STDs - Genital Warts
What Are Genital Warts?
Genital warts are flesh-colored or gray growths found in the genital area and anal region in both men and women. Genital warts are sometimes referred to as condyloma acuminata or venereal warts. They represent the most common sexually-transmitted disease caused by a virus. The warts are caused by the human papillomavirus (HPV). Infection with genital warts may not be obvious.
Genital warts affect both men and women and can occur at any age.
What Causes Genital Warts?
Genital warts are caused by the human papillomavirus (HPV). Over 100 types of HPVs have been identified; about 40 of these types have the potential to infect the genital area.
- About 90% of genital warts are caused by two specific types of the virus (HPV-6 and -11), and these HPV types are considered "low risk," meaning they have a low cancer-causing potential. Other HPV types are known causes of premalignant changes and cervical cancers in women. HPV-16, one of the "high-risk" types, is responsible for about 50% of cervical cancers. HPV types 16, 18, 31, and 45 are other known "high risk" virus types. High-risk HPV types are also referred to as oncogenic HPV types. HPV is believed to cause 100% of cases of cervical cancer.
- Common warts are not the same as genital warts and are caused by different HPV types that infect the skin.
The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once cells are invaded by HPV, a latency (quiet) period of months to years may occur, during which there is no evidence of infection.
- Generally, about two-thirds of people who have sexual contact with a partner who has genital warts develop them within three months.
- Genital warts are indirectly associated with use of birth control pills due to increased sexual contact without the use of barrier protection (such as condoms), multiple sex partners, and having sex at an early age.
Treatments
There is no single effective cure for removal of genital warts. A number of treatment options exist; however, no treatment is 100% effective in eliminating warts and preventing them from coming back in all patients. It also is not possible to eliminate infection with human papillomavirus once it has occurred. Genital warts may go away on their own in about 10%-20% of people over a period of three to four months.
- Cryotherapy: This technique freezes the wart using liquid nitrogen or a "cryoprobe." It is an excellent first-line treatment because response rates are high with few side effects.
- Laser treatment: This treatment is used for extensive or recurrent genital warts. It may require local, regional, or general anesthesia. The laser physically destroys the HPV-induced lesion. Disadvantages include high cost, increased healing time, scarring, and potentially infectious viral particles in the air caused by the laser plume.
- Electrodesiccation: This technique uses an electric current to destroy the warts. It can be done in the office with local anesthesia. Of note, the resulting smoke plume may be infectious.