Genital warts develop in both men and women as a result of infection by some types of the virus known as human papilloma virus (HPV). They are the second most common sexually transmitted disease. Sometimes they can be passed on to children during childbirth, through an infected vagina.
HPV can also cause warts in other parts of the body, such as inside the mouth, and the upper respiratory tract. The latter occurs in a rare condition called recurrent respiratory papillomatosis.
The role of HPV in Genital Warts
HPV types 6 and 11 are responsible for 9 out of 10 genital warts. They may also result in the formation of warts on the conjunctiva, nasal cavity, mouth or larynx. However, most HPV infections are completely asymptomatic. HPV infection is so common that most sexually active people will have at least one episode (usually without knowing it) during their lifetime.
HPV types such as 16, 18, 31, 33 and 35 also cause genital warts, but the presence of HPV 6 or 11 is usually required.
Genital warts are flat, fleshy, large or small bumps that grow in or near the genital areas. Sometimes they appear in a dense cluster, looking like a cauliflower. They may be located on the vagina, vulva, penis, anus, scrotum, cervix, urethra and the groins or the uppermost part of the thigh.
Transmission of HPV
A patient with genital warts can also spread the infection to another area on the body. Thus hand contact or contact with the infected organ may pass the HPV virus on from place to place, and from person to person. Warts can also develop inside the mouth, but this is not very common. Genital warts do not spread through the use of shared items such as cups, towels, plates or cutlery.
The presence of the infection requires that the patient adopt safe sexual behaviour to avoid spreading the infection to sexual partners. Patients may experience discomfort or itching. The warts may also become inflamed and bleed. Sometimes warts in the urethra can also alter the flow of urine.
Some types of HPV cause warts to form on feet and toes. In such cases, patients are advised to ensure that their feet are suitably covered when they use public swimming pools and gyms, where the virus can spread to other people with bare feet.
The occurrence of genital warts is not associated with a higher risk of cervical cancer.
Abstinence from sex, or having only one partner, are ways to minimize the risk of contracting HPV.
HPV type 6 and type 11 are the most common types. These can be prevented by vaccination. Vaccination is most effective when administered to 11-12 year-old girls, before the initiation of sexual intercourse.
Removal of Warts
Warts may be removed using several techniques. Whatever the method adopted, patients are advised to avoid having intercourse until the warts are completely healed. In addition, it is strongly recommended that patients use effective barrier contraception such as good-quality condoms against HPV transmission for at least three months after all visible signs of the warts have disappeared. This minimizes the chance of the infection being passed on by dormant virus within the treated area. Many of the procedures used clinically are less effective in people who smoke.
This is a treatment technique which freezes warts using liquid nitrogen, following which the warts shrink and drop off. Patients often experience a burning feeling. This method is most effective with small warts.
In this procedure, the healthcare provider removes the wart with the help of focused electrical energy passed through a metal loop. Since the electrical current produces burning of the tissue in contact with it, the procedure is usually carried out under general or regional anaesthesia.
This method is used to remove hard warts, such as those which grow to appear like a cauliflower. A sharp scalpel is used to incise the skin and the flesh at the base of the wart and remove it completely, following which the incision is sewn up.
It is also possible to burn off warts with the help of a targeted laser. This requires specialized equipment and technical expertise. The patient is usually given a general or local anaesthetic.
Some specific antiviral creams have been developed to treat the warts. These are available on prescription by your healthcare provider, depending on the type of genital warts.
Reviewed by Dr Liji Thomas, MD