Hawk Dok

Genital Warts Remover and Relief

Here’s a product with a little bit better rating on the Internet. According to its’ description, after 4 to 6 weeks the infected area should be completely healed. Positive comments inform that it doesn’t take that long to notice visible results:

„When it peels of, the skin underneath is raw. It doesn’t get all of the virus in my first 6 weeks, but it got 60-70% of it.”

Negative comments inform warn about skin irritations and that the product adds networked as promised, even after applying for a long time.

Compound W

Wart Remover, Maximum Strength, Fast-Acting Gel, 0.25-Ounce

This is a formula for common, plantar and, apparently, genital warts removal. The active ingredient is salicylic acid (17%); the product should be applied directly to the affected area (each wart should be covered) once or twice daily as needed.

Most customers inform that the product has removed their warts within a couple weeks. One of the reviews suggests to ‘put some tape over the affected area to suffocate the wart some more, and the warts go away faster‘. However, there are customers considering it difficult to use. Bad comments warn that the product dries the skin and did not work as expected.

VidaroX

Wart Removal

The product is claimed to remove genital warts, potential pain or itch. Customers discuss that they saw visible result after the 3d – 4th week after the first application. There are customers who consider the product price totally unacceptable but also admit to have gotten the desired effect: „This is one hell of an expensive cream. My warts did fall off however.”

There are also agents which are created to improve overall immunity, which results in suppressing the development of HPV in human skin. What you can do to help your body heal faster is to enrich your diet with more vitamins and minerals by consuming more fruits and vegetables and have perfect hygiene in the genital area.

Does genital warts removal mean that I am no longer contagious?

Removal of warts does not guarantee destruction of the HPV, but it reduces the chance of transmitting the infection to partners.

Can HPV cause complications?

Yes. The virus that causes genital warts can cause malignant changes (cancer) of the cervix in women. Although very rare, such changes may also occur in men. Persistent infections with high-risk HPV types can lead to cell changes that, if untreated, may progress to cancer, therefore it is strongly recommended to do your regular medical check-up.

Such routine check-up is needed in order to ensure that the reproductive organs are healthy both inside and out. [4]

Do warts have an impact on pregnancy and birth?

It is possible that warts increase in size during pregnancy [3]. In isolated cases, warts can become so numerous that they can hinder normal birth. However, having genital warts during pregnancy is not likely to affect the health of the baby.

It is important to be aware that there are safe methods of removing genital warts during pregnancy that can be used including,  freezing, surgical, or laser removal.Even if mothers have passed on the HPV, the baby is usually able to overcome the symptoms.

Do I need regular genital check-ups?

Yes. Regular genital exams are extremely important because they are what can help determine if a sexually transmitted infection or abnormality is present.

Genital warts can usually be easily diagnosed by a routine check-up. [6] At the exam, the physician will examine warts. Your doctor may also check other areas (e.g. inside the vagina and the skin surrounding your anus). [5]

References

  1. https://www.cdc.gov/std/treatment/2010/genital-warts.htm
    Genital Warts
  2. https://en.wikipedia.org/wiki/Biopsy
    Definition of Biopsy
  3. http://americanpregnancy.org/pregnancy-complications/genital-warts-during-pregnancy/
    Genital Warts During Pregnancy: Symptoms And Treatment
  4. https://www.gannett.cornell.edu/cms/pdf/sexual/upload/AnnualGYNexam.pdf
    The “Annual” Gynecological (GYN) Exam
  5. https://meded.ucsd.edu/clinicalmed/genital.htm
    Male Genital And Rectal Exam
  6.  http://www.nhs.uk/Conditions/Genital_warts/Pages/Diagnosis.aspx
    Genital warts – Diagnosis
  7. http://journals.lww.com/stdjournal/Abstract/2008/04000/Genital_Warts_Among_18__to_59_Year_Olds_in_the.8.aspx
    Genital Warts Among 18- to 59-Year-Olds in the United States, National Health and Nutrition Examination Survey, 19992004

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