Genital Warts: Causes, Symptoms, Diagnosis, Risk factors & Treatments

Genital warts

Genital warts, also known as venereal warts or condylomata acuminate, are one of the most common types of sexually transmitted infections (STIs).

A genital wart is an infection of the skin in the genital or anal area, as well as the mucous membranes of the rectum, cervix, and vagina.

Genital warts are growths on the skin of the genital area and around the anus. They are caused by certain types of the human papilloma virus (HPV).

There are more than 100 types of HPV. Some types of HPV produce warts on different parts of the body, like plantar warts on the feet and common hand warts. Some can lead to certain cancers these are called high-risk types of HPV. And some produce genital warts.

Most genital warts are caused by one of two types of HPV types 6 and 11. Genital warts can appear in the mouth or genital area the vulva, vagina, cervix, rectum, anus, penis, or scrotum. They are passed from one person to another by skin-to-skin contact, usually during sex play.

Genital warts are very common. Between 500,000 and 1 million people get genital warts every year.

How Genital Warts spread?

Genital warts can be spread during vaginal or anal sex, and by sharing sex toys. But you don’t need to have penetrative sex to pass the infection on because HPV is spread by skin-to-skin contact.

It can take months, or even years, for warts to develop after infection with HPV. So if you’re in a relationship and you get genital warts, it does not necessarily mean your partner has been having sex with other people.

HPV is most likely to be transmitted to others when warts are present, although it is still possible to pass the virus on before the warts have developed and after they have disappeared.

Condoms do not provide complete protection because it is possible for the skin around your genital area not covered by the condom to become infected.

Causes of Genital Warts

The virus that causes genital warts is called human papillomavirus (HPV). There are more than 70 different types of HPV. Many cause no problems. Some cause warts on other parts of the body and not the genitals. Types 6 and 11 are most commonly linked to genital warts.

Certain other types of HPV can lead to precancerous changes in the cervix, or to cervical cancer. These are called high-risk types of HPV. They can also lead to vaginal or vulvar cancer, anal cancer, and throat or mouth cancer.

Important facts about HPV:

  • HPV infection spreads from one person to another through sexual contact involving the anus, mouth, or vagina. The virus can be spread, even if you do not see the warts.
  • You may not see warts for 6 weeks to 6 months after becoming infected. You may not notice them for years.
  • Not everyone who has come into contact with the HPV virus and genital warts will develop them.

You are more likely to get genital warts and spread them more quickly if you:

  • Have multiple sexual partners
  • Are sexually active at an early age
  • Use tobacco or alcohol
  • Have a viral infection, such as herpes, and are stressed at the same time
  • Are pregnant
  • Have a weakened immune system due to a condition such as diabetes, pregnancy, HIV/AIDS, or from medicines

If a child has genital warts, sexual abuse should be suspected as a possible cause.

Signs & Symptoms of Genital Warts

Most people with HPV infection will not develop visible warts and the virus will go away on its own. This means you may not know whether you or your partner have the virus.

If warts do appear, this can happen from three weeks to many ,or even years, after coming into contact with the virus. You might notice small, fleshy growths, bumps or skin changes which may appear anywhere in or on the genital or anal area.

  • In women, warts can be found on the vulva (the lips around the opening to the vagina), cervix (entrance to the uterus womb), upper thighs, in the vagina and on, or inside, the anus.
  • In men, warts can be found on the penis, scrotum, urethra (tube where urine comes out), the upper thighs and on, or inside, the anus.
  • You might see or feel them, or your partner might notice them. Often they are so tiny, or so difficult to see, that you don’t even know you have them.
  • They can be flat or smooth small bumps or quite large, pink, cauliflower-like lumps.
  • Warts can appear on their own or in groups.
  • Genital warts are usually painless but may occasionally itch and cause some inflammation.
  • They may cause bleeding from the anus or the urethra.
  • If your flow of urine is distorted this may be a sign of warts in the urethra.

Genital Warts Diagnosis

Diagnosis is often based on findings from the history and appearance of the genital warts.

  • Sometimes, lesions are only visible with an enhancing technique called acetowhitening. This technique involves the application of 5% acetic acid solution to the area of suspicion for about 5-10 minutes. Infected areas will turn white.
  • Magnification of the area (colposcopy) using a scope may be necessary to see the lesions. In females, a colposcope may be used to look for lesions in the vaginal canal and on the cervix.
  • A routine Pap smear should always be done in order to look for evidence of HPV infection and abnormal cells on the cervix.
  • A biopsy can be performed if the lesion appears unusual or recurs after treatment.
  • Special laboratory tests can also be used to confirm the presence of HPV infection.

Risk factors for Genital Warts

  • Having unprotected sex
  • Having unprotected sex with many different people
  • Having sex with a person whose sexual history is unknown
  • Oral sex raises the risk of genital warts developing in the mouth or throat
  • Starting sexual relations at a young age
  • Having stress and other viral infections (such as HIV or herpes) at the same time

Treatment for Genital Warts

Genital warts must be treated by a doctor. Do not use over-the-counter medicines meant for other kinds of warts.

Treatment may include:

  • Medicines applied to your skin or injected by your doctor
  • Prescription medicine that you apply at home several times a week

The warts may also be removed with minor procedures, including:

  • Freezing (cryosurgery)
  • Burning (electrocauterization)
  • Laser therapy
  • Surgery

If you have genital warts, all of your sexual partners must be examined by a health care provider and treated if warts are found. Even if you do not have symptoms, you must be treated. This is to prevent complications and avoid spreading the condition to others.

You will need to return to your health care provider after treatment to make sure all the warts are gone.

Regular Pap smears are recommended if you are a woman who has had genital warts, or if your partner had them. If you had warts on your cervix, you may need to have Pap smears every 3 to 6 months after the first treatment.

Women with precancerous changes caused by HPV infection may need further treatment.

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